Articles: cardiac-arrest.
-
Scand J Trauma Resus · Feb 2025
Letter ReviewBalloon occlusion of the aorta during cardiac arrest -a death blow to the intestines?
The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in non-traumatic cardiac arrest may result in worsened intestinal ischaemia. What are the consequences? ⋯ The impact of intestinal ischaemia following cardiac arrest is uncertain, but ischaemia is likely to be exacerbated by REBOA. However, inflation of the balloon will occur when the patient is still in cardiac arrest and is a means to achieve ROSC. Hence, we argue that the added intestinal ischaemia caused by REBOA may be of limited clinical importance, but this is still to be answered.
-
Anesthesia and analgesia · Feb 2025
ReviewProposed Quality Metrics for Congenital Cardiac Anesthesia: A Scoping Review.
Congenital cardiac anesthesiologists practice in a unique environment with high risk for morbidity and mortality. Quality metrics can be used to focus clinical initiatives on evidence-based care and provide a target for local quality improvement measures. However, there has been no comprehensive review on appropriate quality metrics for congenital cardiac anesthesia to date. ⋯ Of these, 5 candidate metrics were unanimously proposed for local collection and national benchmarking efforts: use of a structured handover in the intensive care unit, use of an infection prevention bundle, use of blood conservation strategies, early extubation of cardiopulmonary bypass cases, and cardiac arrest under the care of a cardiac anesthesiologist. Many metrics were excluded due to a lack of primary data and perceived complexity beyond the scope of cardiac anesthesia practice. There is a need to develop more primary data including linking process measures with outcomes, developing risk-stratification for our patients, and collecting national data for benchmarking purposes.
-
Advanced life support certification has traditionally been the gold standard of resuscitation training for doctors and has been shown to improve outcomes from cardiac arrest. In 2021, Health Education England removed named courses from mandatory Foundational Programme competencies, which has resulted in capping of reimbursement and reduced access to courses. This represents a drop in educational standards which is particularly concerning when the medical school curriculum has been shown to deliver inconsistent, poor-quality resuscitation training. Here we review the benefits and negatives of life support training, looking at both junior and senior clinicians with differing educational requirements.
-
Hanging is a common cause of suicide and asphyxial cardiac arrest. There are few data to inform the treatment of cardiac arrest after hanging. We designed a scoping review to describe evidence relating to interventions and outcomes in patients with and without cardiac arrest after hanging. ⋯ There are few data to inform treatment of patients with cardiac arrest after hanging. The available data suggest that cardiac arrest is a critical determinant of poor outcome following hanging. Further research should uniformly report outcomes of patients with cardiac arrest after hanging based on the Utstein template.
-
Cardiac arrest registries can benchmark, enhance quality of care and provide data for research. Key stakeholders from Emergency Medical Communication Centre (EMCC), Emergency Medical Services (EMS), In-Hospital Care Providers (IHCP) and Recovery and Rehabilitation Providers (RRP) have different perspectives, and registry results and patient cohorts should be tailored to facilitate benchmarking, quality improvement projects and research in all sections of the chain of survival. In this paper, we describe different cohorts of interest, exemplified by data from the Norwegian Cardiac Arrest Registry (NorCAR). ⋯ It is essential to clearly define the cohort of interest when engaging with different stakeholders and to provide data that facilitates quality improvement projects in all areas of the chain of survival. We recommend defining several subgroups of cardiac arrest patients to accommodate benchmarking, quality improvement projects and research relevant for all stakeholders involved in resuscitation and care of cardiac arrest patients.