Resuscitation
-
Randomized Controlled Trial Clinical Trial
A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial).
The outcome after out of hospital cardiac arrest is dismal. Thrombolysis during CPR has been advocated. Our hypothesis was that early administration of bolus thrombolysis could lead to improved survival from out of hospital cardiac arrest. ⋯ In this pilot study, we found the use of early bolus tenecteplase for OHCA to be feasible, and that it appears to increase the rate of ROSC. Larger studies are required to determine if this translates into a survival benefit. Appropriate patient selection for OHCA studies remains problematic.
-
Comparative Study
Improved hemodynamic performance with a novel chest compression device during treatment of in-hospital cardiac arrest.
The purpose of this pilot clinical study was to determine if a novel chest compression device would improve hemodynamics when compared to manual chest compression during cardiopulmonary resuscitation (CPR) in humans. The device is an automated self-adjusting electromechanical chest compressor based on AutoPulse technology (Revivant Corporation) that uses a load distributing compression band (A-CPR) to compress the anterior chest. ⋯ Previous research has shown that increased CPP is correlated to increased coronary blood flow and increased rates of restored native circulation from sudden cardiac arrest. The A-CPR system using AutoPulse technology demonstrated increased coronary perfusion pressure over manual chest compression during CPR in this terminally ill patient population.
-
To study the indications and diagnoses of patients requiring emergency airway management and to evaluate the adequacy of airway management skills of emergency physicians. ⋯ Airway management and rapid sequence induction for intubation can be safely performed by emergency physicians.
-
To evaluate the activity and impact of a Medical Emergency Team (MET) one year after implementation. ⋯ Often only simple interventions are only required to reverse deterioration. Initiating 'do not attempt resuscitation' (DNAR) decisions is a key part of MET activity. Multiple physiological abnormalities are associated with increased mortality and therefore wider and earlier application of the MET to the hospital population may save lives or expedite DNAR decisions. New systems need time to develop ("bed in") and further research is needed to observe significant reductions in cardiac arrests and overall mortality.