Resuscitation
-
Review Comparative Study
Emergency department factors associated with survival after sudden cardiac arrest.
Sudden cardiac arrest (SCA) is a leading cause of death in the US. Recent innovations in post-arrest care have been demonstrated to increase survival. However, little is known about the impact of emergency department (ED) and hospital characteristics on survival to hospital admission and ultimate outcome. ⋯ An estimated 175,000 cases of SCA present to or occur in US EDs each year. Percutaneous coronary intervention capability, ED volume, and teaching status were associated with higher survival to hospital admission. Emergency departments with higher annual SCA volume had lower survival rates, possibly because they transfer fewer patients. An improved understanding of the contribution of ED care to survival following SCA may be useful in advancing our understanding of how best to organize a system of care to ensure optimal outcomes for patients with SCA.
-
Comparative Study
Prognostic value of electrographic postanoxic status epilepticus in comatose cardiac-arrest survivors in the therapeutic hypothermia era.
The independent prognostic significance of postanoxic status epilepticus (PSE) has not been evaluated prospectively since the introduction of therapeutic hypothermia. We studied 1-year functional outcomes and their determinants in comatose survivors of cardiac arrest (CA), with special attention to PSE. ⋯ PSE strongly and independently predicts a poor outcome in comatose CA survivors receiving therapeutic hypothermia, but some patients with PSE survive with good functional outcomes. PSE alone is not sufficient to predict failure to awaken after CA in the era of therapeutic hypothermia.
-
Randomized Controlled Trial Multicenter Study Comparative Study
A critical reappraisal of the ATLS classification of hypovolaemic shock: does it really reflect clinical reality?
The aim of this study was to validate the classification of hypovolaemic shock given by the Advanced Trauma Life Support (ATLS). ⋯ This study indicates that the ATLS classification of hypovolaemic shock does not seem to reflect clinical reality accurately.
-
Multicenter Study Comparative Study
Chest injury following cardiopulmonary resuscitation: a prospective computed tomography evaluation.
Traumatic chest injuries may occur following cardiopulmonary resuscitation (CPR). The aim of this study was to address the frequency of injuries, especially rib and sternal fractures, and also to identify factors that contribute to post-CPR trauma. ⋯ The incidence of rib fracture following CPR was different in various hospitals. The presence of non-physician chest compressors in the ED was one of the contributing factors to rib fracture. Further studies on the influence of resuscitators and relation between quality of chest compression and CPR-induced injuries are warranted to reduce complications following CPR.
-
Multicenter Study Comparative Study
Common laboratory tests predict imminent death in ward patients.
To estimate the ability of commonly measured laboratory variables to predict an imminent (within the same or next calendar day) death in ward patients. ⋯ Commonly performed laboratory tests can help predict imminent death in ward patients. Prospective investigations of the clinical utility of such predictions appear justified.