Resuscitation
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Multicenter Study
Shorter time to target temperature is associated with poor neurologic outcome in post-arrest patients treated with targeted temperature management.
Time to achieve target temperature varies substantially for patients who undergo targeted temperature management (TTM) after cardiac arrest. The association between arrival at target temperature and neurologic outcome is poorly understood. We hypothesized that shorter time from initiation of cooling to target temperature ("induction") will be associated with worse neurologic outcome, reflecting more profound underlying brain injury and impaired thermoregulatory control. ⋯ In this multicenter cohort of post-arrest TTM patients, shorter induction time was associated with poor neurologic outcome.
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Multicenter Study
Factors affecting attitudes and barriers to a medical emergency team among nurses and medical doctors: A multi-centre survey.
To identify factors underlying attitudes towards the medical emergency team (MET) and barriers to its utilisation among ward nurses and physicians. ⋯ The MET was well accepted in participating hospitals. Nurse referral to the covering physician was the major barrier to MET activation. Medical status, working in surgical vs. medical wards, seniority and participation in the METal educational programme were associated with lower likelihood of showing barriers to MET activation.
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Multicenter Study
Do early emergency calls before patient collapse improve survival after out-of-hospital cardiac arrests?
Some out-of-hospital cardiac arrests (OHCAs) are witnessed after emergency calls. This study aimed to confirm the benefit of early emergency calls before patient collapse on survival after OHCAs witnessed by bystanders and/or emergency medical technicians (EMTs). ⋯ Early emergency calls before patient collapse efficiently increases the proportion of EMT-witnessed cases and promotes survival after witnessed OHCAs. However, early emergency call before collapse may worsen the outcome when the patient's condition deteriorates to cardiac arrest before EMT arrival.
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Multicenter Study
Out-of-Hospital Cardiac Arrests in Children and Adolescents: Incidences, Outcomes, and Household Socioeconomic Status.
There is insufficient knowledge of out-of-hospital cardiac arrest (OHCA) in the very young. ⋯ OHCA incidences and survival rates varied significantly between age groups. High parental education was found to be associated with improved survival after OHCA.
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The rhythm analysis algorithm (RAA) of automated external defibrillators (AEDs) may be deceived by many factors. In this observational study we assessed RAA accuracy in prehospital interventions. For every rhythm analysis judged to be inaccurate, we looked for causal factors and estimated the impact on outcome. ⋯ Up to 16% of shockable rhythms were not detected and 4% of non-shockable rhythms were interpreted as shockable. Therefore, all AED interventions should be reviewed. Feedback to caregivers may avoid future deleterious interactions with the AED, whereas AED manufacturers may use this information to improve RAA accuracy. This approach may improve the outcome of some VF patients.