Resuscitation
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Multicenter Study Observational Study
Time on the scene and interventions are associated with improved survival in pediatric out-of-hospital cardiac arrest.
Survival is less than 10% for pediatric patients following out-of-hospital cardiac arrest. It is not known if more time on the scene of the cardiac arrest and advanced life support interventions by emergency services personnel are associated with improved survival. ⋯ In this observational study, a scene time of 10 to 35 min was associated with the highest survival, especially among adolescents. Access for fluid resuscitation was associated with increased survival but advanced airway and resuscitation drugs were not.
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Multicenter Study
Availability and use of capnography for in-hospital cardiac arrests in the United Kingdom.
Airway complications occur more frequently outside the operating theatre and in emergency situations. Capnography remains the gold standard for confirming correct endotracheal tube placement, retaining high sensitivity and specificity in cardiac arrest. The 2010 European Resuscitation Council guidelines for adult advanced life support recommended waveform capnography in this setting. We investigated current UK practice relating to the availability and use of this technology during cardiac arrest. ⋯ We believe this is the first study of its kind to fully investigate the availability and use of capnography during cardiac arrest throughout the hospital. Whilst equipment provision appears adequate in critical care areas, it is insufficient in general wards.
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Multicenter Study
Out-of-hospital cardiac arrest in the elderly: A large-scale population-based study.
There is little information on elderly people who suffer from out-of-hospital cardiac arrest (OHCA). ⋯ Advanced age is an independent predictor of mortality in OHCA patients over 70 years of age. However, even in patients above 90 years of age, defined subsets with a survival rate of more than 10% exist. In survivors, the neurological outcome remains similar regardless of age.
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Multicenter Study
Volume versus Outcome: More Emergency Medical Services Personnel On-scene and Increased Survival after Out-of-Hospital Cardiac Arrest.
The large regional variation in survival after treatment of out-of-hospital cardiac arrest (OHCA) is incompletely explained. Communities respond to OHCA with differing number of emergency medical services (EMS) personnel who respond to the scene. The effect of different numbers of EMS personnel on-scene upon outcomes is unclear. We sought to evaluate the association between number of EMS personnel on-scene and survival after OHCA. ⋯ More EMS personnel on-scene within 15 min of 9-1-1 call was associated with improved survival of out-of-hospital cardiac arrest. It is unlikely that this finding was mediated solely by earlier CPR or earlier defibrillation.
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Multicenter Study Observational Study
The relationship between age and outcome in out-of-hospital cardiac arrest patients.
To determine the association between age and outcome in a large multicenter cohort of out-of-hospital cardiac arrest patients. ⋯ Advanced age is associated with outcomes in out-of-hospital cardiac arrest. We did not identify a specific age threshold beyond which the chance of a meaningful recovery was excluded.