Resuscitation
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The work context of the general practitioner (GP) potentially lends itself to the provision of early community based, cardiac arrest care. GPs have traditionally encountered out of hospital cardiac arrest (OHCA) as a component of routine patient care but have not been formally linked with the statutory ambulance service. Computer aided dispatch technology now allows real time GP text message alert to nearby cardiac arrest events. ⋯ Text alert activation of GPs to nearby OHCA events has proven feasible, with significant activity during the establishment period, but a low survival rate which is similar to the overall national OHCA survival rate. A high proportion of alerts do not involve resuscitation opportunities.
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To investigate the epidemiology and outcomes of cardiac arrests associated with opioid overdoses. Recent data suggest that drug overdoses are responsible for more deaths than motor vehicle crashes or firearms in the United States each year, with opioids being involved in majority of drug overdose deaths. Despite the potential for opioids to cause cardiac arrest, few studies have examined this association. ⋯ Cardiac arrest is more common in patients with opioid overdoses in comparison to non-opioid overdoses. The rate of cardiac arrest is increasing disproportionately in patients with opioid overdoses. Opioid overdoses are independent risk factors for both cardiac arrest and mortality in patients with overdoses.
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To develop a simple risk-score model for predicting in-hospital cardiac arrest (CA) among patients hospitalized with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). ⋯ A simple points score containing five variables readily available on admission predicts in-hospital CA for patients with suspected NSTE-ACS.
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In England, fewer than 1 in 10 out-of-hospital cardiac arrest victims survive to hospital discharge. This could be substantially improved by increasing bystander cardiopulmonary resuscitation and Automated External Defibrillator use. ⋯ In London, when a 999 call-handler identifies cardiac arrest, in addition to dispatching the usual professional resources, London Ambulance Service automatically activates nearby GoodSAM responders. This article discusses the development of GoodSAM, its integration with London Ambulance Service, and the plans for future expansion.
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To examine whether introducing a national standard to improve the recognition of and response to clinical deterioration, was associated with a reduction in cardiovascular events in the hospital environment. ⋯ Introduction of a national standard for deteriorating hospitalised patients was associated with a reduction in the rates of in-hospital cardiac arrests and acute coronary syndromes in acute hospitals. Greatest benefit was seen in the elderly, female and surgical patients.