Resuscitation
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We aim to summarize current evidence on the value of point-of-care (POC) focused echocardiography in the assessment of short-term survival in patients with cardiac arrest. ⋯ POC focused echocardiography can be used to identify reversible causes and predict short-term outcome in patients with cardiac arrest. In patients with a low pretest probability for ROSC, absence of SCM on echocardiography can predict a low likelihood of survival and guide the decision of resuscitation termination.
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Randomized Controlled Trial
Integration of In-Hospital Cardiac Arrest Contextual Curriculum into a Basic Life Support Course: A Randomized, Controlled Simulation Study.
The objective was to compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). ⋯ A hospital focused BLS course utilizing RCDP was associated with improved performance on hospital-specific quality measures compared with the traditional AHA course.
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Most cardiac arrest (CA) patients remain comatose post-resuscitation, prompting goals-of-care (GOC) conversations. The impact of these conversations on patient outcomes has not been well described. ⋯ Most survivors due to family wishes despite poor neurological prognosis die or have poor outcomes at one-year. However, a small number achieve favorable recovery, demonstrating limitations with current prognostication methods. Among nonsurvivors, most WLST occurs while medically unstable, suggesting an overestimation of WLST due to unfavorable neurological prognosis.
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Drowning leading to out-of-hospital cardiac arrest (OHCA) and death is a major public health concern. Submersion with duration of less than 10min is associated with favorable neurological outcome and nearby bystanders play a considerable role in rescue and resuscitation. Drones can provide a visual overview of an accident scene, their potential as lifesaving tools in drowning has not been evaluated. ⋯ A drone transmitting live video to a tablet is feasible, time saving in comparison to traditional search parties and may be used for providing earlier location of submerged victims at a beach. Drone search can possibly contribute to earlier onset of CPR in drowning victims.
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Multicenter Study Comparative Study Observational Study
The Association Between Physician Turnover (the "July Effect") and Survival after In-Hospital Cardiac Arrest.
The July Effect refers to adverse outcomes that occur as a result of turnover of the physician workforce in teaching hospitals during the month of June. ⋯ There may be a July Effect in the intensive care unit but the results were mixed. Most survival models showed a statistically significant difference but this was not supported by the secondary analyses of return of spontaneous circulation and neurological outcome. We found no July Effect in the emergency department or the medical/surgical ward for patients with in-hospital cardiac arrest.