Resuscitation
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Early cardiopulmonary resuscitation (CPR) and defibrillation with an Automated External Defibrillator (AED) increase survival from out-of-hospital cardiac arrest (OHCA). Although international guidelines recommend the use of AED registries to increase AED use, little is known about implementation. The aim of this paper is to describe the development of a national AED registry, to analyse the coverage and barriers to register AEDs. ⋯ A national AED registry may gather information of AEDs on a national level. Although numbers have doubled between 2013-2016 in Sweden, a large proportion is still non-registered. More awareness of the registry and easier registration process is needed. General AED functionality seems high regardless of registered or non-registered AEDs. A key area for future research may be to use AED-registers to ascertain effectiveness of AED programs in terms of actual patient outcome.
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Observational Study
A potential termination of resuscitation rule for EMS to implement in the field for out-of-hospital cardiac arrest: An observational cohort study.
Despite international guidelines recommending termination of resuscitation (TOR) rules for out-of-hospital cardiac arrest (OHCA), their implementation remains low. We aimed to develop and validate a new TOR rule that could allow emergency medical service (EMS) personnel to immediately and objectively decide whether to withhold further resuscitation attempts after their arrival. ⋯ Based on three objective variables: unshockable initial rhythm, unwitnessed by bystanders, and age ≥73 years, which can be collected immediately after the arrival of EMS personnel at the scene, a new TOR can be developed. Our potential new TOR rule provided an excellent PPV (>99%) for unfavourable neurological outcomes at one month after OHCA.
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Ischemic heart disease (IHD) is associated with a shockable rhythm in out-of-hospital cardiac arrest (OHCA). However, the impact of IHD severity on first recorded rhythm is unknown. We hypothesized that the strength of the association between IHD and shockable rhythm increases with increasing IHD severity. ⋯ IHD was associated with a shockable rhythm, with a moderate increase in the association in patients with a CAG or PCI procedure.
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Modern automated external defibrillators (AEDs) are designed to prevent shock delivery when excessive motion produces rhythm disturbances mimicking ventricular fibrillation (VF). This has been reported as a safety issue in airline operations, where turbulent motion is commonplace. We aimed to evaluate whether all seven AEDs can deliver shock appropriately in a flight simulator under turbulent conditions. ⋯ Some AEDs designed primarily for ground use may not perform well under turbulent in-flight conditions. AEDs for possible in-flight or other non-terrestrial use should be fully evaluated by manufacturers or end-users before introduction to service.
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We sought to characterize the number of attempts required to achieve advanced airway management (AAM) success. ⋯ Multiple attempts are often needed to accomplish successful AAM. The number of attempts needed to accomplish AAM varies with AAM technique. These results may guide AAM practices.