Resuscitation
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Studies suggest that hyperoxemia increases short-term mortality after cardiopulmonary resuscitation (CPR), but the effect of hyperoxemia on long-term outcomes is unclear. We determined the prevalence of early hyperoxemia after CPR and its association with long-term neurological outcome and mortality. ⋯ We found no association between early post-arrest hyperoxemia and unfavourable outcome. Subgroup analysis found no differential effect depending on arrest location, initial rhythm or time-to-ROSC.
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Observational Study
Prognostic impact of the conversion to a shockable rhythm from a non-shockable rhythm for patients suffering from out-of-hospital cardiac arrest.
For patients suffering from an out-of-hospital cardiac arrest (OHCA), having an initial shockable rhythm is a marker of good prognosis. It has been suggested as one of the main prognosticating factors for the selection of patients for extracorporeal resuscitation (E-CPR). However, the prognostic implication of converting from a non-shockable to a shockable rhythm, as compared to having an initial shockable rhythm, remains uncertain, especially among patients that can otherwise be considered eligible for E-CPR. The objective of this study was to evaluate the association between the initial rhythm and its subsequent conversion and survival following an OHCA, for the general population and for E-CPR candidates. ⋯ The initial rhythm remains a much better prognostic marker than subsequent rhythms for all patients suffering from an OHCA, including in the subset of potential E-CPR candidates.
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Recent work has demonstrated low rates of layperson CPR training across the US. In an attempt to increase rates, some states passed legislation that requires CPR training before high school graduation. We hypothesized laypeople in states with required training would exhibit a greater likelihood of being currently trained in CPR when compared with laypeople in states without required CPR training. ⋯ Individuals were more likely to be currently trained in CPR in states with mandatory CPR training for high school graduation, suggesting a need for additional research on this public policy.
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It is recommended globally that shocks by automated external defibrillators (AEDs) should be delivered immediately when a shockable out-of-hospital cardiac arrest (OHCA) occurs. However, the actual time-interval from collapse to first shock by public-access AED and its impact on subsequent outcome has not been extensively investigated in real-world settings. ⋯ In Japan, earlier shock by public-access AED led to better outcome after bystander-witnessed OHCA with shockable rhythm in public locations. However, the proportion of OHCA patients who received early shock was still low in public locations.
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Paediatric traumatic out-of-hospital cardiac arrest (OHCA) is a rare event with few survivors. We examined long-term trends in the incidence and outcomes of paediatric traumatic OHCA and explored the frequency and timing of intra-arrest interventions. ⋯ The incidence and outcomes of paediatric traumatic OHCA remained unchanged over an 18 year period. Early correction of reversible causes by reducing delays to the delivery of trauma-specific interventions may yield additional survivors.