Resuscitation
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Neurological status following out-of-hospital cardiac arrest is commonly assessed using measures such as the Cerebral Performance Category (CPC) at hospital discharge. However, it remains unclear if these measures accurately reflect long-term neurological status after discharge. The objective of this systematic review was to determine the association between post-arrest neurological outcome scores at hospital discharge and long-term (>6 months) neurological outcome scores. ⋯ Long-term neurological outcome scores following OHCA were consistent with short-term outcome at hospital discharge or 30 days post-arrest. All included studies measured neurological outcome using CPC, further studies are needed using other standards to better elucidate patient-centered long-term neurological outcome.
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Observational Study
Nationwide trends in residential and non-residential out-of-hospital cardiac arrest and differences in bystander cardiopulmonary resuscitation.
Singapore is highly-urbanized, with >90% of the population living in high-rise apartments. She has implemented several city-wide interventions such as dispatcher-assisted CPR, community CPR training and smartphone activation of volunteers to increase bystander CPR (BCPR) rates for out-of-hospital cardiac arrest (OHCA). These may have different impact on residential and non-residential OHCA. We aimed to evaluate the characteristics, processes-of-care and outcome differences between residential and non-residential OHCA and study the differences in temporal trends of BCPR rates. ⋯ Residential cardiac arrests had poorer bystander intervention and survival from 2010 to 2016 in Singapore. BCPR had improved more in residential arrests compared to non-residential arrests over a period of city-wide interventions to improve BCPR.
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Editorial Comment
Retrieving AEDs to save a life: more complicated than it seems.
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Observational Study
The impact of resuscitation system factors on in-hospital cardiac arrest outcomes across UK hospitals: an observational study.
To explore whether variation in in-hospital cardiac arrest (IHCA) survival can be explained by differences in resuscitation service provision across UK acute hospitals. ⋯ In this study, we identified variation in implementation of system quality indicators. Amongst hospitals that responded to our survey, the probability that individual factors increase the odds of hospital survival ranges from 10 to 89%.
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Defibrillation by public Automated External Defibrillators (AEDs) before EMS arrival is associated with high survival rates. Previous recommendSations suggest that an AED should be placed within a 1-1.5 min "brisk walk" from a cardiac arrest. Current guidelines hold no recommendation. The real-time it takes for a volunteer to retrieve an AED in a public setting has not been studied. ⋯ The median travelling speed of all lay responders dispatched to suspected OHCAs was 2.3 m/s. In densely populated areas the travelling speed was 1.8 m/s. This can be used as support in guidelines for planning placement of AEDs, in simulation studies, as well as in configuration of mobile-based dispatch systems.