Resuscitation
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The importance of high-quality post-cardiac arrest care is well-described in adult and paediatric populations, but data are lacking to inform post-cardiac arrest care in the neonatal intensive care unit (NICU). The objective of this study was to describe post-cardiac arrest physiology and management in a quaternary NICU. ⋯ We identified significant variation in post-arrest management and a high prevalence of hypothermia. These data highlight the need for post-arrest management guidelines specific to neonatal physiology, as well as opportunities for quality improvement initiatives. Further research is needed to ascertain the impact of neonatal post-arrest management on long-term outcomes and survival.
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One-fifth of Australia's population do not speak English at home. International studies have found emergency calls with language barriers (LB) result in longer delays to out-of-hospital cardiac arrest (OHCA) recognition, and lower rates of bystander cardiopulmonary resuscitation (CPR) and survival. This study compared LB and non-LB OHCA call time intervals in an Australian emergency medical service (EMS). ⋯ Time delays found in LB calls point to phases of the call which need further qualitative investigation to understand how to improve communication. Overall, training call-takers for LB calls may assist caller understanding and cooperation during OHCAs.
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To evaluate the effect of pre-charging the defibrillator before rhythm analysis on hands-off time in patients suffering from out-of-hospital cardiac arrest with shockable rhythm. ⋯ Pre-charging the defibrillator reduced hands-off time during defibrillation procedures, reduces the total hands-off fraction and may be associated with increased return of spontaneous circulation in out-of-hospital cardiac arrest with shockable rhythm.
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Although several Utstein variables are known to independently improve survival, how they moderate the effect of emergency medical service (EMS) response times on survival is unknown. ⋯ Delays in EMS response time had the largest reduction in survival odds for OHCAs that did not receive a bystander AED shock but were witnessed, occurred in public, and/or received bystander CPR. A bystander AED shock appears to be protective against a delay in EMS response time.
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Responder smartphone apps use global positioning data to enable emergency medical services to alert volunteer responders of nearby potential out-of-hospital cardiac arrests (OHCA). ⋯ Acceptance rates in Australia and New Zealand were consistent with other smartphone apps. Responder recruitment should be targeted at those with medical backgrounds who have prior CPR experience, as they are more likely to provide care. The very low risk of PTSD is reassuring information when recruiting volunteers.