Resuscitation
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Large racial and socioeconomic inequalities exist for out-of-hospital cardiac arrest (OHCA) care and outcomes. We sought to characterize racial, ethnic, and socioeconomic disparities in OHCA care and outcomes in Texas. ⋯ Minority and poor neighborhoods in Texas experience large and unacceptable disparities in OHCA bystander response and outcomes.
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Observational Study
Software Annotation of Defibrillator Files: Ready for Prime Time?
High-quality chest compressions are associated with improved outcomes after cardiac arrest. Defibrillators record important information about chest compressions during cardiopulmonary resuscitation (CPR) and can be used in quality-improvement programs. Defibrillator review software can automatically annotate files and measure chest compression metrics. However, evidence is limited regarding the accuracy of such measurements. ⋯ Software annotation performed very well for chest compression rate. For CCF, the difference between manual and software annotation measurements was clinically important, while manual vs. limited manual annotation were similar with an ICC that was good-to-excellent.
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The aim of this study was to present new combination of algorithms for rhythm analysis during cardiopulmonary resuscitation (CPR) in automated external defibrillators (AED), called Analyze Whilst Compressing (AWC), designed for decreasing pre-shock pause and early stopping of chest compressions (CC) for treating refibrillation. ⋯ AWC presented similar performances to other AED algorithms during CPR, fulfilling performance goals recommended by standards. AWC provided advances in the challenge for improving CPR quality by: (i) not interrupting chest compressions for prevalent part of non-shockable rhythms (66-83%); (ii) minimizing pre-shock pause for 92.1% of VF patients. AWC required hands-off reconfirmation in 34.4% of cases. Reconfirmation was also common limitation of other reported algorithms (25.7-100%) although following different protocols for triggering chest compression resumption and shock delivery.
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Conduct a diagnostic test accuracy systematic review and meta-analysis of the post-return of spontaneous circulation (ROSC) electrocardiogram (ECG) to indicate an acute-appearing coronary lesion and revascularization. ⋯ Based on low certainty evidence, STE had good classification for acute coronary lesion and fair classification for revascularization. STE was more specific than sensitive for these outcomes and no single ECG feature excluded them. Uniform definitions and terminology would greatly facilitate the interpretation of subsequent studies.
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Review Meta Analysis
Pediatric timing of epinephrine doses: A systematic review.
To evaluate the optimal timing and doses of epinephrine for Infants and children suffering in-hospital or out-of-hospital cardiac arrest. ⋯ Earlier administration of the first epinephrine dose could be more favorable in non-shockable pediatric cardiac arrest. The optimal interval for epinephrine administration remains unclear.