Resuscitation
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Two thirds of Out-of-Hospital Cardiac Arrests (OHCAs) occur at the patient's home ('at-home-CA'), where bystander CPR (B-CPR) rates are significantly lower than in public locations. Knowledge about the circumstances of this specific setting has mainly been limited to quantitative data. To develop a more conceptual understanding of the circumstances and dynamics of 'at-home CA', we conducted a qualitative interview study. ⋯ Integrating these concepts into dispatch protocols and layperson training may improve dispatcher-bystander interaction and the outcomes of 'at-home CA'.
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While telephone-assisted cardiopulmonary resuscitation (T-CPR) is crucial for improving the chances of survival during cardiac arrest, there is limited information available on the effectiveness of T-CPR when administered by laypeople, especially those who are unfamiliar with these procedures. Therefore, we assessed the influence of basic life support and defibrillation (BLSD) training on the proficiency of T-CPR carried out by volunteer medical students participating in a BLSD course, using a simulated cardiac arrest scenario. The quality of T-CPR maneuvers was compared before and after the BLSD course. The results highlight the positive impact of BLSD training, significantly enhancing the quality of T-CPR and bringing it close to optimal levels.
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Multicenter Study Observational Study
Association of blood pressure with neurologic outcome at hospital discharge after pediatric cardiac arrest resuscitation.
Poor outcomes are associated with post cardiac arrest blood pressures <5th percentile for age. We aimed to study the relationship of mean arterial pressure (MAP) with favorable neurologic outcome following cardiac arrest and return of spontaneous circulation (ROSC). ⋯ In the first 6-hours post-ROSC, a lowest documented MAP between the 5th-74th percentile for age was associated with favorable neurologic outcome compared to MAP <5th percentile for age.
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Bag-Valve-Device (BVD) is the most frequently used device for pre-oxygenation and ventilation during cardiopulmonary resuscitation (CPR). A minimal expired fraction of oxygen (FeO2) above 0.85 is recommended during pre-oxygenation while insufflated volume (VTi) should be reduced during manual ventilation. The objective was to compare the performances of different BVD in simulated conditions. ⋯ Several BVD did not reach the FeO2 required during pre-oxygenation. Manual ventilation was significantly less protective in three BVD. These observations are related to the different BVD working principles.
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Clinical Trial
Live stream of prehospital point-of-care ultrasound during cardiopulmonary resuscitation - a feasibility trial.
Current resuscitation guidelines recommend that skilled persons could use ultrasound to detect reversible causes during cardiopulmonary resuscitation (CPR) where the examination can be safely integrated into the Advanced Life Support (ALS) algorithm. However, in a prehospital setting performing and rapidly interpreting ultrasound can be challenging for physicians. Implementing remote, expert-guided, and real-time transmissions of ultrasound examinations offers the opportunity for tele-support, even during an out-of-hospital cardiac arrest (OHCA). The aim of this feasibility study was to evaluate the impact of tele-supported ultrasound in ALS on hands-off time during an OHCA. ⋯ This feasibility study demonstrated that POCUS with tele-support can be safely performed during OHCA in an urban environment. Trial Registration (before patient enrolment): ClinicalTrials.gov, NCT04817475.