Resuscitation
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Prior research shows a greater disease burden, lower BCPR rates, and worse outcomes in Black and Hispanic patients after OHCA. Female OHCA patients have lower rates of BCPR compared to men and other survival outcomes vary. The influence of the COVID-19 pandemic on OHCA incidence and outcomes in different health disparity populations is unknown. ⋯ Many OHCA outcomes worsened for Black and Hispanic patients. While some aspects of care worsened for women, their odds of survival improved compared to males.
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Respiratory failure is a common cause of pulseless electrical activity (PEA) and asystolic cardiac arrest, but the changes in heart rate (HR) pre-arrest are not well described. We describe HR dynamics prior to in-hospital cardiac arrest (IHCA) among PEA/asystole arrest patients with respiratory etiology. ⋯ IHCAs of respiratory etiology follow a model of HR increase from physiologic compensation to hypoxia, followed by rapid HR decrease prior to arrest.
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An uncertain proportion of patients with acute coronary syndrome (ACS) also experience out-of-hospital cardiac arrest (OHCA). Predictors of OHCA in ACS remain unclear and vulnerable to selection bias as pre-hospital deceased patients are usually not included. ⋯ OHCA complicates approximately 10% of ACS in the young. Predictors of OHCA are being non-diabetic, non-obese, having a STEMI presentation, and left main or LAD coronary culprit lesion. For OHCA patients surviving to PCI, higher rates of in-hospital complications are observed. Despite this, recovery of pre-morbid physical and cardiac function is equivalent to non-OHCA patients, apart from higher rates of anxiety/depression.
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To identify whether a novel pulse check technique, carotid artery compression using an ultrasound probe, can reduce pulse check times compared to manual palpation (MP). ⋯ We found that emergency physicians could quickly determine pulses by applying simple POCUS compression of the carotid artery in cardiac arrest patients.