Resuscitation
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Multicenter Study
International variation in survival after out-of-hospital cardiac arrest: a validation study of the Utstein template.
Out-of-hospital cardiac arrest (OHCA) survival varies greatly between communities. The Utstein template was developed and promulgated to improve the comparability of OHCA outcome reports, but it has undergone limited empiric validation. We sought to assess how much of the variation in OHCA survival between emergency medical services (EMS) across the globe is explained by differences in the Utstein factors. We also assessed how accurately the Utstein factors predict OHCA survival. ⋯ The Utstein factors explained 51% of the variation in survival to hospital discharge among multiple large geographically separate EMS agencies. This suggests that quality improvement and public health efforts should continue to target modifiable Utstein factors to improve OHCA survival. Further study is required to identify the reasons for the variation that is incompletely understood.
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Multicenter Study
Prognostication after cardiac arrest: Results of an international, multi-professional survey.
We explored preferences for prognostic test performance characteristics and error tolerance in decisions regarding withdrawal or continuation of life-sustaining therapy (LST) after cardiac arrest in a diverse cohort of medical providers. ⋯ Medical providers are comfortable with low acceptable FPR for withdrawal (≤0.1%) and continuation (≤1%) of LST after cardiac arrest. These FPRs may be lower than can be achieved with current prognostic modalities.
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Randomized Controlled Trial Multicenter Study
The effect of an International competitive leaderboard on self-motivated simulation-based CPR practice among healthcare professionals: A randomized control trial.
Little is known about how best to motivate healthcare professionals to engage in frequent cardiopulmonary resuscitation (CPR) refresher skills practice. A competitive leaderboard for simulated CPR can encourage self-directed practice on a small scale. The study aimed to determine if a large-scale, multi-center leaderboard improved simulated CPR practice frequency and CPR performance among healthcare professionals. ⋯ A competitive leaderboard was not associated with an increase in self-directed simulated CPR practice or improved performance.
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Multicenter Study
Text message alert system and resuscitation outcomes after out-of-hospital cardiac arrest: A before-and-after population-based study.
This study aimed to investigate the association of a resuscitation bundle intervention including text message (TM) alert system and bystander cardiopulmonary resuscitation (CPR) and outcomes of out-of-hospital cardiac arrest (OHCA). ⋯ The bundle intervention including TM alert service for OHCA was associated with better survival outcomes through an increase in bystander CPR. Clinical trials registration; NCT02010151.
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Multicenter Study
Patient and hospital factors predict use of coronary angiography in out-of-hospital cardiac arrest patients.
To describe the association between patient- and hospital-level factors and coronary angiography among patients who suffer out-of-hospital cardiac arrest (OHCA). ⋯ We identified patient- and hospital-level factors that explain some of the variability in the use of coronary angiography for OHCA. Future work should determine which post arrest patients will benefit most from urgent coronary angiography and evaluate knowledge translation strategies to ensure consistent delivery of best practices.