Resuscitation
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Early detection of clinical deterioration on the wards may improve outcomes, and most early warning scores only utilize a patient's current vital signs. The added value of vital sign trends over time is poorly characterized. We investigated whether adding trends improves accuracy and which methods are optimal for modelling trends. ⋯ Vital sign trends increased the accuracy of models designed to detect critical illness on the wards. Our findings have important implications for clinicians at the bedside and for the development of early warning scores.
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Multicenter Study Clinical Trial
A before-after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore.
To evaluate the effects of a comprehensive dispatcher-assisted CPR (DACPR) training program on bystander CPR (BCPR) rate and the outcomes of out-of-hospital cardiac arrest (OHCA) in Singapore. ⋯ A significant increase in BCPR and ROSC was observed after the intervention. There was a trend to suggest improved survival outcomes with the intervention pending further results from the trial.
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Multicenter Study
Automatic Cardiac Rhythm Interpretation during Resuscitation.
Resuscitation guidelines recommend different treatments depending on the patient's cardiac rhythm. Rhythm interpretation is a key tool to retrospectively evaluate and improve the quality of treatment. Manual rhythm annotation is time consuming and an obstacle for handling large resuscitation datasets efficiently. The objective of this study was to develop a system for automatic rhythm interpretation by using signal processing and machine learning algorithms. ⋯ An ECG based automatic rhythm interpreter for resuscitation has been demonstrated. The interpreter handles VT, VF and AS well, while PEA and PR discrimination poses a more difficult problem.
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Multicenter Study
Prognostication of out-of-hospital cardiac arrest patients by 3-min end-tidal capnometry level in emergency department.
To evaluate the role of initial ETCO2 value in prognostication of OHCA patients in an Asian-Chinese cohort. ⋯ A 3-min ETCO2 ≤10mmHg was associated with poor prognosis and low chance of ROSC. Low ETCO2 level may have a role to reduce prolonged medically futile resuscitation.
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Multicenter Study Observational Study
Incidence and outcome of adult in-hospital cardiac arrest in Beijing, China.
To assess the incidence and outcome of in-hospital cardiac arrests (IHCAs) in Beijing, China. ⋯ The incidence of IHCA in Beijing hospitals is high and the survival is poor compared to other industrialized countries.