Resuscitation
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Comparative Study
Amiodarone or nifekalant upon hospital arrival for refractory ventricular fibrillation after out-of-hospital cardiac arrest.
We evaluated the association between nifekalant or amiodarone on hospital admission and in-hospital mortality for cardiac arrest patients with persistent ventricular fibrillation on hospital arrival. ⋯ This nationwide study suggested no significant in-hospital mortality association between nifekalant and amiodarone for cardiogenic out-of-hospital cardiac arrest patients with ventricular fibrillation/persistent ventricular tachycardia on hospital arrival. Although nifekalant may potentially improve hospital admission rates compared with amiodarone for these patients, further studies are required to confirm our results.
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Observational Study
Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries.
Survival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching of the emergency medical services. ⋯ The accuracy of OHCA recognition was high and comparable. We identified large differences in data registration practices despite the use of similar dispatch tools. This raises a discussion of definitions and transparency in general in scientific reporting of OHCA recognition, which is essential if used as quality indicator in emergency medical services.
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Comparative Study
Determining witnessed status for out-of-hospital cardiac arrest.
Witnessed status is considered a core variable in reporting cardiac arrest data and can be ascertained from either the emergency dispatch recording or the pre-hospital record. The purpose of this study is to compare and assess the quality and consistency of these information sources. ⋯ The determination of witnessed status in out-of-hospital cardiac arrest may be challenging, as evidenced by the discrepancies in witnessed status when comparing different sources of information. The large number of cases where the witnessed status could not be determined from the emergency dispatch recording precludes its use as the sole source of information. It is reasonable to use the patient care record alone, however it should be recognized that there is misclassification of witnessed status regardless of the method used and this may affect the strength of association between witnessed status and survival.