Resuscitation
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Multicenter Study
Cardiac arrest survival did not increase in the Resuscitation Outcomes Consortium after implementation of the 2005 AHA CPR and ECC guidelines.
We examined the effect of the 2005 American Heart Association guidelines on survival in the Resuscitation Outcomes Consortium (ROC) Cardiac Arrest Epistry. ⋯ This study found no significant change in survival rate over time in the early months after implementation. Further longitudinal study is needed to determine the full impact of the guidelines on survival and methods to translate knowledge quickly and effectively in EMS.
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Multicenter Study Comparative Study
In-hospital cardiac arrest: impact of monitoring and witnessed event on patient survival and neurologic status at hospital discharge.
In-hospital cardiac arrest is a significant public health problem with a low probability of patient survival to hospital discharge. ⋯ Patients who are witnessed and/or monitored at the time of cardiac arrest demonstrate a significantly higher rate of survival to hospital discharge compared to those patients who are neither monitored nor witnessed. Monitored and/or witnessed cardiac arrest patients were also more likely to be discharged with favorable neurologic outcome. Cardiac monitoring confers no additional outcome benefit over direct observation of patients suffering in-hospital cardiac arrest.
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Multicenter Study Comparative Study
Effect of time and day of admission on 1-month survival and neurologically favourable 1-month survival in out-of-hospital cardiopulmonary arrest patients.
We sought to examine whether the outcomes of out-of-hospital cardiopulmonary arrest (OHCA) patients differed between weekday and weekend/holiday admissions, or between daytime and nighttime admissions. ⋯ Even after adjusting for confounding factors, admission day (weekday vs. weekend/holiday) had no effect on 1-month survival or neurologically favourable 1-month survival. In contrast, daytime admission was associated with significantly better outcomes than nighttime admissions.
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Multicenter Study Comparative Study
Long-term changes in the incidence of out-of-hospital ventricular fibrillation.
To report the long-term changes in the incidence of out-of-hospital ventricular fibrillation (VF), and also to report concurrent changes in the possible explanatory factors for the change. ⋯ The decline in the incidence of out-of-hospital VF seems to have ended, and the annual incidence of VF has stabilised to 11.6 (95% CI 9.7-13.5) per 100,000 inhabitants. During the period of lower incidence of VF, cardiac aetiology caused fewer arrests, and these arrests did not present with VF as often as previously.
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Multicenter Study Clinical Trial
Performance of a rectilinear biphasic waveform in defibrillation of presenting and recurrent ventricular fibrillation: a prospective multicenter study.
We tested the hypothesis that shock success differs with initial and recurrent episodes of ventricular fibrillation (VF). ⋯ Presenting VF was terminated with one shock in 87.8% of cases. We observed no significant difference in the frequency of shock success between initial versus recurrent VF. VF recurred in the majority of patients and did not adversely affect shock success, ROSC, or survival.