Articles: out-of-hospital-cardiac-arrest.
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To examine maternal and neonatal outcomes following Resuscitative Hysterotomy for out of hospital cardiac arrest (OHCA) and to compare with timing from cardiac arrest to delivery. ⋯ There are low rates of maternal survival following resuscitative hysterotomy for OHCA. There are documented neonatal survivors after extended periods of maternal resuscitation, and at extremely preterm gestations (<28 weeks). Further prospective research should assess both maternal and neonatal outcomes to better inform future clinical practice.
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Observational Study
Interaction Effects Between COVID-19 Outbreak and Fever on Mortality Among OHCA Patients Visiting Emergency Departments.
Background and Objectives: Fever in patients who have suffered an out-of-hospital cardiac arrest (OHCA) has been linked to poor clinical outcomes, as a fever can exacerbate neurological damage, increase metabolic demands, and trigger inflammatory responses. This study evaluates the impact of the COVID-19 outbreak and associated fevers on OHCA outcomes and examines how they can worsen patient prognosis. Materials and Methods: Our retrospective observational analysis used data from the National Emergency Department Information System (NEDIS), comprising adult OHCA patients at 402 EDs in Korea between 27 January and 31 December 2020 (COVID-19 pandemic period) and the corresponding period in 2019 (pre-COVID-19). ⋯ Results: During COVID-19, in-hospital mortality was higher among OHCA patients compared to the pre-pandemic period (adjusted OR 1.22, 95% CI 1.11-1.34), particularly among febrile patients (adjusted OR 1.40, 95% CI 1.24-1.59). Interaction analysis revealed that COVID-19 disproportionately increased mortality in febrile OHCA patients compared with non-febrile patients (difference-in-difference: 0.8%, 95% CI 0.2-1.5). Conclusions: Our study found that the COVID-19 pandemic significantly increased mortality among OHCA patients, with febrile patients experiencing disproportionately worse outcomes due to systemic delays and pandemic-related disruptions.
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Observational Study
Optimal wearable camera mount locations for medical supervision during simulated out-of-hospital cardiopulmonary resuscitation.
The quality of the visual information transmitted from a scene is crucial for effective medical supervision in prehospital settings. This study investigated the influence of wearable camera mount locations on visibility during simulated out-of-hospital cardiopulmonary resuscitation. A prospective, observational, non-randomized simulation study was conducted to replicate a cardiac arrest scenario adhering to an advanced life support (ALS) protocol. ⋯ Wearable camera mount location significantly affected visibility during simulated resuscitation. Mounting cameras closer to eye level provided the most accurate visual data. Further research using objective measures, such as artificial intelligence, and evaluating the visibility of wearable cameras in real-world situations is warranted to optimize simulation-based training for prehospital care.
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Optimal timing of adrenaline administration in pediatric out-of-hospital cardiac arrest (OHCA) is unclear. We aimed to evaluate the impact of early versus late adrenaline administration on survival and neurological outcomes at one month in children experiencing OHCA with non-shockable rhythm. ⋯ Early adrenaline administration in pediatric OHCA was not associated with overall one month survival or neurologic outcome.
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Observational Study
Out-of-hospital cardiac arrests in Victoria, 2003-2022: retrospective analysis of Victorian Ambulance Cardiac Arrest Registry data.
To examine changes in out-of-hospital cardiac arrest (OHCA) characteristics and outcomes during 2003-2022, and 12-month outcomes for people who experienced OHCA during 1 January 2010 - 30 June 2022. ⋯ Utstein survival to hospital discharge increased threefold during 2003-2022, and the proportions of cases in which bystanders provided cardio-pulmonary resuscitation or public access defibrillation increased. The COVID-19 pandemic was associated with a substantial reduction in survival, and new strategies are needed to improve outcomes.