Articles: emergency-medical-services.
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Multicenter Study
Is the lactate value predictive of the return of spontaneous circulation during CPR in nontraumatic OHCA?
Cardiac arrest is a major public health issue, in which emergency medical services (EMS) initiating or continuing resuscitation in about 50% to 60% of cases. The aim of this study was to determine whether blood lactate levels and their course during cardiopulmonary resuscitation are prognostic indicators of the return of spontaneous cardiac activity (ROSC) in non-traumatic out-of-hospital cardiac arrest (OHCA). ⋯ In this prospective multi-center study, there was no independent association between lactate values during cardiopulmonary resuscitation and ROSC in non-traumatic OHCA. However, the post-ROSC pre-hospital kinetics of lactate (i.e., during the first 30 min) seem to be associated with survival.
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Scand J Trauma Resus · Apr 2024
Multicenter Study Observational StudyDevelopment and internal validation of an algorithm for estimating mortality in patients encountered by physician-staffed helicopter emergency medical services.
Severity of illness scoring systems are used in intensive care units to enable the calculation of adjusted outcomes for audit and benchmarking purposes. Similar tools are lacking for pre-hospital emergency medicine. Therefore, using a national helicopter emergency medical services database, we developed and internally validated a mortality prediction algorithm. ⋯ Based on 11 demographic, mission-specific, and physiologic variables, we developed and internally validated a novel severity of illness algorithm for use with patients encountered by physician-staffed helicopter emergency medical services, which may help in future quality improvement.
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Multicenter Study Observational Study
Midazolam for Post-Arrest Sedation in Pre-Hospital Emergency Care—a Multicenter Propensity Score Analysis.
An out-of-hospital cardiac arrest (OHCA) with return of spontaneous circulation (ROSC) may need to be treated with airway management, emergency ventilation, invasive interventions, and post-arrest sedation. We investigated the influence of the use of midazolam for post-arrest sedation on achieving postresuscitation care targets and the associated risk of hemodynamic complications. ⋯ The pre-hospital administration of midazolam leads to more frequent pre-hospital attainment of the oxygenation and ventilation targets in post-resuscitation care, without any evidence of an elevated risk of hemodynamic complications.
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Acta Anaesthesiol Scand · Apr 2024
Multicenter Study Observational StudyTransthoracic impedance variability to assess quality of chest compression in out-of-hospital cardiac arrest.
Chest compression is a lifesaving intervention in out-of-hospital cardiac arrest (OHCA), but the optimal metrics to assess its quality have yet to be identified. The objective of this study was to investigate whether a new parameter, that is, the variability of the chest compression-generated transthoracic impedance (TTI), namely ImpCC , which measures the consistency of the chest compression maneuver, relates to resuscitation outcome. ⋯ In this population, consistency of chest compression maneuver, measured by variability in TTI, was an independent predictor of defibrillation outcome. ImpCC may be a useful novel metrics for improving quality of care in OHCA.
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Multicenter Study Observational Study
Long-term risk of death in patients with infection attended by prehospital emergency services.
To develop and validate a risk model for 1-year mortality based on variables available from early prehospital emergency attendance of patients with infection. ⋯ The model showed excellent ability to predict 1-year mortality based on epidemiological, analytical, and clinical variables, identifying patients at high risk of death soon after their first contact with the health care system.