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    1 OF 418

    Influence of learning styles on the practical performance after the four-step basic life support training approach - An observational cohort study.
    PLoS One 2017 22;12(5):e0178210. Epub 2017 May 22.
    Department of Anaesthesiology, University Hospital RWTH Aachen University, Aachen, North Rhine-Westphalia, Germany.
    Background: Learning and training basic life support (BLS)-especially external chest compressions (ECC) within the BLS-algorithm-are essential resuscitation training for laypersons as well as for health care professionals. The objective of this study was to evaluate the influence of learning styles on the performance of BLS and to identify whether all types of learners are sufficiently addressed by Peyton's four-step approach for BLS training.

    Methods: A study group of first-year medical students (n = 334) without previous medical knowledge was categorized according to learning styles using the German Lernstilinventar questionnaire based on Kolb's Learning Styles Inventory. Read More

    Retrospective population-based study of emergency medical services-attended out-of-hospital cardiac arrests in children in Belgium.
    Eur J Emerg Med 2017 May 24. Epub 2017 May 24.
    Department of Emergency Medicine, University Hospital Ghent, Ghent, Belgium.
    Objective: This study presents an analysis of clinical data of the circumstances and outcome of paediatric (0-16 years) out-of-hospital cardiac arrests (p-OHCA) in Belgium.

    Methods: This was a retrospective study of a prospective population-based registration of physician-attended [mobile emergency group (MUG)] emergency medical services (EMS) interventions of p-OHCA in Belgium between 2010 and 2012.

    Results: We identified 365 OHCA in 18 295 paediatric MUG interventions (2%). Read More

    When Teachable Moments Become Ethically Problematic.
    Camb Q Healthc Ethics 2017 Jul;26(3):491-494
    There is frequently tension in medical education between teaching moments that provide skills and knowledge for medical trainees, and instrumentalizing patients for the purpose of teaching. In this commentary, I question the ethical acceptability of the practice of providing cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS) to dying patients who would be unlikely to survive resuscitation, as a teaching opportunity for medical trainees. This practice violates the principle of informed consent, as the patient agreed to resuscitation for the purpose of potentially prolonging life rather than to futile resuscitation as a teaching opportunity. Read More

    Development of the Emergency Preservation and Resuscitation for Cardiac Arrest from Trauma (EPR-CAT) Clinical Trial.
    J Trauma Acute Care Surg 2017 May 22. Epub 2017 May 22.
    University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD Department of Surgery, University of Michigan, Ann Arbor, MI Department of Surgery, Emory University, Atlanta, GA University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA Department of Surgery, University of Pittsburgh, Pittsburgh, PA Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.
    Background: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery. Read More

    Cardiopulmonary Resuscitation in Adults and Children With Mechanical Circulatory Support: A Scientific Statement From the American Heart Association.
    Circulation 2017 May 22. Epub 2017 May 22.
    Cardiac arrest in patients on mechanical support is a new phenomenon brought about by the increased use of this therapy in patients with end-stage heart failure. This American Heart Association scientific statement highlights the recognition and treatment of cardiovascular collapse or cardiopulmonary arrest in an adult or pediatric patient who has a ventricular assist device or total artificial heart. Specific, expert consensus recommendations are provided for the role of external chest compressions in such patients. Read More

    Multiple thoracic vertebral fractures as a complication of cardiopulmonary resuscitation: A case report.
    Ulus Travma Acil Cerrahi Derg 2017 May;23(3):263-265
    Department of Neurosurgery, Gil Medical Center, Gachon University, Incheon-Korea.
    A 50-year-old man experienced cardiac arrest. The patient underwent standard cardiopulmonary resuscitative measures for approximately 20 minutes before spontaneous circulation returned. He was diagnosed with variant angina, and subsequent imaging for evaluation of upper back pain revealed fractures of the fifth through eighth thoracic vertebrae. Read More

    North American Public Opinion Survey on the Acceptability of Crowdsourcing Basic Life Support for Out-of-Hospital Cardiac Arrest With the PulsePoint Mobile Phone App.
    JMIR Mhealth Uhealth 2017 May 17;5(5):e63. Epub 2017 May 17.
    Department of Emergency Medicine, Queen's University, Kingston, ON, Canada.
    Background: The PulsePoint Respond app is a novel system that can be implemented in emergency dispatch centers to crowdsource basic life support (BLS) for patients with cardiac arrest and facilitate bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator use while first responders are en route.

    Objective: The aim of this study was to conduct a North American survey to evaluate the public perception of the above-mentioned strategy, including acceptability and willingness to respond to alerts.

    Methods: We designed a Web-based survey administered by IPSOS Reid, an established external polling vendor. Read More

    Automated external defibrillator and operator performance in out-of-hospital cardiac arrest.
    Resuscitation 2017 May 16. Epub 2017 May 16.
    Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
    Aim: An increasing number of failing automated external defibrillators (AEDs) is reported: AEDs not giving a shock or other malfunction. We assessed to what extent AEDs are 'failing' and whether this had a device-related or operator-related cause.

    Methods: We studied analysis periods from AEDs used between January 2012 and December 2014. Read More

    The Girona Territori Cardioprotegit Project: Performance Evaluation of Public Defibrillators.
    Rev Esp Cardiol (Engl Ed) 2017 May 15. Epub 2017 May 15.
    Servicio de Cardiología, Hospital Universitari Dr. Josep Trueta, Girona, Spain; Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Girona, Girona, Spain; Centro de Genética Cardiovascular, Instituto de investigación biomédica de Girona (IDIBGI), Girona, Spain.
    Introduction And Objectives: In recent years, public access defibrillation programs have exponentially increased the availability of automatic external defibrillators (AED) in public spaces but there are no data on their performance in our setting. We conducted a descriptive analysis of the performance of AED since the launch of a public defibrillation program in our region.

    Methods: A retrospective analysis was conducted of electrocardiographic tracings and the performance of AED in a public defibrillation program from June 2011 to June 2015 in the province of Girona, Spain. Read More

    Is Pre-Hospital CPR a Risk Factor for Early Death in Patients Transferred to an Adult Burn Center?
    J Am Coll Surg 2017 May 15. Epub 2017 May 15.
    Connecticut Burn Center, Bridgeport Hospital, Bridgeport, CT.
    Background: Burn patients who require cardiopulmonary resuscitation (CPR) prior to admission to a Burn Center are anecdotally known to suffer higher mortality than those who do not require pre-hospital CPR.

    Study Design: A retrospective chart review identified adult patients admitted to our burn center between 2013 and 2015. Included patients met one or both of the following criteria: (1) 20 percent or more total body surface area (%TBSA) burned and (2) need for intubation prior to admission to our facility. Read More

    Comparison of early sequential hypothermia and delayed hypothermia on neurological function after resuscitation in a swine model.
    Am J Emerg Med 2017 May 11. Epub 2017 May 11.
    Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China; Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, China. Electronic address:
    Background: We utilized a porcine cardiac arrest model to compare early sequential hypothermia (ESH) with delayed hypothermia (DH) and no hypothermia (NH) to investigate the different effects on cerebral function after resuscitation.

    Methods: After return of spontaneous circulation (ROSC), resuscitated 24 pigs divided into three groups. The ESH group implemented early sequential hypothermia immediately, and the DH group implemented delayed hypothermia at 1 h after ROSC. Read More

    Management of untreatable ventricular arrhythmias during pharmacologic challenges with sodium channel blockers for suspected Brugada syndrome.
    Europace 2017 May 17. Epub 2017 May 17.
    Cardiothoracic Department, University Hospital of Udine, P.le Santa Maria della Misericordia, 15, 33100, Udine, Italy.
    Pharmacologic challenge with sodium channel blockers is part of the diagnostic workout in patients with suspected Brugada syndrome. The test is overall considered safe but both ajmaline and flecainide detain well known pro-arrhythmic properties. Moreover, the treatment of patients with life-threatening arrhythmias during these diagnostic procedures is not well defined. Read More

    [Psychological impact of out-of-hospital cardiopulmonary resuscitation (CPR) on the witness engaged in gestures of survival].
    Rev Med Liege 2017 May;72(5):236-240
    Département de Médecine d'Urgence, CHU de Liège, Belgique.
    The occurrence of an unexpected sudden death puts the witnesses of this event in a situation of high emotional impact. The benefit to allow the families of victims to dispense the first resuscitation techniques has been emphasized. However, little data exist on the emotional impact of a cardio-respiratory arrest outside the hospital on the witness, who is often a close family member. Read More

    Cardiopulmonary Resuscitation Training Disparities in the United States.
    J Am Heart Assoc 2017 May 17;6(5). Epub 2017 May 17.
    Department of Emergency Medicine and Center for Resuscitation Science, University of Pennsylvania, Philadelphia, PA
    Background: Bystander cardiopulmonary resuscitation (CPR) is associated with increased survival from cardiac arrest, yet bystander CPR rates are low in many communities. The overall prevalence of CPR training in the United States and associated individual-level disparities are unknown. We sought to measure the national prevalence of CPR training and hypothesized that older age and lower socioeconomic status would be independently associated with a lower likelihood of CPR training. Read More

    Epileptiform discharge detection with the 4-channel frontal electroencephalography during post-resuscitation care.
    Resuscitation 2017 May 13. Epub 2017 May 13.
    Department of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
    Introduction: We performed this study to investigate whether the SEDline system, a 4-channel-processed electroencephalography (EEG) monitoring device in the frontal area, can detect epileptiform discharges accurately during post-resuscitation care in comatose cardiac arrest survivors.

    Methods: Adult comatose cardiac arrest survivors, who were admitted to the intensive care unit (ICU) for post-resuscitation care including TTM, were enrolled. Within 72h post-return of spontaneous circulation (ROSC), conventional EEG was conducted for 30minutes. Read More

    Doctors' attitudes towards the introduction and clinical operation of do not resuscitate orders (DNRs) in Ireland.
    Ir J Med Sci 2017 May 16. Epub 2017 May 16.
    School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, Cork, Ireland.
    Background: Do not resuscitate orders (DNRs) are documents which state that should a patient suffer from cardiopulmonary failure, resuscitation should not be attempted. Internationally, DNRs are often misunderstood and used inappropriately in a clinical setting.

    Aims: The aim of this paper was to determine the current understanding of DNRs and their clinical operation among hospital doctors in Ireland. Read More

    Repetitive postoperative extubation failure and cardiac arrest due to laryngomalacia after general anesthesia in an elderly patient: a case report.
    J Anesth 2017 May 15. Epub 2017 May 15.
    Department of Emergency and Critical Care Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
    The authors report a case involving an elderly patient who experienced repetitive perioperative cardiac arrest caused by laryngomalacia. The patient underwent surgery under general anesthesia; however, 2 h after initial extubation, he experienced cardiopulmonary arrest. Return of spontaneous circulation was achieved by immediate resuscitation. Read More

    [Mistakes in drug prescription during simulated pediatric resuscitations and other urgency procedures].
    Arch Argent Pediatr 2017 Jun;115(3):294-299
    Oklahoma University Health Science Center (OUHSC), Oklahoma City, Estados Unidos de América.
    Introduction: The probability of making mistakes in the prescription of medicines is high in pediatrics, and substantially increases in emergency situations.

    Material And Methods: This prospective observational study analyzed the prescriptions issued by physicians during 23 cardiopulmonary resuscitation pediatric emergency training sessions.

    Results: During 94 simulated cases, 96 physicians participated. Read More

    Successful use of lipid emulsion to resuscitate a foal after intravenous lidocaine induced cardiovascular collapse.
    Equine Vet J 2017 May 14. Epub 2017 May 14.
    Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, Cáceres, 10003, Spain.
    Background: Lipid emulsion has been reported to be effective for the treatment of local anaesthetic overdoses in rats, dogs and humans.

    Objectives: To describe the successful treatment of cardiovascular lidocaine toxicity in a foal with intravenous lipid administration.

    Study Design: Observational study: case report. Read More

    Sudden Death in a Diver: A Diagnostic Conundrum.
    Wilderness Environ Med 2017 May 10. Epub 2017 May 10.
    Merton Cottages, Tintagel, Cornwall, United Kingdom (Dr Francis).
    We discuss the case of an experienced diver who ran out of air during his final ascent while scuba diving. He lost consciousness rapidly after surfacing and despite immediate cardiopulmonary resuscitation, could not be revived. On arrival at the emergency department he was noted to have copious amounts of blood in his upper airway and had developed extensive subcutaneous emphysema. Read More

    Comparison of four different intraosseous access devices during simulated pediatric resuscitation. A randomized crossover manikin trial.
    Eur J Pediatr 2017 May 12. Epub 2017 May 12.
    Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA.
    The aim of the study was to compare the success rate, procedure time, and user satisfaction of pediatric NIO™ compared to Pediatric BIG®, EZ-IO®, and Jamshidi intraosseous access devices. This was a randomized, crossover manikin trial with 87 paramedics. The correct location of intraosseous access when using NIO, BIG, EZ-IO, and Jamshidi was varied and was respectively 100, 90, 90, and 90%. Read More

    Improving CPR performance.
    Chest 2017 May 9. Epub 2017 May 9.
    division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA.
    Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. Cardiopulmonary resuscitation (CPR) is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Read More

    ["Kids Save Lives"-resuscitation training for schoolchildren : Systematic review].
    Anaesthesist 2017 May 11. Epub 2017 May 11.
    Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln, Kerpener Str.62, 50937, Köln, Deutschland.
    Background: Even in western developed countries, the probability of survival after out-of-hospital cardiac arrest (OHCA) is only 6-10%. In order to improve survival after OHCA, early initiation of cardiopulmonary resuscitation (CPR) by laypersons is essential. Introduction of CPR training in schoolchildren seems to be effective to increase lay-CPR rates. Read More

    Bystander CPR is Clustered and Associated with Neighborhood Socioeconomic Characteristics: A Geospatial Analysis of Kent County, Michigan.
    Acad Emerg Med 2017 May 11. Epub 2017 May 11.
    Department of Emergency Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
    Objectives: Geographic clustering of bystander CPR is associated with demographic and socioeconomic features of the community where out-of-hospital cardiac arrest (OHCA) occurred, though this association remains largely untested in rural areas. With a significant rural component and relative racial homogeneity, Kent County, Michigan provides a unique setting to externally validate or identify new community features associated with bystander CPR. Using a large, countywide dataset, we tested for geographic clustering of bystander CPR, and its associations with community socioeconomic features. Read More

    Risk factors of prognosis after acute kidney injury in hospitalized patients.
    Front Med 2017 May 11. Epub 2017 May 11.
    Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, 100853, China.
    The risk factors, especially laboratory indicators, of prognosis after acute kidney injury (AKI) remain unclear. We conducted a retrospective survey of Chinese People's Liberation Army General Hospital from January 1, 2012 to December 31, 2012 according to the AKI diagnosis standard issued by Kidney Disease Improving Global Outcomes. The epidemiological features and factors influencing hospital mortality and renal function recovery were evaluated through logistic regression analysis. Read More

    Fast therapeutic hypothermia prevents post-cardiac arrest syndrome through cyclophilin D-mediated mitochondrial permeability transition inhibition.
    Basic Res Cardiol 2017 Jul 10;112(4):35. Epub 2017 May 10.
    Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Réanimation Médicale, 5 Place d'Arsonval, 69437, Lyon Cedex 03, France.
    The opening of the mitochondrial permeability transition pore (PTP), which is regulated by the matrix protein cyclophilin D (CypD), plays a key role in the pathophysiology of post-cardiac arrest (CA) syndrome. We hypothesized that therapeutic hypothermia could prevent post-CA syndrome through a CypD-mediated PTP inhibition in both heart and brain. In addition, we investigated whether specific pharmacological PTP inhibition would confer additive protection to cooling. Read More

    [The use of mechanical chest compression devices for both out-of-hospital and in-hospital refractory cardiac arrest].
    G Ital Cardiol (Rome) 2017 Apr;18(4):305-312
    U.O.C. Cardiologia, Dipartimento Cardiovascolare, Ospedale Ca' Foncello, Treviso.
    The purpose of cardiopulmonary resuscitation after sudden cardiac arrest is to restore minimal blood flow to provide oxygen to the brain and other vital organs. Chest compressions and external defibrillation are the first line for circulatory support. Although early defibrillation is the main factor influencing survival, cardiopulmonary resuscitation must be characterized by high-quality external chest compressions. Read More

    Enhanced neuroprotective efficacy of bone marrow mesenchymal stem cells co-overexpressing BDNF and VEGF in a rat model of cardiac arrest-induced global cerebral ischemia.
    Cell Death Dis 2017 May 11;8(5):e2774. Epub 2017 May 11.
    Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
    Cardiac arrest-induced global cerebral ischemia injury (CA-GCII) usually leads to a poor neurological outcome without an effective treatment. Bone marrow-derived mesenchymal stem cells (BMMSCs) may provide a potential cell-based therapy against neurologic disorders through induction of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF). To optimize the neuroprotective efficacy of BMMSCs further, in this study we have derived BMMSCs, which co-overexpress both BDNF and VEGF, and tested them for the treatment of CA-GCII in a rat model. Read More

    Practice guideline summary: Reducing brain injury following cardiopulmonary resuscitation: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.
    Neurology 2017 May 10. Epub 2017 May 10.
    From the Departments of Neurology, Anesthesiology-Critical Care Medicine, and Neurosurgery (R.G.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (E.W., A.R.), Mayo Clinic, Rochester, MN; Department of Neurology (M.J.A.), University of Florida-McKnight Brain Institute, Gainesville; Department of Neurology and Neurocritical Care Unit (M.D.), Cambridge University Hospitals; The Ipswich Hospital (M.D.), Cambridge, UK; Departments of Neurology and Neurosurgery (S.A.M.), Mount Sinai-Icahn School of Medicine, New York, NY; Departments of Emergency Medicine and Internal Medicine (Cardiology) (J.P.O.), Virginia Commonwealth University College of Medicine, Richmond; Department of Neurology (J.I.S.), Baylor College of Medicine, Houston, TX; Department of Neurology and Neurosurgery (M.T.T.), Ohio State University, Columbus; Department of Neurology (R.M.D.), Kansas University Medical Center, Kansas City; and Department of Neurology (J.L.), University of Toronto, Canada.
    Objective: To assess the evidence and make evidence-based recommendations for acute interventions to reduce brain injury in adult patients who are comatose after successful cardiopulmonary resuscitation.

    Methods: Published literature from 1966 to August 29, 2016, was reviewed with evidence-based classification of relevant articles.

    Results And Recommendations: For patients who are comatose in whom the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) after out-of-hospital cardiac arrest (OHCA), therapeutic hypothermia (TH; 32-34°C for 24 hours) is highly likely to be effective in improving functional neurologic outcome and survival compared with non-TH and should be offered (Level A). Read More

    Benefits of anti‑inflammatory therapy in the treatment of ischemia/reperfusion injury in the renal microvascular endothelium of rats with return of spontaneous circulation.
    Mol Med Rep 2017 Jun 3;15(6):4231-4238. Epub 2017 May 3.
    Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, P.R. China.
    The aim of the present study was to investigate whether prostaglandin E1 (PGE1), target temperature management (TTM) and a combined intervention involving the two would be beneficial as anti‑inflammatory therapies for ischemia/reperfusion (I/R) injury to the renal microvascular endothelium of rats with return of spontaneous circulation (ROSC). In each group of rats with different interventions, following successful cardiopulmonary resuscitation, the levels of thrombomodulin (TM), interleukin‑6 (IL‑6) and tumor necrosis factor‑α (TNF‑α) in the plasma were evaluated. The expression of vascular endothelial (VE)‑cadherin and vascular cell adhesion molecule‑1 (VCAM‑1) mRNA was analyzed in the kidney. Read More

    Examining the utility of the Hamilton early warning scores (HEWS) at triage: Retrospective pilot study in a Canadian emergency department.
    CJEM 2017 May 10:1-9. Epub 2017 May 10.
    †Division of Critical Care,McMaster University,Hamilton General Hospital,Hamilton,ON.
    Objectives: Early warning scores use vital signs to identify patients at risk of critical illness. The current study examines the Hamilton Early Warning Score (HEWS) at emergency department (ED) triage among patients who experienced a critical event during their hospitalization. HEWS was also evaluated as a predictor of sepsis. Read More

    Effect of pre-hospital advanced airway management for out-of-hospital cardiac arrest caused by respiratory disease: a propensity score-matched study.
    Anaesth Intensive Care 2017 May;45(3):375-383
    Emeritus Professor, Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
    Optimal pre-hospital care for out-of-hospital cardiac arrest (OHCA) caused by respiratory disease may differ from that for OHCA associated with other aetiologies, especially with respect to respiratory management. We aimed to investigate whether pre-hospital advanced airway management (AAM) was associated with favourable outcomes after OHCA caused by intrinsic respiratory disease. This nationwide, population-based, propensity score-matched study of adult patients in Japan with OHCA due to respiratory disease from 1 January 2005 to 31 December 2012 compared patients with and without pre-hospital AAM. Read More

    Cardiopulmonary resuscitation-from the patient's perspective.
    Anaesth Intensive Care 2017 May;45(3):344-350
    Consultant, Department of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore.
    With increasing emphasis on patient autonomy, patients are encouraged to be more involved in end-of-life issues, including the use of extraordinary efforts to prolong their lives. Being able to make anticipatory decisions is seen to promote autonomy, empower patients and optimise patient care. To facilitate shared decision-making, patients need to have a clear and accurate understanding of cardiopulmonary resuscitation (CPR). Read More

    Developing, implementing and sustaining an end-of-life care programme in residential care homes.
    Int J Palliat Nurs 2017 Apr;23(4):186-193
    Practice Development Clinical Nurse Specialist; All part of the Care Home Project Team at St Christopher's Hospice, Sydenham, London UK.
    Background: In the UK 15.8% of people aged 85 years and over live in a care home or long-stay hospital setting. With the projection of an ageing population it is realistic to expect that the number of people both living and dying in all care homes will increase. Read More

    A Novel Porcine Model of Septic Shock Induced by Acute Respiratory Distress Syndrome due to Methicillin-resistant Staphylococcus aureus.
    Chin Med J (Engl) 2017 May;130(10):1226-1235
    Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing 100020, China.
    Background: Sepsis is one of the main causes of mortality in critically ill patients following progression to septic shock. To investigate the pathophysiologic changes of sepsis, we developed a novel porcine model of septic shock induced by acute respiratory distress syndrome (ARDS) due to methicillin-resistant Staphylococcus aureus(MRSA) pneumonia.

    Methods: Twenty-six male Landraces (Lvyuanweiye, Beijing, China) weighing 30 ± 2 kg were divided into four groups: sham group (SH; n = 5); cotton smoke inhalation group (SM; n = 6); MRSA pneumonia group (MR; n = 6); and septic shock group with cotton smoke inhalation + MRSA pneumonia (SS; n = 9). Read More

    Comparison of Quantitative Characteristics of Early Post-resuscitation EEG Between Asphyxial and Ventricular Fibrillation Cardiac Arrest in Rats.
    Neurocrit Care 2017 May 8. Epub 2017 May 8.
    School of Biomedical Engineering, Third Military Medical University, 30 Gaotanyan Main Street, Chongqing, 400038, China.
    Background: Quantitative electroencephalogram (EEG) analysis has shown promising results in studying brain injury and functional recovery after cardiac arrest (CA). However, whether the quantitative characteristics of EEG, as potential indicators of neurological prognosis, are influenced by CA causes is unknown. The purpose of this study was designed to compare the quantitative characteristics of early post-resuscitation EEG between asphyxial CA (ACA) and ventricular fibrillation CA (VFCA) in rats. Read More

    Effectiveness of finger-marker for maintaining the correct compression point during paediatric resuscitation: A simulation study.
    Am J Emerg Med 2017 Apr 11. Epub 2017 Apr 11.
    Interdisciplinary Program of Bioengineering, Seoul National University Graduate School, Seoul, Republic of Korea. Electronic address:
    Objective: High-quality cardiopulmonary resuscitation is a significant factor for increasing the survival rate of paediatric patients. This study is to investigate the effectiveness of finger-marker stickers for maintaining the correct compression point during simulated infant cardiopulmonary resuscitation (CPR).

    Methods: This crossover simulation study was conducted with 40 emergency physicians and paramedics at emergency departments of 2 tertiary hospitals. Read More

    Automated External Defibrillators and Survival After Nonresidential Out of Hospital Cardiac Arrest in a Small North American City.
    Am J Cardiol 2017 Mar 29. Epub 2017 Mar 29.
    Department of Internal Medicine, Sinai Health System, Chicago, Illinois.
    Most studies demonstrate that the use of automated external defibrillators (AEDs) during out of hospital cardiac arrest is associated with survival, but the majority of these studies were performed in large cities. With this in mind, the aims of our study were to examine AED placement and variables associated with survival after nonresidential out of hospital cardiac arrest (NROHCA) in a small North American city. Cases of NROHCA and locations with AEDs, in Regina, between January 2010 and December 2014 were reviewed. Read More

    Do pre-hospital poisoning deaths differ from in-hospital deaths? A retrospective analysis.
    Scand J Trauma Resusc Emerg Med 2017 May 8;25(1):48. Epub 2017 May 8.
    Department of Anesthesiology, Division of Intensive Care Medicine, Oulu University Hospital, P.O. BOX 21, 90029 OYS, Oulu, Finland.
    Background: Most fatal poisonings occur outside the hospital and the victims found dead. The purpose of this study was to determine the general pattern and patient demographics of fatal poisonings in Northern Finland. In particular, we wanted to analyze differences between pre-hospital and in-hospital deaths. Read More

    Mountain rescue cardiopulmonary resuscitation: a comparison between manual and mechanical chest compressions during manikin cardio resuscitation.
    Emerg Med J 2017 May 5. Epub 2017 May 5.
    Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.
    Aim: Chest compression devices are useful during mountain rescue but may cause a delay in transport if not immediately available. The aims of this prospective observational study were to compare manual and mechanical cardiopulmonary resuscitation (CPR) during transport on a sledge connected to a snowmobile with a non-moving setting and to compare CPR quality between manual and two mechanical chest compression devices.

    Methods: Sixteen healthcare providers simulated four different combined CPR scenarios on a sledge in a non-moving setting and during transport and two mechanical chest compression devices during transport on the sledge. Read More

    The cost-effectiveness of a mechanical compression device in out of hospital cardiac arrest.
    Resuscitation 2017 May 2. Epub 2017 May 2.
    Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK; Heart of England NHS Foundation Trust, Bordesley Green, Birmingham, B9 5SS, UK.
    Aim: To assess the cost-effectiveness of LUCAS-2, a mechanical device for cardiopulmonary resuscitation (CPR) as compared to manual chest compressions in adults with non-traumatic, out-of-hospital cardiac arrest.

    Methods: We analysed patient-level data from a large, pragmatic, multi-centre trial linked to administrative secondary care data from the Hospital Episode Statistics (HES) to measure healthcare resource use, costs and outcomes in both arms. A within-trial analysis using quality adjusted life years derived from the EQ-5D-3L was conducted at 12-month follow-up and results were extrapolated to the lifetime horizon using a decision-analytic model. Read More

    Kids (learn how to) save lives in the school with the serious game Relive.
    Resuscitation 2017 May 2;116:27-32. Epub 2017 May 2.
    Italian Resuscitation Council (IRC), Scientific Committe, Bologna, Italy; Department of Anaesthesia and Intensive Care, Ospedale Maggiore, Bologna, Italy.
    Introduction: Relive is a serious game focusing on increasing kids and young adults' awareness on CPR. We evaluated the use of Relive on schoolchildren.

    Methods: A longitudinal, prospective study was carried out in two high schools in Italy over a 8-month period, divided in three phases: baseline, competition, and retention. Read More

    Lower chest compression fraction associated with ROSC in OHCA patients with longer downtimes.
    Resuscitation 2017 May 2;116:60-65. Epub 2017 May 2.
    Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, WA, Australia; St John Ambulance, Western Australia, Belmont, WA, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Discipline of Emergency Medicine, University of Western Australia, Crawley, WA, Australia.
    Aim: To investigate the relationship between chest compression fraction (CCF) and survival outcomes in OHCA, including whether the relationship varied based upon downtime from onset of arrest to provision of cardiopulmonary resuscitation (CPR) by emergency medical services (EMS).

    Methods: Data from resuscitations performed by St John Ambulance Western Australia (SJA-WA) paramedics between July 2014 and June 2016 was captured using the Q-CPR feedback device. Logistic regression analysis was used to study the relationship between CCF and return of spontaneous circulation (ROSC). Read More

    The association between AHA CPR quality guideline compliance and clinical outcomes from out-of-hospital cardiac arrest.
    Resuscitation 2017 May 2;116:39-45. Epub 2017 May 2.
    University of British Columbia, Vancouver, British, Colombia.
    Background: Measures of chest compression fraction (CCF), compression rate, compression depth and pre-shock pause have all been independently associated with improved outcomes from out-of-hospital (OHCA) cardiac arrest. However, it is unknown whether compliance with American Heart Association (AHA) guidelines incorporating all the aforementioned metrics, is associated with improved survival from OHCA.

    Methods: We performed a secondary analysis of prospectively collected data from the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest database. Read More

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