Emergency Cardiopulmonary Resuscitation Research Articles

Influence of Hospice Palliative Care on Medical Service Usage in Prolonged Mechanical Ventilation Cases: A Nationwide Cohort Study.

Numerous studies have demonstrated that hospice palliative care interventions for cancer patients can reduce health care utilzation. In Taiwan, 20-25% of patients who require mechanical ventilation are using prolonged mechanical ventilation (PMV); however, only a limited number of studies have addressed the effectiveness of hospice palliative care for these patients. This study investigated the impact of hospice palliative care utilization on medical utilization among subjects using PMV. By using the health insurance database of a nationwide population-based study, we identified subjects who had been on mechanical ventilation for > 21 d, were age ≥18 y between 2009 and 2017, and had received hospice palliative care. The control group was formed through 1:1 matching by using propensity scoring after excluding patients who had participated in palliative care for <15 d or for >181 d. Furthermore, we used a conditional logistic regression analysis to investigate the incidence of ICU admission, emergency department presentation, and cardiopulmonary resuscitation within 14 d before death. A total of 186,533 new subjects receiving PMV age ≥ 18 y were admitted between 2009 and 2017. In addition, the number of subjects receiving palliative care increased annually, rising from 0.6% in 2009 to 41.33% in 2017. The emergency department visits (odds ratio [OR] 0.68, 95% CI 0.63-0.74), ICU admission (OR 0.59, 95% CI 0.53-0.66), cardiopulmonary resuscitation (OR 0.40, 95% CI 0.35-0.46), and total hospitalization cost ($1,319.91 ± $1,821.66 versus $1,544.37 ± $2,309.27 [$USD], P < .001) were significant lower in the palliative care group. Subjects undergoing PMV while receiving hospice palliative care experienced significant reductions in total hospitalization costs, ICU admissions, cardiopulmonary resuscitation, and medical expenses within 14 d before death.

Impact of quality control circles on the quality and outcomes of in-hospital emergency cardiopulmonary resuscitation.

Impact of quality control circles on the quality and outcomes of in-hospital emergency cardiopulmonary resuscitation.

Pre-hospital emergency medicine: a spectrum of imaging findings.

The goal of emergency medical services (EMS) is to provide urgent medical care and stabilization prior to patient transport to a healthcare facility for definitive treatment. The number and variety of interventions performed in the field by EMS providers continues to grow as early management of severe injuries and critical illness in the pre-hospital setting has been shown to improve patient outcomes. The sequela of many field interventions, including those associated with airway management, emergent vascular access, cardiopulmonary resuscitation (CPR), patient immobilization, and hemorrhage control may be appreciated on emergency department admission imaging. Attention to these imaging findings is important for the emergency radiologist, who may be the first to identify a malpositioned device or an iatrogenic complication arising from pre-hospital treatment. Recognition of these findings may allow for earlier corrective action to be taken in the acute care setting. This review describes common EMS interventions and their imaging findings.

Volunteer Responder Interventions in Out-of-Hospital Cardiac Arrest in Urban, Suburban, and Rural Areas.

Patients with out-of-hospital cardiac arrest (OHCA) in rural areas experience longer emergency response times and have lower survival rates compared with patients in urban areas. Volunteer responders might improve care and outcomes for patients with OHCA specifically in rural areas. Therefore, we investigated volunteer responder interventions based on the degree of urbanization. We included 1310 OHCAs from 3 different regions in Denmark where volunteer responders had arrived at the OHCA location. The location was classified as urban, suburban, or rural according to the Eurostat Degree of Urbanization Tool. A logistic regression model was used to examine associations between the degree of urbanization and volunteer responder arrival before emergency medical services, cardiopulmonary resuscitation, or defibrillation. We found the odds for volunteer responder arrival before emergency medical services more than doubled in rural areas (odds ratio [OR], 2.60 [95% CI, 1.91-3.53]) and suburban areas (OR, 2.05 [95% CI, 1.56-2.69]) compared with urban areas. In OHCA cases where volunteer responders arrived first, odds for bystander cardiopulmonary resuscitation was tripled in rural areas (OR, 3.83 [95% CI, 1.64-8.93]) and doubled in suburban areas (OR, 2.27 [95% CI, 1.17-4.41]) compared with urban areas. Bystander defibrillation was more common in suburban areas (OR, 1.53 [95% CI, 1.02-2.31]), where almost 1 out of 4 patients received bystander defibrillation, compared with urban areas. Volunteer responders are significantly more likely to arrive before emergency medical services in rural and suburban areas than in urban areas. Patients with OHCA received more cardiopulmonary resuscitation in rural and suburban areas and more defibrillation in suburban areas than in urban areas.

Effectiveness of an E-learning System for Emergency Signs and CPR Emergency Preparedness in Marathon Events: A Comparative Study

This study investigates the implementation, effectiveness, and impact of a unique e-learning system designed specifically for emergency signs and cardiopulmonary resuscitation (CPR) emergency preparedness in marathon events. Our approach introduces the first e-learning system specifically designed for marathon events. It delivers engaging content, including infographic stories, expert lectures, and interactive modules, to provide registered runners with comprehensive knowledge of first aid and emergency signs for CPR. To evaluate the e-learning application, we conducted a comparative experiment during the CMU (Chiang Mai University) marathon with 9,761 participants. We used pre- and post-tests, as well as a survey questionnaire. The results showed significant improvements in participants’ CPR knowledge across all educational backgrounds. The integration of e-learning into the registration process contributed to a safer marathon environment, as participants felt more confident in handling emergencies. Approximately 85% of participants expressed a willingness to recommend the e-learning system. This increased confidence among participants in handling emergencies benefits both runners and marathon organizers by enhancing safety measures and emergency response during events. In conclusion, our findings strongly support the integration of e-learning into the registration process for marathon events. Recommendations based on our research include providing comprehensive guidelines for other marathon events, instilling stakeholder confidence, and emphasizing the suitability of e-learning for medium- to largescale events. However, caution is advised for smaller events due to potential complexities and costs. Additionally, we suggest limiting the validity of e-certificates to ensure that participants have up-to-date CPR knowledge.

Design and Evaluation of CPR Emergency Equipment for Non-Professionals.

Sudden cardiac death is a sudden and highly fatal condition. Implementing high-quality emergency cardiopulmonary resuscitation (CPR) early on is an effective rescue method for this disease. However, the rescue steps of CPR are complicated and difficult to remember, and the quantitative indicators are difficult to control, which leads to a poor quality of CPR emergency actions outside the hospital setting. Therefore, we have developed CPR emergency equipment with a multisensory feedback function, aiming to guide rescuers in performing CPR through visual, auditory, and tactile interaction. This equipment consists of three components: first aid clothing, an audio-visual integrated terminal, and a vital sign detector. These three components are based on a micro-power WiFi-Mesh network, enabling the long-term wireless transmission of the multisensor data. To evaluate the impact of the multisensory feedback CPR emergency equipment on nonprofessionals, we conducted a controlled experiment involving 32 nonmedical subjects. Each subject was assigned to either the experimental group, which used the equipment, or the control group, which did not. The main evaluation criteria were the chest compression (CC) depth, the CC rate, the precise depth of the CC ratio (5-6 cm), and the precise rate of the CC ratio -(100-120 times/min). The results indicated that the average CC depth in the experimental group was 51.5 ± 1.3 mm, which was significantly better than that of the control group (50.2 ± 2.2 mm, p = 0.012). Moreover, the average CC rate in the experimental group (110.1 ± 6.2 times/min) was significantly higher than that of the control group (100.4 ± 6.6 times/min) (p < 0.001). Compared to the control group (66.37%), the experimental group showed a higher proportion of precise CC depth (82.11%), which is closer to the standard CPR rate of 100%. In addition, the CC ratio of the precise rate was 93.75% in the experimental group, which was significantly better than that of 56.52% in the control group (p = 0.024). Following the experiment, the revised System Availability Scale (SUS) was utilized to evaluate the equipment's usability. The average total SUS score was 78.594, indicating that the equipment's acceptability range was evaluated as 'acceptable', and the overall adjective rating was 'good'. In conclusion, the multisensory feedback CPR emergency equipment significantly enhances the CC performance (CC depth, CC rate, the precise depth of CC ratio, the precise rate of CC ratio) of nonprofessionals during CPR, and the majority of participants perceive the equipment as being easy to use.

Prone cardiopulmonary resuscitation: an intensive care unit case series

Background: Critically ill patients frequently receive mechanical ventilation in the prone position. If hypoxic respiratory failure progresses, pulseless events requiring emergent cardiopulmonary resuscitation may occur. Administering cardiopulmonary resuscitation in the prone position provides an opportunity to initiate chest compressions quickly, eliminating delays in resuscitative efforts.

P059 Composition of intra-hospital emergency teams’ personnel: a comparison of Medical Emergency Teams and Cardiopulmonary Resuscitation Teams in Austria

P059 Composition of intra-hospital emergency teams’ personnel: a comparison of Medical Emergency Teams and Cardiopulmonary Resuscitation Teams in Austria

National survey of do not attempt resuscitation decisions on out-of-hospital cardiac arrest in China

BackgroundTo investigate and understand the determinants of decisions not to attempt resuscitation following out-of-hospital cardiac arrest, to contribute to establishing rules that are appropriate to China.MethodsWe recruited participants through directors of emergency medical services across China. A 28-question web survey was available between February 5 and March 6, 2021 that targeted demographic information and views on emergency work and cardiopulmonary resuscitation. Each question was assigned a value between 1 and 7 based on the level of importance from low to high. T-tests, one-way analysis of variance, and Kruskal–Wallis H-tests were used to compare continuous variables. Binary logistic regression analysis was used to identify factors influencing when people considered it suitable to initiate cardiopulmonary resuscitation.ResultsThe study involved 4289 participants from 31 provinces, autonomous regions and municipalities in mainland China, of whom 52.8% were male. The top three reasons for not attempting cardiopulmonary resuscitation were decomposition/hypostasis/rigor mortis (6.39 ± 1.44 points), massive injury (4.57 ± 2.08 points) and family members’ preference (4.35 ± 1.98 points). In total, 2761 (64.4%) thought emergency services should not attempt cardiopulmonary resuscitation when cardiac arrest had happened more than 30 min before, and there had been no bystander cardiopulmonary resuscitation. Gender (OR 1.233, p = 0.002), religion (OR 1.147, p = 0.046), level (OR 0.903, p = 0.028) or classification of city (OR 0.920, p = 0.049), years of work experience (OR 0.884, p = 0.004), and major (OR 1.032, p = 0.044) all influenced how long after cardiac arrest was considered suitable for initiating cardiopulmonary resuscitation.ConclusionsChinese emergency physicians have different perceptions of when not to attempt resuscitation to those practicing elsewhere. The existing guidelines for resuscitation are not suitable for China, and China-specific guidelines need to be established.

Design and application of rescue stretcher dedicated for cardiopulmonary resuscitation mechanical compression device

Continuous chest compressions during the transportation of patients with cardiac arrest have always been a difficult part in the field of pre-hospital emergency cardiopulmonary resuscitation (CPR). How to ensure continuous high-quality chest compressions is an important part of the patient's entire rescue process. At present, mechanical compression devices are commonly used to provide continuous high-quality chest compressions during the transportation. However, the installation process of the mechanical compression device involves posture changes of the patient, the placement of the device base, etc., and it is very likely to affect the continuous high-quality CPR treatment in the pre-hospital emergency process with limited human resources. Therefore, the First Affiliated Hospital of Huzhou University and Huzhou University jointly designed a rescue stretcher dedicated for CPR mechanical compression device, and has obtained the national utility model patent (ZL 2019 2 1005444.9). The main design feature of this stretcher is that the base of the compression device is combined with the stretcher, which eliminates the installation and fixation process of the base during the installation of the mechanical compression device, shortens the installation time. It has certain clinical applications value.

Successful treatment of severe electrolyte imbalance-induced cardiac arrest caused by adrenal tuberculosis with ECMO in the ED

BackgroundTuberculosis (TB) is a chronic infectious disease, common in China. TB bacteria can invade multiple organs throughout the body, but they rarely cause critical illness. We present a complex critically ill case in this report.Case presentationA 40-year-old man suffered sudden cardiac arrest during an emergency room visit. Spontaneous circulation resumed after emergency cardiopulmonary resuscitation (CPR), but recurrent ventricular fibrillation and refractory cardiac shock emerged. Thereafter, extracorporeal membrane oxygenation (ECMO) was implemented to maintain hemodynamic stability. Blood test results revealed that the patient had severe electrolyte imbalance and adrenal insufficiency. Further imaging examination showed multiple tuberculosis lesions throughout the body, including the lungs, adrenal glands, and lumbar spine. In the end, the patient was successfully moved from the ICU after weaning from ECMO and the ventilator, and then transferred to an infectious disease specialist hospital for standard anti-tuberculosis therapy.ConclusionsECMO has won the opportunity for the diagnosis and treatment of this young patient who suffered from a rare cause of cardiac arrest and finally achieved a good prognosis.

The Usefulness of Laryngeal Tube in Airway Maintenance and Intermittent Positive Pressure Ventilation for Paramedics

Background: Supraglottic airway devices (SADs) are used to keep the upper airway open and to provide unobstructed ventilation. The recent addition to SADs is the laryngeal tube (LT). It can be inserted blindly past the oropharynx into the hypopharynx to provide a patent airway and mechanical ventilation during emergency conditions and cardiopulmonary resuscitation. Aim: To evaluate the success rate and usefulness of LT insertion for airway maintenance and intermittent positive pressure ventilation on manikins by paramedical personnel. Methods: The technique of LT insertion was explained to 200 paramedical personnel, all of whom attempted its insertion three times; the maximum time allowed for 3 attempts was 3 min. The success rate in terms of ease of insertion, adequacy of ventilation and the audible leak was assessed. The average time taken for insertion and success rate in the first, second and third attempts was assessed. Confirmation was done by ventilation with a self-inflating bag and adequate lung inflation. Results: Average time taken for insertion of LT was 14.66 ± 4.96 s. With progressive attempts, the success rate improved to 86.5%, adequacy of ventilation to 96.5% and only a minimal leak was appreciated in all. Conclusion: The LT could be a reliable device for airway management in emergencies by paramedical personnel as all participants successfully placed it within three attempts with a very good success rate.

Resuscitation and COVID-19: Recalibrating Patient and Family Expectations Throughout a Virus

Resuscitation is that the method of correcting physiological disorders (such as lack of respiratory or heartbeat) in associate degree acutely unwell patient. It’s a crucial a part of medical aid drugs, trauma surgery and medical specialty. Standard examples are emergency procedure and cardiopulmonary resuscitation. The procedure of restoring to life, as in emergency procedure . In this page you'll be able to discover nineteen synonyms, antonyms, formulation expressions, and connected words for resuscitate, like: revive, restore to life, resurrect, save, revivify, restore, bring around, revitalize, reactivate, revivify and wake

Effect of Oropharyngeal Airway Tube with Mask Balloon Combined with Tracheal Intubation in the Treatment of Emergency Cardiopulmonary Resuscitation

Effect of Oropharyngeal Airway Tube with Mask Balloon Combined with Tracheal Intubation in the Treatment of Emergency Cardiopulmonary Resuscitation

COVID-19 and Resuscitationof the Patientand their Family Expectations Throughout the Treatment of the Virus

Resuscitation is that the method of correcting physiological disorders (such as lack ofrespiratory or heartbeat)in associate degree acutely unwell patient. It’s a crucial a part of medical aid drugs, trauma surgery and medical specialty. Standard examples are emergency procedure and cardiopulmonary resuscitation. The procedure of restoring to life, as in emergency procedure . In this page you'll be able to discover nineteen synonyms, antonyms, formulation expressions, and connected words for resuscitate, like: revive, restore to life, resurrect, save, revivify, restore, bring around, revitalize, reactivate, revivify and wake.

Assessing the Status of Yazd Province Medical Emergency and Accident Management Center in Terms of Necessary Standards for Air Emergencies

Background: Air emergency medical services provide advanced medical care to patients and critically injured as soon as possible to reduce injuries and casualties. In this study, the status of the Medical Emergency and Accident Management Center in Yazd Province in terms of the necessary standards for air emergencies was investigated and compared with existing standards. Materials and Methods: The present research was a cross-sectional descriptive study. Using a researcher-made checklist, the required data, such as human resource requirements, physical and environmental space, time, communication equipment, medical equipment, equipment for traffic detection and management, and equipment for technical and safety services, were collected by asking relevant officials and experts. Finally, data analysis was performed using tables and descriptive statistics. Results: The study findings showed that in total, 2 items in the field of human resource requirements, 7 items in physical space and environmental requirements, 2 items regarding time requirements, 4 items regarding communication equipment requirements, 43 items regarding equipment and medicine requirements, including patient cabin equipment, emergency resuscitation kit and Cardiopulmonary Resuscitation (CPR), medicine and jump bag equipment, delivery set, triage bag, dressing equipment and technical and safety service equipment requirements were in accordance with the existing standards. Conclusion: Based on the existing standards, the air emergency in Yazd Province in most areas was satisfactory. Because of the importance of the issue, authorities must take the necessary measures to address the deficiencies and limitations so that the emergency missions be carried out in the best conditions.

Designing and implementing a practical prehospital emergency trauma care curriculum for lay first responders in Guatemala

BackgroundInjury disproportionately affects low-income and middle-income countries, yet robust emergency medical services are often lacking to effectively address the prehospital injury burden. A half-day prehospital emergency trauma care curriculum was...

Safety of inter-hospital transfer of patients with acute ischemic stroke for evaluation of endovascular thrombectomy

Stroke networks facilitate access to endovascular treatment (EVT) for patients with ischemic stroke due to large vessel occlusion. In this study we aimed to determine the safety of inter-hospital transfer and included all patients with acute ischemic stroke who were transferred within our stroke network for evaluation of EVT between 06/2016 and 12/2018. Data were derived from our prospective EVT database and transfer protocols. We analyzed major complications and medical interventions associated with inter-hospital transfer. Among 615 transferred patients, 377 patients (61.3%) were transferred within our telestroke network and had transfer protocols available (median age 76 years [interquartile range, IQR 17], 190 [50.4%] male, median baseline NIHSS score 17 [IQR 8], 246 [65.3%] drip-and-ship i.v.-thrombolysis). No patient suffered from cardio-respiratory failure or required emergency intubation or cardiopulmonary resuscitation during the transfer. Among 343 patients who were not intubated prior departure, 35 patients (10.2%) required medical interventions during the transfer. The performance of medical interventions was associated with a lower EVT rate and higher mortality at three months. In conclusion, the transfer of acute stroke patients for evaluation of EVT was not associated with major complications and transfer-related medical interventions were required in a minority of patients.

A survey of practice among doctors in India belonging to different specialities towards peripheral tracheal intubation calls

Introduction: Airway management in critically ill patients in emergency room and periphery wards is an essential component of resuscitation and is considered a high-risk procedure with one or more complications occurring in 22–54% of all intubations performed. As there are few hospitals in India with dedicated emergency physician available, the airway management in emergencies and peripheral wards is done by residents pooled from various specialities. This survey was conducted with objective to assess the challenges encountered during tracheal intubation in emergency settings outside the controlled environment of operation theatre and to know the complications occurring during airway management in these scenarios. Further assessment was conducted with objectives to assess the challenges and dilemma faced by them and to know complications and outcomes associated airway management in these cases. Materials and Methods: An anonymous 30 questions survey was sent online to 500 doctors from different branches in India as online google forms via email. Data pertaining to respondent demographics, practice characteristics (including availability of resources, medications and equipment’s) were collected and analysed descriptively using different frequencies and percentages and Fisher’s exact tests followed by post hoc multiple comparisons. Results: 248 residents filled up the questionnaire, 78% were anaesthesiologists, and rest were from different medical branches. Ninety-seven percentage felt the need for display of protocol regarding the guidelines for intubation and cardiopulmonary resuscitation in emergency and periphery locations. All participants felt the need for teaching residents from all specialities to manage peripheral intubation calls. Conclusions: Airway management at periphery locations is challenging and needs the implementation of algorithms including the new airway devices. Finally, the standard airway guidelines for difficult airway managem

Observation on the effect of platinum ten minutes ambulance mode in pre-hospital emergency

Objective To explore the effect of platinum ten minutes ambulance mode in pre-hospital emergency. Methods From January 2015 to June 2016, a total of 816 patients who underwent pre-hospital emergency treatment in the emergency department of the hospital were selected.Descriptive investigation and analysis were conducted on the composition ratio of disease classification and the influencing factors of cardiopulmonary resuscitation in emergency patients.According to the analysis results, patients with two types of diseases (cardiovascular and cerebrovascular diseases and sudden death) with relatively large classification and sensitivity to platinum 10-minute intervention measures were selected as the target population for the later intervention study.From June 2015 to June 2016, 273 patients who received pre-hospital emergency treatment due to cardiovascular and cerebrovascular diseases and sudden death in the hospital were selected.Divided into two layers according to disease types, 129 cases in the intervention group and 144 cases in the control group were randomly divided into two layers.The control group received routine pre-hospital emergency procedures, and the intervention group implemented platinum 10-minute mode on this basis.The morbidity, mortality, length of hospital stay, nursing satisfaction and incidence of medical disputes were compared between the two groups. Results The results of baseline investigation showed that the proportion of prehospital emergency diseases in the hospital was dominated by cardiovascular and cerebrovascular diseases, sudden death and other diseases. The factors influencing the rate of pre-hospital emergency cardiopulmonary resuscitation were accurate information reception, cardiogenic diseases, clarity of disease description and radius. Intervention studies based on baseline survey data showed that there were statistically significant differences in disability rate, case fatality rate, length of stay and nursing satisfaction between the two groups(P<0.05). Conclusion Applying platinum 10-minute mode in pre-hospital first aid has certain effects on improving the timeliness, filling the and medical blank of blind area of rescue , improving the prognosis of patients, shortening hospitalization time and improving nursing satisfaction. Key words: Platinum ten minutes; Pre-hospital emergency; Intervention study