Success Of Cardiopulmonary Resuscitation Research Articles

The Rate of Success of CPR in Patients Suffering from Cardiac Arrest in Patients Admitted in CCU in Cardiology Department Ayub Medical Teaching Institute

Cardiopulmonary resuscitation (CPR) is an essential procedure used to treat patients who are in cardiac arrest, particularly in the Critical Care Unit (CCU). Objective: To assess the success rate of CPR admitted to the CCU, revealing insight on the effectiveness of current resuscitation techniques. Methods: This retrospective study was conducted at Department of Cardiology Ayub Medical Teaching Institute, Abbottabad, between 13th April 2023 to 30th November 2023, 110 patients had cardiac arrest while in the intensive care unit. Data were gathered and examined on patient demographics, pre-existing comorbidities, time to start CPR, duration of CPR, and results. CPR success was defined as a sustained restoration of spontaneous circulation (ROSC) for at least 20 minutes. Results: This study included 110 cardiac patients. Most patients (68.18%) were male. Hypertension was the most common comorbidity at 72.7%. CPR started on average 4.8 minutes late, with a 1.2-minute standard deviation. The average CPR time was 18.2 minutes, with a 5.6-minute SD. After cardiac arrest, 60 (54.5%) patients began CPR within 5 minutes. Another subgroup found 96.0% CPR success in 25 (22.7%) ventricular fibrillation patients. Then occurred ventricular tachycardia (80.0%), pulseless electrical activity (76.0%), and asystole (68.9%). These data suggest that CPR works better in ventricular fibrillation patients. Conclusions: This research sheds light on cardiac arrest CCU patients' demographics, care, and outcomes. The data show that early CPR and ventricular fibrillation detection and treatment improve outcomes for these individuals.

Cardiorespiratory arrest due to grade IV anaphylactic shock with succinylcholine , report of a case and review of the literature.

Anaphylactic shock caused by anesthetic agents is a serious complication that can lead to the death of the patient despite well-conducted resuscitation. Succinylcholine is the primary source of anaphylactic shock in anesthesia. Used for over 60 years as the product of choice in emergency situations and during difficult intubation; its use is wide in all countries of the globe. We report the observation of a 77-year-old patient who underwent ophthalmological surgery under general anesthesia. After induction with propofol and placement of a laryngeal mask, a decision to orotracheal intubation was made given the ventilation difficulties. An anesthetic protocol combining a hypnotic to deepen the narcosis with propofol and curarization using suxamethonium was chosen. A few minutes after intubation, ventilator capnia is undetectable and the pulse is unobtainable while an ECG tracing persists. CPR is performed by external cardiac massage, bolus injection of adrenaline (4 mg in cumulative doses) associated with manual ventilation with FIO2 at 100%, cessation of any current product, filling with crystalloids and 250ml of bicarbonate 4, 2%. An effective pulse and blood pressure are found after no-flow for one (1) minute and low-flow for 10 minutes. Samples were taken for additional explorations. With the success of cardiopulmonary resuscitation and non-urgent surgery, it was decided not to begin the intervention and to transfer the patient to intensive care for continued treatment in the face of suspicion of serious anaphylactic shock. After twenty-four (24) hours of monitoring, he was extubated and his release from intensive care was authorized after the seventy-second hours. The allergological consultation carried out after the event concluded that there was allergic hypersensitivity to suxamethonium, a molecule contraindicated for life in this patient.

Effective ventilation and chest compressions during neonatal resuscitation – the role of the respiratory device

Background The success of cardiopulmonary resuscitation (CPR) in newborns largely depends on effective lung ventilation; however, a direct randomized comparison using different available devices has not yet been performed. Methods Thirty-six professionals were exposed to a realistic newborn CPR scenario. Ventilation with either a bag-valve mask (BVM), T-piece, or ventilator was applied in a randomized manner during CPR using a Laerdal manikin. The primary outcome was the number of unimpaired inflations, defined as the peak of the inflation occurring after chest compression and lasting at least 0.35 s before the following chest compression takes place. The secondary outcomes were tidal volume delivered and heart compression rate. To simulate potential distractions, the entire scenario was performed with or without a quiz. Statistically, a mixed model assessing fixed effects for experience, profession, device, and distraction was used to analyze the data. For direct comparison, one-way ANOVA with Bonferroni‘s correction was applied. Results The number of unimpaired inflations was highest in health care professionals using the BVM with a mean ± standard deviation of 12.8 ± 2.8 (target: 15 within 30 s). However, the tidal volumes were too large in this group with a tidal volume of 42.5 ± 10.9 ml (target: 25–30 ml). The number of unimpaired breaths with the mechanical ventilator and the T-piece system were 11.6 (±3.6) and 10.1 (±3.7), respectively. Distraction did not change these outcomes, except for the significantly lower tidal volumes with the T-piece during the quiz. Conclusions In summary, for our health care professionals, ventilation using the mechanical ventilator seemed to provide the best approach during CPR, especially in a population of preterm infants prone to volutrauma.

Abstract 197: Establishing a Novel Pulse Wave Velocity-Guided Mouse Model of Cardiac Arrest With Different Durations

Background: Neurological and cardiovascular injuries are the leading causes of death following cardiac arrest (CA). Few rodent models recapitulate these post-resuscitation symptoms. Aims: To develop extended ischemic CA models under Pulse Wave Velocity ( PWV) guidance with consistent post-CA brain injury (PCABI) and coronary dysfunction as potential therapeutic targets and mechanical studies. Methods: Forty-eight mice were randomized into four experimental groups (control, 8-, 12-, and 16-min CA). Potassium chloride (KCL) was intravenously injected, resulting in immediate asystole. Mice were resuscitated with an injection of epinephrine and manual chest compressions. PWV was monitored for the left carotid artery velocity and coronary flow reserve (CFR). Resuscitability, synaptic density in the hippocampal CA1 region, blood-brain barrier (BBB), and neurologic deficit scores (NDS) were also evaluated. Results: The PWV could monitor rapid asystole after KCL injection, improve cardiopulmonary resuscitation (CPR) success rates, and avoid the pre-matured end of resuscitation. Compared to the standard control, mice with 8-min CA had preserved CFR, mild loss of synaptic density (p>0.05), mild hypothermal, and a normal electrocardiogram. They maintained BBB integrity with no significant change to neurologic function. Compared with a 92% CPR success rate in 8 min-CA mice, 12 min-CA mice had 83%, and 16 min-CA mice had 58% resuscitability. Twelve min-CA mice had significantly impaired CFR at 24 hours and high lethality (40%, P<0.05) within the first three days; 16 min-CA mice worsened (33% survival rate, p<0.01). The 24 hrs electron microscope showed that CA-induced synaptic vesicle densities were ischemic time-dependent [350±60 (control) vs. 289±64 (8 min CA) vs. 269±34 (12 min CA) vs. 181±41/field (16 min CA)], consistent with NDS. The cerebrum and hippocampus were the most valuable regions, indicated by Evans blue evaluation at 48 hrs after CA. Conclusions: We established elongated PWV-guided CA models as with successful CPR, post-CA neurological deficits, leaky BBB, loss of synaptic density, coronary endothelial dysfunction, and even death in mice, which closely recapitulated the post-resuscitation symptoms in survived patients after CPR.

Prehospital resuscitation : Current status, results and strategies for improvement in Germany

Out-of-hospital cardiac arrest (OHCA) is one of the most frequent causes of death in Europe and is associated with adismal prognosis. The annual incidence in Germany is approximately 100-120 per 100,000 inhabitants (ca. 80,000-100,000 cases). With the use of cardiopulmonary resuscitation (CPR) about 40% of patients have areturn of spontaneous circulation (ROSC); however, after OHCA only 15% of patients survive for 30 days and less than 10% survive with no or only minor neurological deficits. Data from the German Resuscitation Register demonstrate that there was no change in the results over the last 15years, despite all medical innovations, higher rates of coronary interventions, higher use of mechanical support systems and improvement in intensive care treatment. Ahigh proportion of patients with OHCA have acardiac or coronary cause. As shown by the data from the German Cardiac Arrest Register (G-CAR) an early coronary angiography is often carried out after CPR in Germany; however, in randomized clinical studies an immediate coronary angiography in patients with non-ST segment elevation in the electrocardiogram (ECG) was not associated with an improvement in the prognosis. In large randomized studies the use of mechanical CPR systems and the implantation of mechanical circulatory support devices after OHCA also did not lead to a reduction in mortality. The most important impact factor for the success of CPR is the time interval between collapse and start of CPR, if possible also by bystander resuscitation. Therefore, the focus of efforts for improving CPR should be on increasing the rate of patients with early CPR. Experiences from Denmark and The Netherlands indicate that this can be successful by education and training of the general population, telephone resuscitation and apps for alerting lay persons.

Prediction of Return of Spontaneous Circulation in a Pediatric Swine Model of Cardiac Arrest Using Low-Resolution Multimodal Physiological Waveforms.

Monitoring physiological waveforms, specifically hemodynamic variables (e.g., blood pressure waveforms) and end-tidal CO2 (EtCO2), during pediatric cardiopulmonary resuscitation (CPR) has been demonstrated to improve survival rates and outcomes when compared to standard depth-guided CPR. However, waveform guidance has largely been based on thresholds for single parameters and therefore does not leverage all the information contained in multimodal data. We hypothesize that the combination of multimodal physiological features improves the prediction of the return of spontaneous circulation (ROSC), the clinical indicator of short-term CPR success. We used machine learning algorithms to evaluate features extracted from eight low-resolution (4 samples per minute) physiological waveforms to predict ROSC. The waveforms were acquired from the 2nd to 10th minute of CPR in pediatric swine models of cardiac arrest (N = 89, 8-12 kg). The waveforms were divided into segments with increasing length (both forward and backward) for feature extraction, and machine learning algorithms were trained for ROSC prediction. For the full CPR period (2nd to 10th minute), the area under the receiver operating characteristics curve (AUC) was 0.93 (95% CI: 0.87-0.99) for the multivariate model, 0.70 (0.55-0.85) for EtCO2 and 0.80 (0.67-0.93) for coronary perfusion pressure. The best prediction performances were achieved when the period from the 6th to the 10th minute was included. Poor predictions were observed for some individual waveforms, e.g., right atrial pressure. In conclusion, multimodal waveform features carry relevant information for ROSC prediction. Using multimodal waveform features in CPR guidance has the potential to improve resuscitation success and reduce mortality.

The Effectiveness of In-service Training Course on Adult Cardiopulmonary Resuscitation Based on the Kirkpatrick Model

Background: Cardiopulmonary arrest is one of the most critical medical emergencies in the emergency department. Nurses’ knowledge and skills play an essential role in successful cardiopulmonary resuscitation. Therefore, holding in-service training courses is considered vital. Objectives: This study evaluated the effectiveness of an in-service training course (ISTC) on adult cardiopulmonary resuscitation (CPR) based on the Kirkpatrick model. Methods: This cross-sectional descriptive study was conducted on 50 emergency department nurses of 5-Azar Hospital in Gorgan, Iran. Training effectiveness was implemented on the four levels of Kirkpatrick's model (including reaction, learning, performance, and findings). The raw data were analyzed by the SPSS version 21 software with descriptive statistics (frequency, mean and standard deviation) and inferential statistics (including Paired t-test and Independent Samples t-test) in a significant level of α = 0.05. Results: The overall effectiveness of ISTC for adult CPR was reported as 83.23%. The chance of cardiopulmonary resuscitation success increased from 25% in the first six months to 53% in the second six months. In addition, the effectiveness of ISTC was observed in the four levels of the Kirkpatrick model. Conclusions: Based on the findings, in-service CPR training had a favorable effect on all four levels of the Kirkpatrick model for nurses. The findings of this study significantly increased the efficiency of personnel because evaluating the quality of training courses made them more effective.

The success rate of cardiopulmonary resuscitation and its correlated factors in patients with emergency prehospital cardiac arrest

ABSTRACT To assess the initial success rate and its correlated factors on cardiopulmonary resuscitation (CPR) in emergency prehospital cardiac arrest patients. The clinical information of 429 patients with cardiac arrest who underwent prehospital CPR in the fourth hospital of Hebei Medical University from Jan 2020 to Apr 2022 were evaluated. The patients were divided into the successful group (ROSC, n = 25) and the unsuccessful group (non-ROSC, n = 404) according to whether the autonomous circulation (ROSC) was resumed. The univariate analysis was performed to evaluate the differences in age, the start time of CPR, the application of electric defibrillation, and other related data between the two groups. The multivariate analysis evaluated protective factors affecting CPR’s success in prehospital cardiac arrest patients. Patients with cardiogenic causes had the highest success rate of cardiopulmonary resuscitation. The causes of traffic accidents and drowning account for a low proportion. Furthermore, the median CPR length was 25.0 min, alternating from 1.5 to 64 mi. The univariate analysis revealed that age, the start time of CPR, application of electric defibrillation, and adrenaline dosage were correlated with CPR attempts (p < 0.05). Multivariate logistic regression analysis showed that the age of patients with prehospital CA, the location of prehospital CA, etiology, bystander CPR, CPR start time, defibrillation start time, tracheal intubation time, type of rhythm before resuscitation, adrenaline dosage <5 mg, and adrenaline administration time were all the influencing factors of prehospital CPR success (p < 0.01). The factors affecting CPR’s success rate in prehospital CA patients are complicated. Establishing a few procedures to diminish the incidence of these risk factors is crucial.

Comparison of code blue application and results in a training and research hospital before and during the COVID-19 pandemic

Background &amp; Objective: Code blue is an emergency management system that allows for a rapid professional response to the patients of cardiopulmonary arrest (CPA) in hospitals. The time to initiate the call and the response of the ‘Code Blue Team’ may vary in different hospitals, and it me be linked with the survival of the victim. We examined and compared the code blue application utilized in our hospital before and during the COVID-19 pandemic.&#x0D; Methodology: Code Blue Call (CBC) logs from March 01, 2018 to March 31, 2022 were retrospectively analyzed. The study period was divided into two parts: March 01, 2018–February 28, 2020 (Group I, pre-pandemic period) and March 01, 2020–March 31, 2022 (Group II, pandemic period).&#x0D; Results: During the study period, a total of 1542 CBC’s were received, of which 837 (54.3%) were ‘true’ CBC’s. Of the 837 true CBC’s included in the study, 477 (56.7%) were for male patients and 360 (43.3%) were for the females. We evaluated the month-wise distribution of the CBC’s; the month with the highest number of calls in Group I was January 2019 (n = 29, 17.3%), while in Group II it was December 2020 (n = 59, 23.1%). The arrival time of the code blue team was significantly different between the groups, e.g., 3.15 ± 0.52 vs. 3.81 ± 0.58 min in Group I vs. Group II respectively.&#x0D; Conclusion: The intervention times of the code blue team and the success of cardiopulmonary resuscitation were observed to be comparable during the pre-pandemic and pandemic periods. The duration of commencement of intervention is important for the efficacy of cardiopulmonary resuscitation during a pandemic.&#x0D; Abbreviations: CBC: Code Blue Call; CBT: code blue team; COVID-19: Coronavirus Disease-19; CPA: cardiopulmonary arrest&#x0D; Key words: COVID-19; CPR; Code Blue; Pandemic&#x0D; Citation: Çelik HK, Kuşderci HS. Comparison of code blue application and results in a training and research hospital before and during the COVID-19 pandemic. Anaesth. pain intensive care 2022;27(1):123−130. DOI: 10.35975/apic.v27i1.2121&#x0D; Received: September 20, 2022; Reviewed: November 30, 2022; Accepted: December 01, 2022

IS CARDIOPULMONARY RESUSCITATION OUTCOME IN PRE-HOSPITAL EMERGENCY MEDICINE RELATED TO AIRWAY MANAGEMENT TECHNIQUE?

According to current European Resuscitation Council guidelines, priorities in advanced life support in adult are chest compression with minimal interruption and early defibrillation. Endotracheal intubation is still considered the gold standard in airway management, but guidelines suggest that securing the airway be incremental, ranging from basic techniques to more complex ones. Doctors who work in pre-hospital emergency medicine teams (EMT) in Croatia usually lack sufficient education and expertise. The aim of this study was to determine whether there was a significant difference in recovery of spontaneous circulation during cardiopulmonary resuscitation (CPR) in out-of-hospital setting depending on the EMT airway management technique of choice. This retrospective analysis included data collected during a 10-year period at the Krapina-Zagorje County Emergency Medicine Institute on all patients with CPR performed by EMTs 20 minutes from initial emergency call. The airway management groups included oropharyngeal tube, i-gel supraglottic device, and endotracheal tube. There were 968 patients, mean age 70. In 74.61% of patients, the cause of arrest was of cardiac etiology. Our study did not find a statistically significant in difference of CPR success among the three groups analyzed according to the airway management technique of choice (p=0.74, χ2-test).

Medical Students' Awareness, Knowledge, and Attitudes toward Basic Life Support at King Faisal University, Saudi Arabia

Background: Life-threatening emergencies can strike anytime, anywhere, and to anyone. The consequences of cardiopulmonary arrest are devastating, and the mortality rate is very high. Cardiopulmonary resuscitation (CPR) is initiated during cardiac arrest and involves breathing and chest compressions to supply immediate blood to the brain. CPR success rates vary depending on the circumstances of cardiopulmonary arrest (in-hospital as opposed to out-of-hospital, witnessed versus unwitnessed, Etc.) and the knowledge and skills of the health care personnel. Aim: This study aimed to determine the knowledge of BLS and related skills among undergraduate students from King Faisal University's medical colleges. Materials and Methods: a descriptive cross-sectional study was conducted between May 11 and July 15, 2022, with King Faisal University Students, Medical Colleges. The sample size of this study was 479. A structured questionnaire was utilized to assess participants' levels of awareness, practical knowledge, and attitudes toward BLS. Results: The results revealed a low level of students’ awareness of BLS. Only 59 (12.8%) of the respondents showed good knowledge of cardiopulmonary resuscitation (CPR) in newborns and adults. only 45 (9.8%) of the respondents had good knowledge about the choking of adults and infants. Only 15 (3.2%) of the participants had a "good" understanding of all BLS items. The study results also indicated that senior students were likelier than junior students to have good BLS knowledge, a statistically significant relationship. Attending BLS training classes and traditional sources of information were significant predictors of having good BLS knowledge. Conclusion: The study's findings revealed that medical and health college students had just a fair understanding of BLS. This finding indicates the essential need for ongoing refresher courses for this vital subject, particularly in the wake of pandemics like COVID-19.

Tele-Rapid Response Team (Tele-RRT): The effect of implementing patient safety network system on outcomes of medical patients-A before and after cohort study.

Rapid Response Teams were developed to provide interventions for deteriorating patients. Their activation depends on timely detection of deterioration. Automated calculation of warning scores may lead to early recognition, and improvement of RRT effectiveness. This was a "Before" and "After" study, in the "Before" period ward nurses activated RRT after manually recording vital signs and calculating warning scores. In the "After" period, vital signs and warning calculations were automatically relayed to RRT through a wireless monitoring network. When compared to the before group, the after group had significantly lower incidence and rate of cardiopulmonary resuscitation (CPR) (2.3 / 1000 inpatient days versus 3.8 / 1000 inpatient days respectively, p = 0.01), significantly shorter length of hospital stay and lower hospital mortality, but significantly higher number of RRT activations. In multivariable logistic regression model, being in the "After" group decreases odds of CPR by 33% (OR = 0.67 [95% CI: 0.46-0.99]; p = 0.04). There was no difference between groups in ICU admission. Automated activation of the RRT significantly reduced CPR events and rates, improved CPR success rate, reduced hospital length of stay and mortality, but increased the number of RRT activations. There were no differences in unplanned ICU admission or readmission.

Peripheral Arterial Compression as a New Adjunct Technique to Cardiopulmonary Resuscitation.

The success of cardiopulmonary resuscitation (CPR) is critically dependent on the maintenance of myocardial and cerebral perfusion; therefore, preferential perfusion of these vital organs over non-vital vascular beds, such as the extremities, is desirable. We propose that compression of the femoral and/or brachial arteries during CPR improves resuscitation outcomes.

Reassessment of mitochondrial cyclophilin D as a target for improving cardiac arrest outcomes in the era of therapeutic hypothermia

Uncertainty exists regarding whether cyclophilin D (CypD), a mitochondrial matrix protein that plays a key role in ischemia-reperfusion injury, can be a pharmacological target for improving outcomes after cardiac arrest (CA), especially when therapeutic hypothermia is used. Using CypD knockout mice (CypD-/-), we investigated the effects of loss of CypD on short-term and medium-term outcomes after CA. CypD-/- mice or their wild-type (WT) littermates underwent either 5 minute CA followed by resuscitation with and/or without hypothermia at 33°C-34°C (targeted temperature reached within minutes after resuscitation), or a sham procedure. Brain and cardiac injury were assessed using echocardiography, neurological scores, MRI and biomarkers. Seven day survival was compared using Kaplan-Meier estimates. The rate of restoration of spontaneous circulation was significantly higher in CypD-/- mice (with shorter cardiac massage duration) than in WT mice (P < 0.05). Loss of CypD significantly attenuated CA-induced release of troponin and S100ß protein, and limited myocardial dysfunction at 150 minutes after CA. Loss of CypD combined with hypothermia led to the best neurological and MRI scores at 24 hours and highest survival rates at 7 days compared to other groups (P < 0.05). In animals successfully resuscitated, loss of CypD had no benefits on day 7 survival while hypothermia was highly protective. Pharmacological inhibition of CypD with cyclosporine A combined with hypothermia provided similar day 7 survival than loss of CypD combined with hypothermia. CypD is a viable target to improve success of cardiopulmonary resuscitation but its inhibition is unlikely to improve long-term outcomes, unless therapeutic hypothermia is associated.

The Cardiopulmonary Resuscitation Success Rate and Its Related Factors in Patients Referred to Dr. Heshmat Hospital in Rasht, Iran

Background: Cardiopulmonary Resuscitation (CPR) is an emergency procedure for the return of spontaneous circulation in patients with cardiac arrest. Many factors can affect the success of CPR. Objective: This study aims to investigate the success rate of CPR and its related factors in patients referred to Dr. Heshmat Hospital in Rasht, Iran. Methods: In this retrospective cohort study, participants were 1008 patients who had underwent CPR in Dr. Heshmat Hospital in Rasht, Iran. Data were collected from April 2016 to March 2019 using the Utstein style standard form, which assesses related factors and the times related to CPR. The association between CPR outcome and demographic/clinical factors was examined using independent samples t-test, chi-square test, and multiple logistic regression analysis. Results: The CPR success rate was 34.8%. The CPR success rate was higher in patients with no asystole rhythm, short CPR duration, and in-hospital cardiac arrest. Compared to patients in CCU ward, those received CPR in other wards (except ICU) were more likely to have successful CPR. Furthermore, in patients with in-hospital cardiac arrest, the odds of successful CPR decreased with the increase of age. Conclusion: Since patients with asystole rhythm had the lowest success rate of CPR and this rhythm occurs due to delay in initiation of treatment at the end of cardiac arrest, early treatment of patients with cardiac arrest caused by ventricular tachycardia or ventricular fibrillation can increase the chances of a successful CPR.

Advanced Cardiovascular Life Support Performance: Study on the Effectiveness of Training among Nurses in a Tertiary Care Hospital, Karachi

Nurses are the integral part of health care delivery system and play a vital role in critical areas. Nurses are required to respond quickly and effectively in the situation of cardiac arrest and the success of cardiopulmonary resuscitation depends upon their competence. Nurses’ knowledge, preparedness and skills in regard to cardiopulmonary resuscitation have to be at advanced level. Hence, this study was conducted to determine the effectiveness of advanced cardiovascular life support training among nurses at a tertiary care hospital, Karachi, Pakistan.&#x0D; Study Design: Quasi-experimental (pre and post) study was employed.&#x0D; Place and Duration of Study: Study was accomplished at Dr. Ruth K.M Pfau Civil Hospital, Karachi for the period of ten months from December 2018 to September 2019.&#x0D; Methodology: Sample size was calculated through PASS version 11.0 with proportion formula, calculated sample size was 180 nurses. Nurses’ responses regarding advanced cardiovascular life support were assessed by validated and structured questionnaire. The collected data was analyzed by using SPSS version 21. The mean score of pre-test and post-test of advanced cardiovascular life support training were computed by using paired t-test. p-value ≤0.05 were considered as level of significance.&#x0D; Results: The pre mean of advanced cardiac life support score was 19.28±5.29. While, after training mean score of advanced cardiac life support score was 22.38±4.0. It is also statistically significant (p&lt;0.001).&#x0D; Conclusion: Successful resuscitation in patients with cardiac emergencies necessitates early credit of condition, prompt activation of responders, timely and effective basic life support and timed defibrillation when needed. Formal basic life support and advanced cardiovascular life support trainings are essential for nurses to enhance their skills that lead to improve victim survival after cardiopulmonary resuscitation.

The unrealistic expectations of CPR success: a comparative public survey of Saudi Arabia and the United States

Background: Success rates of cardiopulmonary resuscitation (CPR) in in-hospital cardiac arrest (INCA) and out-of-hospital cardiac arrest OOHCA is reported to be 15% and 3%, respectively. However, people in the general population have high and unrealistic expectations of the success of CPR outcomes. Many studies have attributed these false expectations to be due to misinformation disseminated by the mainstream television media. To this end, we have set to investigate this by performing a survey among the general public of the Kingdom of Saudi Arabia (KSA) and the general public in the United States (US). Methods: Two cross-sectional surveys were carried out in the general populations of KSA and USA. The US data was collected via an electronic questionnaire delivered on the survey platform SurveyMonkey® and the data was analyzed for the public\&amp;apos;s expectations and the source from which the information was obtained. Statistical analysis was later done to check the impact of TV and medical dramas on the public\&amp;apos;s expectations. Results: Out of 402 participants in KSA and 346 in the US, the subjects with accurate expectations of CPR outcomes in OOHCA and INCA settings were 11.4% and 14.7%, respectively, in KSA, and 10.7% and 12.7%, respectively in the US. Most subjects thought that CPR would be successful &amp;gt; 50% of the time, and a quarter of those believe that CPR is effective&amp;gt; 90% of the time! subgroup analysis showed no relation between TV dramas and the general public&amp;apos;s expectations. Conclusion: Public&amp;apos;s expectations about CPR outcomes for INCA and OOHCA settings were largely unrealistic. Only 11.6% and 13%, respectively, had accurate prognoses and realistic expectations and were not influenced by TV medical dramas.

Cardiopulmonary Resuscitation Outcomes of Patients with COVID-19; a One-Year Survey.

Introduction:Assessing cardiopulmonary resuscitation (CPR) outcomes of patients with COVID-19 and employing effective strategies for their improvement are essential. This study is designed in this regard. Methods:This cross-sectional study was conducted between January 20, 2020 and January 20, 2021 in the emergency departments of two hospitals in Hamadan and Kermanshah, Iran. Participants were 487 patients with confirmed COVID-19 and cardiac arrest (CA) who had undergone CPR during the study period. Data were collected using the available CPR documentation forms developed based on the Utstein Style and analyses were performed using Chi-square, Fisher’s exact, and Mann-Whitney U tests and the logistic regression analysis.Results:Participants’ mean age was 69.31±14.73 years and most of them were male (61.8%) and suffered from at least one underlying disease (58.1%). The rate of total and in-hospital CA was 9.67% and 9.39%, respectively. The most prevalent first documented rhythm was asystole (67.9%) and the highest responsivity to CPR was for shockable rhythms. The rate of the return of spontaneous circulation (ROSC) was 9% and the rate of survival to hospital discharge was 2%. The significant predictors of CPR success were age (p = 0.035), epinephrine administration time interval (p = 0.00), CPR duration (p = 0.00), and First documented rhythm (p = 0.009).Conclusion:The rate of in-hospital CA among studied COVID-19 cases was 9.39% with 9% ROSC and 2% survival to hospital discharge rates after CPR. Primary CPR success among patients with COVID-19 was poor, particularly among those with asystole and bradycardia. It seems that old age and improper doses of epinephrine can reduce CPR success.

Prehospital Cross-Sectional Study of Drowning Patients Across the United States.

Every year drowning is responsible for 7% of injury-related deaths worldwide, making it the third leading cause of unintentional injury-related death. However, in the United States, little is known regarding the prehospital presentation and management of these patients. The purpose of this study was to describe the drowning population in the United States, with a focus on prehospital time intervals, transport, and cardiac arrest frequency. A retrospective cross-sectional study was performed querying records from emergency medical services encounters across the United States over 30 mo (January 2016 to July 2018) using the ESO (Austin, TX) national emergency medical services data registry. Patients with a dispatch or chief complaint of drowning were included. Descriptive statistics, binomial proportion tests, and general linear and logistic regression models were used. There were 1859 encounters that met the study criteria. Median age was 18 y (n=1855, LQ-UQ 4-46). Pediatric patients accounted for 50% (n=919, 95% CI 47-52). Cardiac arrest occurred in 29% (n=537, 95% CI 27-31), and return of spontaneous circulation occurred in 37% (n=186, 95% CI 32-41). Times were 8±5, 19±17, and 15±10 min (mean±SD) for arrival, on-scene, and transport times, respectively. This national prehospital drowning study demonstrated that despite an 18% fatality rate in drowning encounters, patients were more likely to have return of spontaneous circulation when compared to the overall prehospital national average, with rates higher in pediatric patients. Future studies with outcomes data should focus on identifying factors that improve cardiopulmonary resuscitation success rates.

HUBUNGAN PENGALAMAN PERAWAT DAN KEBERHASILAN RESUSITASI JANTUNG PARU DI RUANG IGD,ICU DAN ICCU RSUD PROF.W.Z JOHANNES KUPANG

Cardiovascular disease is a global threat and is the number one cause of death worldwide. Until now, CPR is a very vital management in cases of cardiac arrest. The results of the initial survey found that nurses often found patients who had cardiac arrest, which required CPR. Some patients were saved and some died. Based on this, it is necessary to conduct research on the experience of ER, ICU and ICCU nurses in performing cardiopulmonary resuscitation. The aim of the study was to determine the relationship between nurses' experience and the success of cardiopulmonary resuscitation in the ER, ICU and ICCU RSUD Prof. Dr. W. Z. Johannes Kupang. This research is a quantitative research, correlation study design. The sample used is 41 nurses. Quota sampling technique. Analysis using Chi Square. The results showed that most of the respondents had sufficient experience of cardiopulmonary resuscitation, namely 37 people (90.8%). Most of the respondents managed to perform CPR, namely 34 people (82.9%). There is a relationship between experience and the success of cardiopulmonary resuscitation with a p value of 0.0001. Suggestions Training for emergency cardiac arrest needs to be carried out routinely to improve the quality of CPR