Review
Emergency Medicine
David B. Crabb, Yasmeen O. Elmelige, Zoe C. Gibson, Daniel C. Ralston, Caleb Harrell, Scott A. Cohen, Desmond E. Fitzpatrick, Torben K. Becker
Summary: Immediate recognition of out-of-hospital cardiac arrest (OHCA) is crucial for timely initiation of T-CPR. The study found difficulty in communicating the patient's respiratory status as the main reason for EMD's lack of recognition of OHCA. It is recommended to enhance the identification of respiratory issues in unconscious patients in EMD training and algorithms.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Review
Critical Care Medicine
Ian R. Drennan, Guillaume Geri, Steve Brooks, Keith Couper, Tetsuo Hatanaka, Peter Kudenchuk, Theresa Olasveengen, Jeffrey Pellegrino, Stephen M. Schexnayder, Peter Morley
Summary: Studies found variations in sensitivity and specificity of cardiac arrest recognition at the time of emergency call across different dispatch centers, unaffected by dispatch algorithms or dispatcher education levels. Future work should focus on enhancing the sensitivity of cardiac arrest recognition to improve patient care and ensure timely resource utilization.
Article
Critical Care Medicine
Brian Grunau, Takahisa Kawano, Thomas D. Rea, Masashi Okubo, Frank X. Scheuermeyer, Joshua C. Reynolds, Matthieu Heidet, Ian R. Drennan, Sheldon Cheskes, Christopher B. Fordyce, Brian Twaites, Jim Christenson
Summary: Regional emergency medical services (EMS) intra-arrest transport (IAT) practices are associated with patient outcomes in out-of-hospital cardiac arrest cases. Regions utilizing IAT less frequently showed associations with improved clinical outcomes at hospital discharge.
Article
Critical Care Medicine
Lorenzo Gamberini, Donatella Del Giudice, Stefano Saltalamacchia, Benjamin Taylor, Isabella Sala, Davide Allegri, Antonio Pastori, Carlo Coniglio, Giovanni Gordini, Federico Semeraro
Summary: This retrospective observational study aimed to identify the factors associated with first responders' arrival before EMS in a regional first responder program. The study found that the immediate availability of a defibrillator for the responder and special categories of responders, such as taxi drivers and police, were significantly associated with arriving before EMS. Additionally, the study suggested that first responder programs may have a greater impact in rural areas.
Article
Critical Care Medicine
Filip Gnesin, Elisabeth Helen Anna Mills, Britta Jensen, Amalie Lykkemark Moller, Nertila Zylyftari, Henrik Boggild, Kristian Bundgaard Ringgren, Kristian Kragholm, Stig Nikolaj Fasmer Blomberg, Helle Collatz Christensen, Freddy Lippert, Lars Kober, Fredrik Folke, Christian Torp-Pedersen
Summary: More than 10% of OHCA patients had contact with emergency medical services within 24 hours before the event, and the most common symptom was breathing problems, which had lower 30-day survival compared to chest pain.
Article
Public, Environmental & Occupational Health
Christopher T. Richards, Danielle M. McCarthy, Eddie Markul, Doreen R. Rottman, Patricia Lindeman, Shyam Prabhakaran, Diego Klabjan, Jane L. Holl, Kenzie A. Cameron
Summary: This study describes the importance of communication characteristics in identifying out-of-hospital cardiac arrest (OHCA) and facilitating cardiopulmonary resuscitation (CPR) during emergency calls. Based on the analysis of 9-1-1 calls, it was found that the language and emotional state of callers had an impact on OHCA recognition and the initiation of CPR.
PATIENT EDUCATION AND COUNSELING
(2022)
Article
Critical Care Medicine
Catherine R. Counts, Jennifer Blackwood, Ryan Winchell, Christopher Drucker, Ann L. Jennerich, Sylvia Feder, Kathy Pompeo, Jody Waldron, Michael R. Sayre, Peter J. Kudenchuk, Thomas Rea
Summary: About 10% of out-of-hospital cardiac arrest patients involved in Emergency Medical Services (EMS) had Do Not Attempt Resuscitation (DNAR) directives, with a higher proportion when EMS did not attempt resuscitation. EMS typically received DNAR directives within 6 minutes of arrival and typically ceased resuscitation efforts as a result.
Article
Cardiac & Cardiovascular Systems
Jeffrey Eric Rollman, Robert A. Kloner, Nichole Bosson, James T. Niemann, Marianne Gausche-Hill, Michelle Williams, Christine Clare, Weiyi Tan, Xiaoyan Wang, David M. Shavelle, Asim M. Rafique
Summary: During the 2020 COVID-19 pandemic, emergency medical services in Los Angeles County, CA experienced an increase in responses to out-of-hospital cardiac arrest (OHCA) and a decrease in responses to ST-segment-elevation myocardial infarction (STEMI). Compared to 2018 and 2019, the proportion of OHCA patients who received defibrillation and had return of spontaneous circulation was lower after the implementation of California's stay-at-home order on March 19, 2020. Emergency medical services also saw a significant increase in dead on arrival cases in 2020 compared to previous years.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Critical Care Medicine
Stuart Howell, Karen Smith, Judith Finn, Peter Cameron, Stephen Ball, Emma Bosley, Tan Doan, Bridget Dicker, Steven Faddy, Ziad Nehme, Andy Swain, Melanie Thorrowgood, Andrew Thomas, Samuel Perillo, Mike McDermott, Tony Smith, Janet Bray
Summary: The aim of this study was to develop a risk adjustment strategy for benchmarking EMS performance for OHCA in Australia and New Zealand. Logistic regression was applied to develop risk adjustment models for event survival and survival to hospital discharge/30 days. The Utstein variables were important in risk-adjustment but only explained a small proportion of the variation in survival.
Article
Cardiac & Cardiovascular Systems
Raul A. Garcia, Saket Girotra, Philip G. Jones, Bryan McNally, John A. Spertus, Paul S. Chan
Summary: Survival after out-of-hospital cardiac arrest (OHCA) varies significantly across emergency medical service (EMS) agencies. EMS response time and termination of resuscitation practices are associated with agency-level rates of survival to hospital admission.
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES
(2022)
Article
Pediatrics
Kate McKenzie, Saoirse Cameron, Natalya Odoardi, Katelyn Gray, Michael R. Miller, Janice A. Tijssen
Summary: This study found that paramedics had deviations from best practice in pediatric out-of-hospital cardiac arrest events, resulting in low survival rates. Medication deviations and timing issues were commonly observed. Importantly, epinephrine administration frequently occurred outside of the recommended timeframe, highlighting the need for quality improvement.
FRONTIERS IN PEDIATRICS
(2022)
Article
Critical Care Medicine
Zainab Alqudah, Ziad Nehme, Brett Williams, Alaa Oteir, Karen Smith
Summary: The trauma-based resuscitation protocol led to an increase in trauma interventions, but did not result in improved survival outcomes for EMS-witnessed traumatic OHCA cases in the study region.
Article
Cardiac & Cardiovascular Systems
Victor Waldmann, Nicole Karam, Bamba Gaye, Wulfran Bougouin, Florence Dumas, Ardalan Sharifzadehgan, Kumar Narayanan, Haoiinda Kassim, Frankie Beganton, Daniel Jost, Lionel Lamhaut, Thomas Loeb, Frederic Adnet, Jean-Marc Agostinucci, Sandrine Deltour, Francois Revaux, Bertrand Ludes, Sebastian Voicu, Bruno Megarbane, Patricia Jabre, Alain Cariou, Eloi Marijon, Xavier Jouven
Summary: The study demonstrated an increase in the total number of out-of-hospital cardiac arrests (OHCA) related to cases where emergency medical services (EMS) did not attempt resuscitation. Factors such as patient age, gender, location of OHCA, and presence of bystanders were associated with the likelihood of no resuscitation attempt by EMS. While survival rates improved in cases where EMS attempted resuscitation, the overall survival improvement did not reach statistical significance due to the increasing number of cases without resuscitation attempts.
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES
(2021)
Article
Critical Care Medicine
Quelly Mae Rivadillo Ramos, Ki Hong Kim, Jeong Ho Park, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong
Summary: This study found that in out-of-hospital cardiac arrest (OHCA) patients in Korea, those with lower socioeconomic status were associated with longer emergency medical service (EMS) response times and lower rates of dual dispatch response.
Article
Emergency Medicine
Mallika R. Singh, Jennifer S. Jackson, Mark A. Newberry, Cameron Riopelle, Vu Huy Tran, Leila L. PoSaw
Summary: The study found that most attending and resident physicians in the Emergency Department utilize point-of-care ultrasound during cardiac arrest, but there are barriers to high-quality implementation. Attending physicians' top barriers relate to POCUS education, while resident physicians' top barriers relate to logistics and equipment. Interventions to overcome these barriers could optimize POCUS performance during cardiac arrest in the ED.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)