BACKGROUND Emergency medical services (EMS) are crucial in the management of out-of-hospital cardiac arrest (OHCA). Despite accepted termination-of-resuscitation criteria, many patients are transported to the hospital without achieving field return of spontaneous circulation (ROSC). OBJECTIVE We examine field ROSC influence on OHCA survival to hospital discharge in two large urban EMS systems...

OBJECTIVE Epinephrine (adrenaline) is widely used as a primary adjuvant for improving perfusion pressure and resuscitation rates during cardiopulmonary resuscitation (CPR). Epinephrine is also associated with significant myocardial dysfunction in the post-resuscitation period. We tested the hypothesis that the cardiac effects of epinephrine vary according to the duration of cardiac arrest. ME...

A short-cut review was carried out to establish whether prehospital adrenaline affects long-term morbidity or mortality after out-of-hospital cardiac arrest. Fifty-five papers were found using the reported search. Of these, three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results...

BACKGROUND In-hospital cardiac arrest (IHCA) is a catastrophic complication for patients while admitted in a medical institution. The outcome of IHCA remains poor, and understanding of the prognostic factors for survival outcome after IHCA is lacking, specifically in an oriental population. METHODS A retrospective observational cohort study of 382 patients with IHCA who required resuscitation...

Objectives The National Institute for Health and Clinical Excellence (NICE) recommend that after out of hospital cardiac arrest (OHCA) in patients with return of spontaneous circulation (ROSC), therapeutic hypothermia is induced “as soon as possible” to maintain core body temperature at 32-34°C for 12-24 hours.[1] Surface or internal cooling techniques are technically challenging in the Emergen...

Cardiac arrest (CA) is a leading cause of mortality worldwide. The majority of the associated mortalities are caused by post‑CA syndrome, which includes symptoms, such as neurologic damage, myocardial dysfunction and systemic inflammation. Following CA, return of spontaneous circulation (ROSC) leads to a brain reperfusion injury, which subsequently causes adverse neurologic outcomes or mortalit...

BACKGROUND Animal models of asphyxiation cardiac arrest (ACA) are frequently used in basic research to mirror the clinical course of cardiac arrest (CA). The rates of the return of spontaneous circulation (ROSC) in ACA animal models are lower than those from studies that have utilized ventricular fibrillation (VF) animal models. The purpose of this study was to characterize the factors associat...

OBJECTIVES To develop new methods for studying correlations between the performance and outcome of resuscitation efforts in real-world clinical settings using data recorded by automatic devices, such as automatic external defibrillators (AEDs), and to explore effects of shock timing and chest compression depth in the field. METHODS In 695 records of AED use in the pre-hospital setting, contin...

INTRODUCTION By maintaining sufficient cerebral blood flow and oxygenation, the goal of cardiopulmonary resuscitation (CPR) is to preserve the pre-arrest neurological state. To date, cerebral monitoring abilities during CPR have been limited. Therefore, we investigated the time-course of cerebral oxygen saturation values (rSO₂) during advanced life support in out-of-hospital cardiac arrest. Our...

Prognostication of survival after out-of-hospital cardiac arrest (OHCA) remains challenging with current guidelines recommending the prognostication no earlier than 72 h return spontaneous circulation (ROSC). Prognostic factors that could be used ROSC, like lactate clearance, are still being studied. This paper aims to investigate prognostic strength early clearance for OHCA. retrospective obse...