Emergency Medicine Perspectives: The Importance of Bystanders and Their Impact on On-Site Resuscitation Measures and Immediate Outcomes of Out-of-Hospital Cardiac Arrest

Bednarz, Kamil; Goniewicz, Krzysztof; Al-Wathinani, Ahmed M.; Goniewicz, Mariusz

doi:10.3390/jcm12216815

Cited by 2 publications

(2 citation statements)

References 32 publications

(31 reference statements)

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“…There is ample evidence to suggest the benefits of bystander action in emergencies 21,22 . Bystander action has been noted for a variety of emergencies 23 .…”

Section: B the Scenementioning

confidence: 99%

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From Fragmentation to Integration in Emergency Medicine: Providing Care Our Patients Deserve

Venkataraman,

Chin Lim,

Hao

et al. 2024

MRAJ

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The emergency care systems of most communities around the world have multiple components through which patients move and which are, at best, disjointed and not well coordinated. Illnesses and injuries which begin in the community and frequently preventable often do not have the benefit of bystander assistance or dedicated immediate emergency ambulance care and arrive at Emergency Departments that are crowded. Patients often spend long hours in these Emergency Departments and, if requiring inpatient care, have to wait many hours before an inpatient bed becomes available. Those requiring further convalescent care may often find inadequate arrangements available for them to recover smoothly. The end result is delays and adverse clinical outcomes that are often not measured or even appreciated. This report discusses each of ten components of the emergency care system as in exists in most communities, including injury and illness prevention, the community burden of emergencies, bystander first responder care, ambulance-based second responder care, emergency department crowding and its contributory factors, transitions of care to the inpatient departments and community convalescent care units, coordination of emergency departments in the community, the patient’s family and, of course, the emergency patient. The effects of fragmentation in each of these components are described and strategies to address each mentioned. There is a need for a patient-centric, integrated approach to the provision of emergency care in any community which can break down the barriers created by fragmented care and provide the seamless, high-quality care that all our patients deserve.

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“…There is ample evidence to suggest the benefits of bystander action in emergencies 21,22 . Bystander action has been noted for a variety of emergencies 23 .…”

Section: B the Scenementioning

confidence: 99%

“…Bystander action has been noted for a variety of emergencies 23 . The rate of bystander response in various communities has, traditionally, been very variable and between 10% and 65%, 22,23,24,25 .…”

Section: B the Scenementioning

confidence: 99%

From Fragmentation to Integration in Emergency Medicine: Providing Care Our Patients Deserve

Venkataraman,

Chin Lim,

Hao

et al. 2024

MRAJ

View full text Add to dashboard Cite

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Amiodarone Administration during Cardiopulmonary Resuscitation Is Not Associated with Changes in Short-Term Mortality or Neurological Outcomes in Cardiac Arrest Patients with Shockable Rhythms

Kramser,

Duse,

Gröne

et al. 2024

JCM

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Background: The search for the best therapeutic approach in cardiopulmonary resuscitations (CPR) remains open to question. In this study, we evaluated if Amiodarone administration during CPR was associated with short-term mortality or neurological development. Methods: A total of 232 patients with sudden cardiac arrest (CA) with shockable rhythms were included in our analysis. Propensity score matching based on age, gender, type of CA, and CPR duration was used to stratify between patients with and without Amiodarone during CPR. Primary endpoints were short-term mortality (30-day) and neurological outcomes assessed by the cerebral performance category. Secondary endpoints were plasma lactate, phosphate levels at hospital admission, and the peak Neuron-specific enolase. Results: Propensity score matching was successful with a caliper size used for matching of 0.089 and a sample size of n = 82 per group. The 30-day mortality rates were similar between both groups (p = 0.24). There were no significant differences in lactate levels at hospital admission and during the following five days between the groups. Patients receiving Amiodarone showed slightly higher phosphate levels at hospital admission, while the levels decreased to a similar value during the following days. Among CA survivors to hospital discharge, no differences between the proportion of good neurological outcomes were detected between the two groups (p = 0.58), despite slightly higher peak neuron-specific enolase levels in CA patients receiving Amiodarone (p = 0.03). Conclusions: Amiodarone administration is not associated with short-term mortality or neurological outcomes in CA patients with shockable rhythms receiving CPR.

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Emergency Medicine Perspectives: The Importance of Bystanders and Their Impact on On-Site Resuscitation Measures and Immediate Outcomes of Out-of-Hospital Cardiac Arrest

Cited by 2 publications

References 32 publications

From Fragmentation to Integration in Emergency Medicine: Providing Care Our Patients Deserve

From Fragmentation to Integration in Emergency Medicine: Providing Care Our Patients Deserve

Amiodarone Administration during Cardiopulmonary Resuscitation Is Not Associated with Changes in Short-Term Mortality or Neurological Outcomes in Cardiac Arrest Patients with Shockable Rhythms

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