Part 4: CPR Overview

Travers, Andrew H.; Rea, Thomas D.; Bobrow, Bentley J.; Edelson, Dana P.; Berg, Robert A.; Sayre, Michael R.; Berg, Marc D.; Chameides, Leon; O’Connor, Robert E.; Swor, Robert A.

doi:10.1161/circulationaha.110.970913

Cited by 407 publications

(288 citation statements)

References 54 publications

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“…28 This registry has been used to answer OHCA-related questions, which have been incorporated into the current American Heart Association guidelines. 5 The large sample size provides adequate power to detect small differences in outcomes. Second, the rigorous proposed analytic approach uses hierarchical modelling to account for patient and neighbourhood variables, and for patient clustering within neighbourhoods.…”

Section: Discussionmentioning

confidence: 99%

“…3 Although early cardiopulmonary resuscitation (CPR) and rapid successful defibrillation can improve survival rates to almost 40%, 4 it is highly dependent on numerous factors as represented by the links in the cardiac chain of survival, including immediate recognition of the event and activation of emergency medical services (EMS), early CPR, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. 5 The Utstein variables were formulated as a template for cardiac arrest research and as a way to report the contribution of individual links in the chain. 6 This template also highlights core data elements necessary for OHCA studies with the appropriate definitions (e.g., cardiac arrest witness status, EMS response time, bystander CPR, etiology).…”

Section: Introductionmentioning

confidence: 99%

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Does location matter? A proposed methodology to evaluate neighbourhood effects on cardiac arrest survival and bystander CPR

Buick

Allan

Ray

et al. 2015

CJEM

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Background: Traditional variables used to explain survival following out-of-hospital cardiac arrest (OHCA) account for only 72% of survival, suggesting that other unknown factors may influence outcomes. Research on other diseases suggests that neighbourhood factors may partly determine health outcomes. Yet, this approach has rarely been used for OHCA. This work outlines a methodology to investigate multiple neighbourhood factors as determinants of OHCA outcomes. Methods: A retrospective, observational cohort study design will be used. All adult non-emergency medical service witnessed OHCAs of cardiac etiology within the city of Toronto between 2006 and 2010 will be included. Event details will be extracted from the Toronto site of the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest, an existing population-based dataset of consecutive OHCA patients. Geographic information systems technology will be used to assign patients to census tracts. Neighbourhood variables to be explored include the Ontario Marginalization Index (deprivation, dependency, ethnicity, and instability), crime rate, and density of family physicians. Hierarchical logistic regression analysis will be used to explore the association between neighbourhood characteristics and 1) survival-to-hospital discharge, 2) return-of-spontaneous circulation at hospital arrival, and 3) provision of bystander cardiopulmonary resuscitation (CPR). Receiver operating characteristics curves will evaluate each model's ability to discriminate between those with and without each outcome. Discussion: This study will determine the role of neighbourhood characteristics in OHCA and their association with clinical outcomes. The results can be used as the basis to focus on specific neighbourhoods for facilitating educational interventions, CPR awareness programs, and higher utilization of automatic defibrillation devices.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does location matter? A proposed methodology to evaluate neighbourhood effects on cardiac arrest survival and bystander CPR

Buick

Allan

Ray

et al. 2015

CJEM

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“…4 Previous work has demonstrated that victims of OHCA may be sensitive to changes in CPR techniques. [4][5][6][7][8] A recent consensus statement by the AHA stressed the importance of improving CPR quality and measuring key CPR metrics as part of a continuous quality improvement methodology to reduce preventable deaths from cardiac arrest. 9 The following highlights the key components of the consensus statement.…”

Section: Cpr Qualitymentioning

confidence: 99%

“…During cardiac arrest, ETCo2 is recommended as an adjunct to detect ROSC, guide CPR quality, and prognosticate the probability of survival of cardiac arrest victims. 4,8,62 OHCA management now employs ETCo2 as part of a provider CPR feedback bundle on many commonly used defibrillators so that both CPR quality metrics and "real-time" ETCo2 can be monitored simultaneously during the resuscitation. ETCo2, when employed with recently developed CPR filtering software (which allows for the removal of CPR artifact during ongoing chest compressions), 63 provides paramedics with the earliest signal to a successful resuscitation, often prior to the actual finding of palpable pulses.…”

Section: End-tidal Carbon Dioxidementioning

confidence: 99%

The impact of prehospital resuscitation research on in-hospital care

Mausz

Cheskes

2015

CJEM

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Since their introduction over 40 years ago, paramedics have been trained to deliver select advanced life support interventions in the community with the goal of reducing morbidity and mortality from cardiovascular disease and trauma. The ensuing decades witnessed a great deal of interest in paramedic care, with an exponential growth in prehospital resuscitation research. As part of the CJEM series on emergency medical services (EMS), we review recent prehospital research in out-of-hospital cardiac arrest and discuss how, in a novel departure from the origins of EMS, prehospital research is beginning to influence in-hospital care. We discuss emerging areas of study related to cardiopulmonary resuscitation (CPR) quality, therapeutic hypothermia, termination of resuscitation, and the use of end-tidal carbon dioxide measurement, as well as the subtle ripple effects that prehospital research is having on the broader understanding of the management of these critically ill patients. RÉSUMÉDepuis leur arrivée il y a plus d'une quarantaine d'années, les ambulanciers paramédicaux sont formés pour pratiquer certaines interventions de réanimation cardiorespiratoire (RCR) médicalisée dans la collectivité dans le but de réduire la morbidité et la mortalité liées aux maladies cardiovasculaires et aux traumas. Au cours des décennies suivantes, les soins paramédicaux ont suscité un vif intérêt, qui s'est accompagné d'une forte croissance de la recherche en réanimation préhospitalière. Dans le cadre de la série d'articles portant sur les services médi-caux d'urgence (SMU) dans le JCMU, il sera question de la recherche récente sur la prise en charge préhospitalière des arrêts cardiaques qui surviennent dans la collectivité ainsi que de l'influence que commence à avoir la recherche dans le domaine préhospitalier sur les soins hospitaliers, influence qui signe une nouvelle orientation par rapport au point de départ des SMU. L'article portera sur de nouveaux champs d'étude liés à la qualité de la RCR, à l'hypothermie thérapeutique, à l'arrêt des manoeuvres de réanimation et à l'utilisation de la mesure du gaz carbonique en fin d'expiration ainsi que sur les effets d'entraînement discrets que la recherche dans le domaine préhospitalier a sur la compréhension élargie du traitement des personnes gravement malades ou blessées.

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“…However, the long-term survival effects of chest compression alone versus compression plus rescue breathing among bystanders in a generalizable community setting is uncertain [2]. Resuscitation for the chain of survival includes early arrest recognition and emergency activation, early CPR; early defibrillation, expert advanced life support, and integrated postresuscitation care [3]. Early CPR performed by layperson can double the chances of survival and provides an important foundation for subsequent links in the chain of survival [4].…”

Section: Introductionmentioning

confidence: 99%

Early Chest Compressions Applied to an Out-Of-Hospital Cardio-Pulmonary Arrest Case by an Untrained Savior

Al¹,

Oktay²,

Zengin³

et al. 2016

Arc Cas Rep CMed

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Recognizing arrest victim, starting early chest compressions, activating the emergency medical services and knowing the steps of Basic Life Support especially the chest compression for bystanders who witness the sudden collapse of an adult will have positive effects on the mortality of out-of-hospital cardio-pulmonary arrest cases. In present case we discussed a cardiopulmonary arrested patient to whom cardiopulmonary resuscitation was applied by an untrained savior.

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Part 4: CPR Overview

Cited by 407 publications

References 54 publications

Does location matter? A proposed methodology to evaluate neighbourhood effects on cardiac arrest survival and bystander CPR

Does location matter? A proposed methodology to evaluate neighbourhood effects on cardiac arrest survival and bystander CPR

The impact of prehospital resuscitation research on in-hospital care

Early Chest Compressions Applied to an Out-Of-Hospital Cardio-Pulmonary Arrest Case by an Untrained Savior

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