Cardiac arrest

Cardiovascular disease is the most common cause of sudden cardiac arrest, which causes over 60% of adult coronary heart disease deaths. Most cardiac arrests are preventable. Survival depends on early recognition and prompt initiation of chest compressions and ventilations (cardiopulmonary resuscitation), and early defibrillation if appropriate. High-quality cardiopulmonary resuscitation is defined by compressions to a depth of 5–6 cm, at a rate of 100–120 per minute, full release of pressure between compressions and minimal interruptions to chest compression. Drugs have a limited role in treating cardiac arrest. If initial resuscitation is successful the quality of post-resuscitation care determines the patient’s final outcome. Use emergency care treatment plans to record in advance, recommendations for emergency treatments, including CPR.

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Out of Hospital Cardiac Arrest

Acute Care Casebook ◽

10.1093/med/9780190865412.003.0019 ◽

2018 ◽

pp. 89-93

Author(s):

Erik Rueckmann

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Emergency Medical Services ◽

Evidence Based ◽

Early Defibrillation ◽

Key Factors ◽

High Quality ◽

Key Points ◽

Neurologically Intact ◽

Hospital Cardiac Arrest

The management of out-of-hospital, atraumatic cardiac arrest has changed over the past decade. This case details the evidence-based changes in care that optimize the chance of neurologically intact survival. The key factors include immediate, continuous, high-quality cardiopulmonary resuscitation with minimal interruptions, early defibrillation, and the use of capnography to assess resuscitative efforts. The orchestration of resuscitative efforts is a bundle of care that must all be met to provide the patient the best chance of survival. Furthermore, this case illustrates the key points of postarrest care and touches on termination of resuscitation. This chapter examines the case of emergency medical services call for an unresponsive patient in cardiac arrest on arrival.

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Automatic and manual devices for cardiopulmonary resuscitation: A review

Advances in Mechanical Engineering ◽

10.1177/1687814017748749 ◽

2018 ◽

Vol 10 (1) ◽

pp. 168781401774874 ◽

Cited By ~ 3

Author(s):

Carlo Remino ◽

Manuela Baronio ◽

Nicola Pellegrini ◽

Francesco Aggogeri ◽

Riccardo Adamini

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Early Recognition ◽

Hemodynamic Effects ◽

Chest Compressions ◽

High Quality ◽

Working Space ◽

Meta Analyses ◽

Positioning Time ◽

Actuation Method

Rate of survival without any neurological consequence after cardiac arrest is driven not only by early recognition but also by high-quality cardiopulmonary resuscitation. Because the effectiveness of the manual cardiopulmonary resuscitation is usually impaired by rescuers’ fatigue, devices have been devised to improve it by appliances or ergonomic solutions. However, some devices are thought to replace the manual resuscitation altogether, either mimicking its action or generating hemodynamic effects with working principles which are entirely different. This article reviews such devices, both manual and automatic. They are mainly classified by actuation method, applied force, working space, and positioning time. Most of the trials and meta-analyses have not demonstrated that chest compressions given with automatic devices are more effective than those given manually. However, advances in clinical research and technology, with an improved understanding of the organizational implications of their use, are constantly improving the effectiveness of such devices.

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Cardiopulmonary Resuscitation

AACN Advanced Critical Care ◽

10.4037/15597768-2009-4011 ◽

2009 ◽

Vol 20 (4) ◽

pp. 373-383

Author(s):

Cindy Goodrich

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Survival Rates ◽

Sudden Cardiac Arrest ◽

Heart Association ◽

New Techniques ◽

Cardiac Assist ◽

Mechanical Devices

Dismal survival statistics associated with sudden cardiac arrest have led to the development of new strategies and mechanical devices aimed at improving the quality of cardiopulmonary resuscitation (CPR). The most recent American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care were published in 2005. Major changes included revisions to current practices related to airway and ventilation, circulation, and defibrillation management. Greater emphasis is placed on providing simple, high-quality, effective CPR. New techniques and mechanical devices have been developed to augment CPR, hopefully improving survival rates and long-term outcomes. These include active compression-decompression CPR, Lund University Cardiac Assist System, LifeBelt, AutoPulse, and the impedance threshold device. This article focuses on current strategies aimed at improving survival rates for patients with sudden cardiac arrest. New techniques and mechanical devices developed to augment cardiopulmonary resuscitation will be discussed. These strategies will most likely shape future resuscitation practices.

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Cardiopulmonary resuscitation: the science behind the hands

Heart ◽

10.1136/heartjnl-2017-312696 ◽

2018 ◽

Vol 104 (13) ◽

pp. 1056-1061 ◽

Cited By ~ 7

Author(s):

Andrew W Harris ◽

Peter J Kudenchuk

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Sudden Cardiac Arrest ◽

Heart Association ◽

Scientific Basis ◽

Chest Compressions ◽

High Quality ◽

Physiological Basis ◽

Successful Resuscitation ◽

External Chest Compressions

Sudden cardiac arrest is a leading cause of death worldwide. Despite significant advances in resuscitation science since the initial use of external chest compressions in humans nearly 60 years ago, there continues to be wide variability in rates of successful resuscitation across communities. The American Heart Association (AHA) and European Resuscitation Council emphasise the importance of high-quality chest compressions as the foundation of resuscitation care. We review the physiological basis for the association between chest compression quality and clinical outcomes and the scientific basis for the AHA’s key metrics for high-quality cardiopulmonary resuscitation. Finally, we highlight that implementation of strategies that promote effective chest compressions can improve outcomes in all patients with cardiac arrest.

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Tripling survival from sudden cardiac arrest via early defibrillation without traditional education in cardiopulmonary resuscitation

ACC Current Journal Review ◽

10.1016/s1062-1458(02)01052-8 ◽

2003 ◽

Vol 12 (1) ◽

pp. 71-72 ◽

Cited By ~ 1

Author(s):

A. Cappuci ◽

D. Aschieri ◽

M.F. Piepoli

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Sudden Cardiac Arrest ◽

Traditional Education ◽

Early Defibrillation

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Global incidence of sudden cardiac arrest in young athletes and military members: a systematic review and meta-analysis

10.1101/2020.09.13.20193714 ◽

2020 ◽

Cited By ~ 1

Author(s):

Aaron Lear ◽

Niraj Patel ◽

Chanda Mullen ◽

Marian Simonson ◽

Vince Leone ◽

...

Keyword(s):

Cardiac Arrest ◽

Incidence Rate ◽

Meta Analysis ◽

Large Population ◽

Sudden Cardiac Arrest ◽

Risk Of Bias ◽

Low Risk ◽

High Quality ◽

Military Members

AbstractObjectivesThe goals of this review are to evaluate the quality of the evidence on the incidence of sudden cardiac arrest and death (SCA/D) in athletes and military members; and to estimate annual incidence of SCA/D.Data SourcesMEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORT discus, PEDro, and clinicaltrials.gov were searched from inception to dates between 2/21/19 and 7/29/19.Study SelectionStudies which reported incidence of SCA/D or both in athletes, or military members under age 40 were eligible for inclusion. 40 studies were identified for inclusionData ExtractionRisk of bias was assessed using a validated, customized tool for prevalence studies in all included studies. 12 were found to be low ROB, with the remaining 28 moderate or high ROB. Data was extracted for narrative review, and meta-analysis.Data SynthesisRandom-effects meta-analysis was performed in studies judged to be low risk of bias in two separate categories: 5 studies on regional or national level data including athletes at all levels, and both sexes included 130 events of SCD, with a total of 11,272,560 athlete years showing a cumulative incidence rate of 0.98 [95%CI: 0.62, 1.53] per 100,000 athlete years, with high heterogeneity with I2 of 78%; 3 Studies focusing on competitive athletes between the ages of 14 and 25 were combined, and included 183 events, and 17,798758 athlete years showing an incidence rate of 1.91[95%CI: 0.71; 5.14] per 100,000 athlete years with high heterogeneity with I2 of 97%.ConclusionThe worldwide incidence of SCD is a rare event. Low risk of bias studies indicate levels of SCD to be below 2 per 100,000 athlete years. Overall, the quality of the evidence available on the subject of SCA/D is low, but there are high quality individual studies to inform the question of incidence levels.PROSPERO RegistrationCRD42019125560Key PointsThere are several published articles which give a clear picture on the estimate of sudden cardiac arrest and death in athletes and military members, but the overall state of the literature has substantial risk of bias, with only 12 of 40 included articles at low risk of bias.Meta-analysis of sudden cardiac death was shown to be rare overall in athletes, with high quality, large population level studies synthesized to show a rate of 0.98 [95%CI: 0.62, 1.53] per 100,000 athlete years, and more focused studies on competitive younger athletes synthesized to show a rate 1.91[95%CI: 0.71; 5.14] per 100,000 athlete years. There was high heterogeneity present in both meta-analyses.

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Cardiac arrest

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.1701_update_002 ◽

2010 ◽

pp. 3097-3105

Author(s):

Jasmeet Soar ◽

Jerry P. Nolan ◽

David A. Gabbott

Keyword(s):

Cardiac Arrest ◽

Life Support ◽

Early Recognition ◽

Sudden Cardiac Arrest ◽

Advanced Life Support ◽

Early Defibrillation ◽

Medical Systems ◽

Postresuscitation Care ◽

Chain Of Survival ◽

Emergency Medical Systems

Cardiovascular disease is the most common cause of sudden cardiac arrest, which causes over 60% of adult coronary heart disease deaths. In Europe, the annual incidence of out-of-hospital cardiopulmonary arrests treated by emergency medical systems is 38 per 100 000. Survival from cardiac arrest depends on a sequence of interventions—the Chain of Survival—comprising (1) early recognition and call for help, (2) early cardiopulmonary resuscitation (CPR), (3) early defibrillation, and (4) postresuscitation care. The division between basic life support and advanced life support (ALS) is arbitrary—the resuscitation process is a continuum....

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Impact of Application of Multifunction Electrode (MFE) Pads on Cardiopulmonary Resuscitation Quality

Emergency Medicine International ◽

10.1155/2020/2675214 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Radosław Zalewski ◽

Mateusz Puślecki ◽

Łukasz Szarpak ◽

Tomasz Kłosiewicz ◽

Marek Dąbrowski ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Sudden Cardiac Arrest ◽

Flow Time ◽

Early Defibrillation ◽

Chest Compressions ◽

Airway Patency ◽

Emergency Team ◽

Simulation Based ◽

Cpr Quality

Background. Early defibrillation and high-quality chest compressions are crucial in treatment of sudden cardiac arrest (SCA) subjects. The aim of this study was to assess an impact of defibrillation methods on cardiopulmonary resuscitation (CPR) quality. Methods. A randomized simulation cross-study was designed, in which 100 two-person paramedical teams participated. Two 10-minute scenarios of SCA in the mechanism of ventricular fibrillation were analysed. In the first one, teams had at their disposal defibrillator with hard paddles (group C), whereas in the second one, adhesive electrodes were used (group MFE). The CPR quality was evaluated on the basis of the chest compression parameters (rate, depth, recoil, compression fraction (CCF), and no-flow time), airways patency achievement, and successful emergency drug administration. Results. Substituting standard hard paddles with adhesive electrodes led to an increase in CCF (77% vs 73%; p < 0.05 ), higher rate of complete chest recoil, and a decrease in no-flow time (6.0 ± 1.1 vs. 7.3 ± 1.1; p < 0.001 ). The airway patency was ensured sooner in group MFE (271 ± 118 s vs. 322 ± 106 s in group C; p < 0.001 ). All teams in scenario with adhesive electrodes were able to administer two doses of adrenaline, meanwhile only 74% of them in group C ( p < 0.001 ). Moreover, in 8% of group C scenarios, paramedics did not have enough time to administer amiodarone. Conclusion. Our simulation-based analysis revealed that use of adhesive electrodes during defibrillation instead of standard hard paddles may improve the quality of CPR performed by two-person emergency team.

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Decreasing the Stress of Medication Management During Cardiac Arrest

AACN Advanced Critical Care ◽

10.4037/aacnacc2020570 ◽

2020 ◽

Vol 31 (4) ◽

pp. 394-400

Author(s):

Colleen Teevan ◽

Emily Perriello

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Medication Management ◽

Morbidity And Mortality ◽

Early Defibrillation ◽

High Quality ◽

Treatment Algorithms ◽

Routes Of Administration

Cardiac arrest affects more than 500 000 people every year, with significant associated morbidity and mortality. In addition to high-quality cardiopulmonary resuscitation and early defibrillation, medications are included in treatment algorithms. Epinephrine and amiodarone are commonly used, with other medications being used in specific situations of cardiac arrest. Although participating in the care of a patient in cardiac arrest is complex and stressful, having a baseline understanding of the medications being used, routes of administration, and special considerations can be helpful in mitigating some of the stress in these situations.

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