Visual Fixation on the Thorax Predicts Bystander Breathing Detection in Simulated Out-of-Hospital Cardiac Arrest, but Video Debriefing With Eye Tracking Gaze Overlay Does Not Enhance Postallocation Success Rate

Purpose: Amplitude spectrum area (AMSA), which is calculated from the ventricular fibrillation (VF) waveform using fast Fourier transformation, has been recognized as a predictor of successful defibrillation (DF) and as an index of myocardial perfusion and viability during resuscitation. In this study, we investigated whether a change in AMSA occurring during CPR would predict DF outcome for subsequent DF attempts after a failed DF. We hypothesized that a patient responding to CPR with an increase in AMSA would have an increased likelihood of DF success. Methods: This was a retrospective analysis of out-of-hospital cardiac arrest patients who received a second DF due to initially shock-resistant VF. A total of 193 patients with an unsuccessful first DF were identified in a manufacturer database of electrocardiographic defibrillator records. AMSA was calculated for the first DF (AMSA1) and the second DF (AMSA2) during a 2.1 sec window ending 0.5 sec prior to DF. A successful DF attempt was defined as the presence of an organized rhythm with a rate ≥ 40 / min starting within 60 sec from the DF and lasting for > 30 sec. After the failed first DF, all patients received CPR for 2 to 3 minutes before delivery of the second DF. Change in AMSA (dAMSA) was calculated as dAMSA = AMSA2 - AMSA1. Results: The overall second DF success rate was 14.5%. Multivariable logistic regression showed that both AMSA1 and dAMSA were independent predictors of second DF success with odds ratios of 1.24 (95% CI 1.12 - 1.38, p<0.001) and 1.27 (95% CI 1.16 - 1.41, p<0.001) for each mVHz change in AMSA or dAMSA, respectively. Conclusions: In initially DF-resistant VF, a high initial AMSA value predicted an increased likelihood of second shock success. An increase of AMSA in response to CPR also predicted a higher second shock success rate. Monitoring of AMSA during resuscitation therefore may be useful to guide CPR efforts, possibly including timing of second shock delivery. These findings also further support the value of AMSA as indicator of myocardial viability.

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Success rate of resuscitation after out-of-hospital cardiac arrest

Hong Kong Medical Journal ◽

10.12809/hkmj187596 ◽

2019 ◽

pp. 254-256

Author(s):

Anthony MH Ho ◽

◽

Glenio B Mizubuti ◽

Adrienne K Ho ◽

Song Wan ◽

...

Keyword(s):

Cardiac Arrest ◽

Success Rate ◽

Hospital Cardiac Arrest

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267: Humeral Intraosseous Access Success Rate In Adult Out–of–Hospital Cardiac Arrest

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2010.06.316 ◽

2010 ◽

Vol 56 (3) ◽

pp. S88-S89 ◽

Cited By ~ 1

Author(s):

D.A. Wampler ◽

J. Shumaker ◽

C. Manifold ◽

S. Bolleter ◽

J. Frandsen

Keyword(s):

Cardiac Arrest ◽

Success Rate ◽

Intraosseous Access ◽

Hospital Cardiac Arrest

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Response to Improving the Success Rate of Chest Compression-Only CPR by Untrained Bystanders in Adult Out-of-Hospital Cardiac Arrest

Anesthesia & Analgesia ◽

10.1213/ane.0000000000002506 ◽

2018 ◽

Vol 126 (2) ◽

pp. 723 ◽

Cited By ~ 1

Author(s):

Jerry P. Nolan ◽

Gavin D. Perkins ◽

Robert W. Neumar ◽

Theresa M. Olasveengen

Keyword(s):

Cardiac Arrest ◽

Success Rate ◽

Chest Compression ◽

Hospital Cardiac Arrest

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Comparative Study of Mechanical and Manual Compression in the Resuscitation of Patients with Out-of-hospital Cardiac Arrest

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v4i2.1081 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Bing Han ◽

Lan Hong

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Success Rate ◽

Small Error ◽

Control Group ◽

Observation Group ◽

Manual Compression ◽

Blood Oxygen Saturation ◽

Bare Hand ◽

Hospital Cardiac Arrest

Objective: To analyze the effect of mechanical and manual compression on the resuscitation effect of out-of-hospital cardiac arrest patients. Methods: The 40 trained medical personnel who are skilled in bare hand compression and cardiopulmonary resuscitation machines were divided into two groups with 20 people in each group. The control group consists of a bare hand compression group while the observation group consists of cardiopulmonary resuscitation group. The two groups of people performed heart compression on the simulated person and observe the effect of the two compression methods on the patient during the cardiac arrest operation. Results: The resuscitation success rate in the control group was 65%, the resuscitation success rate in the observation group was 90%. The systolic blood pressure, heart rate, blood oxygen saturation, the accuracy rate of compression depth frequency, and interruption time in the observation group (cardiac resuscitation compression group) were significantly better than the control group (bare hand compression group). Conclusion: The use of mechanical compression has a small error rate, a high success rate, saves time and effort, and can effectively help patients. It is worth promoting and applying.

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Abstract 202: Video Laryngoscopy for Out of Hospital Cardiac Arrest

Circulation ◽

10.1161/circ.142.suppl_4.202 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Ryan M Huebinger ◽

Hutch Stilgenbauer ◽

Jeffrey L Jarvis ◽

Daniel Ostermayer ◽

Kevin Schulz ◽

...

Keyword(s):

Cardiac Arrest ◽

Success Rate ◽

Mixed Model ◽

Model Analysis ◽

Video Laryngoscopy ◽

Mixed Model Analysis ◽

Shockable Rhythm ◽

First Pass ◽

Bystander Cpr ◽

Hospital Cardiac Arrest

Introduction: Intubation is an essential component of cardiac arrest resuscitation. While prior studies have evaluated video laryngoscopy (VL) to assist intubation for in hospital cardiac arrest, there is a paucity of research evaluating VL for out of hospital cardiac arrest (OHCA). We sought to evaluate the association of video laryngoscopy with first pass success and ROSC. Hypothesis: Video laryngoscopy improves first pass success rate and improves the rate of ROSC Methods: We analyzed the 2018 data from ESO Inc. (Austin, TX), a national prehospital electronic health record used by 1289 EMS agencies in the US. We included all adult (age >18 years), non-traumatic cardiac arrests that were intubated with an endotracheal device. We applied a chi2 test to evaluate the first pass success rate for VL vs direct laryngoscopy (DL). We then created a mixed model, fitting agency as a random intercept and adjusting for age, gender, race, location of arrest, witnessed arrest, initial shockable rhythm, and bystander CPR. We applied the mixed model to analyze the association between VL and first pass success rate, ROSC, and sustained ROSC (survival to ED or ROSC for greater than 20 minutes). Results: We included 22,097 patients cared for by 914 agencies. 5,674 (25.7%) patients were intubated with video laryngoscopy. The median age was 66 (IQR 55-77). 61.9% of patients were male and 73.0% were white. 71.9% of cardiac arrest happened at home, 56.8% of were witnessed, 37.4% had bystander CPR, and 20.6% had a shockable rhythm. Compared to DL, VL had a lower rate of bystander CPR (41.4% v 36.1%, p<.001), but other characteristics were similar between the groups. We found that VL had a higher first pass success rate than DL (75.1% v 69.5%, p<.001). Using a mixed model analysis, VL was associated with a higher rate of first pass success (OR 1.5, CI 1.3-1.6), but VL was not associated with improvement in ROSC (OR 1.1, CI 0.97-1.2) or sustained ROSC (OR 1.1, CI 0.9-1.2). Conclusion: VL had a higher first pass success rate than DL, and on adjusted, mixed-model analysis, VL use was associated with increased rate of first pass success. However, VL was not associated with increased rate of ROSC

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A prospective observational study comparing two supraglottic airway devices in out-of-hospital cardiac arrest

BMC Emergency Medicine ◽

10.1186/s12873-021-00444-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maja Pålsdatter Lønvik ◽

Odd Eirik Elden ◽

Mats Joakimsen Lunde ◽

Trond Nordseth ◽

Karin Elvenes Bakkelund ◽

...

Keyword(s):

Cardiac Arrest ◽

Airway Management ◽

Success Rate ◽

Clinical Performance ◽

Airway Device ◽

Supraglottic Airway ◽

Ambulance Personnel ◽

Increased Risk ◽

Supraglottic Airway Devices ◽

Hospital Cardiac Arrest

Abstract Background Airway management in patients with out of hospital cardiac arrest (OHCA) is important and several methods are used. The establishment of a supraglottic airway device (SAD) is a common technique used during OHCA. Two types of SAD are routinely used in Norway; the Kings LTS-D™ and the I-gel®. The aim of this study was to compare the clinical performance of these two devices in terms of difficulty, number of attempts before successful insertion and overall success rate of insertion. Methods All adult patients with OHCA, in whom ambulance personnel used a SAD over a one-year period in the ambulance services of Central Norway, were included. After the event, a questionnaire was completed and the personnel responsible for the airway management were interviewed. Primary outcomes were number of attempts until successful insertion, by either same or different ambulance personnel, and the difficulty of insertion graded by easy, medium or hard. Secondary outcomes were reported complications with inserting the SAD’s. Results Two hundred and fifty patients were included, of whom 191 received I-gel and 59 received LTS-D. Overall success rate was significantly higher in I-gel (86%) compared to LTS-D (75%, p = 0.043). The rates of successful placements were higher when using I-gel compared to LTS-D, and there was a significant increased risk that the insertion of the LTS-D was unsuccessful compared to the I-gel (risk ratio 1.8, p = 0.04). I-gel was assessed to be easy to insert in 80% of the patients, as opposed to LTS-D which was easy to insert in 51% of the patients. Conclusions Overall success rate was significantly higher and the difficulty in insertion was significantly lower in the I-gel group compared to the LTS-D in patients with OHCA.

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Improving the Success Rate of Chest Compression-Only CPR by Untrained Bystanders in Adult Out-of-Hospital Cardiac Arrest

Anesthesia & Analgesia ◽

10.1213/ane.0000000000002300 ◽

2018 ◽

Vol 126 (1) ◽

pp. 351-353 ◽

Cited By ~ 4

Author(s):

Anthony M.-H. Ho ◽

Glenio B. Mizubuti ◽

Song Wan

Keyword(s):

Cardiac Arrest ◽

Success Rate ◽

Chest Compression ◽

Hospital Cardiac Arrest

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Airway management during out-of-hospital cardiac arrest; a prospective observational study comparing I-gel® and LTS-D ™

10.21203/rs.3.rs-114113/v1 ◽

2020 ◽

Author(s):

Maja Lønvik ◽

Odd Eirik Elden ◽

Mats Lunde ◽

Trond Nordseth ◽

Karin Bakkelund ◽

...

Keyword(s):

Cardiac Arrest ◽

Airway Management ◽

Success Rate ◽

Clinical Performance ◽

Airway Device ◽

Supraglottic Airway ◽

Chi Square ◽

Ambulance Personnel ◽

Chi Square Test ◽

Hospital Cardiac Arrest

Abstract Background: Airway management in patients with out of hospital cardiac arrest (OHCA) is important and several methods are used. The establishment of a supraglottic airway device (SAD) is a common technique used during OHCA. Two types of SAD are routinely used in Norway; the Kings LTS-D™ and the I-gel®. The aim of this study was to compare the clinical performance of these two devices in terms of difficulty and number of attempts before successful insertion.Methods: All adult patients with OHCA, in whom ambulance personnel used a SAD over a one-year period in the ambulance services of Central Norway, were included. After the event, a questionnaire was completed and the personnel responsible for the airway management were interviewed. Primary outcomes were number of attempts until successful placement of SAD and graded difficulty of insertion. Secondary outcomes were specified challenges with the SAD at insertion. Intergroup differences were compared using Chi-square test for multiple groups.Results: Two hundred and fifty patients were included, of whom 191 received I-gel and 59 received LTS-D. Overall success rate was significantly higher in I-gel (86 %) compared to LTS-D (75%, p = 0,043). The difficulties of insertion were significantly lower among patients receiving I-gel (easy 80 %, medium 13 % and difficult 7 %) compared to LTS-D (easy 51 %, medium 22 % and difficult 27 %, p < 0,001). Conclusions: Overall success rate was significantly higher and the difficulty in insertion was significantly lower in the I-gel group compared to the LTS-D in patients with OHCA.

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Outcomes of Cardiopulmonary Resuscitation and Its Predictors in Hospitalized Patients

Multidisciplinary Cardiovascular Annals ◽

10.5812/mca.104654 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Meisam Moezzi ◽

Golshan Afshari ◽

Fakher Rahim ◽

Meysam Alavian ◽

Maryam Banitorfi ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Success Rate ◽

Age Groups ◽

Medical Intervention ◽

Success Rates ◽

Significant Difference ◽

And Gender ◽

Evening Shift ◽

Hospital Cardiac Arrest

Background: Cardiopulmonary resuscitation (CPR) has been a frequently performed medical intervention that increases the chance of survival of a person stricken by cardiac arrest, and there is an excellent value of diversity in the rate of successful rehabilitation in societies. Methods: A retrospective observational study was carried out. The medical records of all in-hospital and out-hospital cardiac arrest patients who underwent CPR were collected. A total of 587 people with who underwent CPR during two years between January 2017 and June 2018, using a designed form were enrolled. Demographic information, the ward which CPR was committed, hospitalization, the delay before the onset of CPR and time of the day were recorded. Results: The overall success rate of CPR in this study was 25.89%. There was no significant difference in the success rate of CPR between men and women. A comparison of age groups revealed a difference between the success rates of CPR in 14 - 64 years group compared with the group above 64. Analysis of the data revealed no difference between CPR success rates in various seasons. Investigating the occurrence of cardiac arrest and its success rate at the hospital shifting showed a significant difference between the success rate of CPR in the morning shift with the evening shift and night. The dual comparison revealed a significant difference in the success rate of CPR only between the emergency department and intensive care units. Conclusions: The current study revealed a significant difference in age group and location, and did not show any significant success rate of CPR in the presence of witnesses, location of cardiac arrest, season and gender.

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