scholarly journals Medical Image of the Month: Stercoral Colitis

2021 ◽  
Vol 23 (3) ◽  
pp. 73-75
Author(s):  
Kirstin Peters ◽  
◽  
Angela Gibbs ◽  
Janet Campion
Keyword(s):  
Medical Image ◽  
Rectal Wall ◽  
Sudden Cardiac Arrest ◽  
Hypovolemic Shock ◽  
Spontaneous Circulation ◽  
Wall Thickening ◽  
Magnesium Citrate ◽  
Return Of Spontaneous Circulation ◽  
The Past ◽  
Distended Rectum

No abstract available. Article truncated after 150 words. A 78-year-old- man with cerebral palsy requiring an in-home caregiver presented to the emergency room in hypovolemic shock post-sudden cardiac arrest in the setting of hematemesis. The caregiver noticed the patient become unresponsive after having one episode of bright red emesis. EMS arrived and found the patient to be pulseless and performed three rounds of CPR and gave 1 mg of epinephrine before return of spontaneous circulation was obtained. The caregiver reported the patient had been complaining of diarrhea for the past few days after being started on magnesium citrate for constipation by his PCP. In the ED patient was intubated, sedated, and started on pressors due to undifferentiated shock. CT abdomen pelvis demonstrated diffuse dilation of the colon with massive stool burden and markedly distended rectum with impacted stool and circumferential rectal wall thickening consistent with stercoral colitis (Figures 1 and 2). In addition, there was a large hiatal …

scholarly journals Return of spontaneous circulation and heart rhythm during the first analysis of the heart electrical activity

2019 ◽  
Vol 18 (3) ◽  
pp. 147-150
Author(s):  
Sebastian Kowalski ◽  
Adrian Moskal ◽  
Karolina Żak-Kowalska ◽  
Mariusz Goniewicz
Keyword(s):  
Cardiac Arrest ◽  
Electrical Activity ◽  
Statistical Significance ◽  
Sudden Cardiac Arrest ◽  
Heart Rhythm ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
Heart Electrical Activity ◽  
First Moment ◽  
The Relationship

AbstractIntroduction. Return of spontaneous circulation (ROSC) of a patient with cardiac arrest is the main goal of carrying out cardiopulmonary resuscitation.Aim. Evaluation of frequency of return of spontaneous circulation depending on the heart rhythms in the first moment of heart electrical activity.Material and methods. Analysis of 105 cases of sudden cardiac arrest in out-of-hospital conditions on the premises of Brzozow Emergency Medical Service from September 2016 to the end of February 2018. The data was collected from intervention medical cards and medical rescue procedure cards. Statistical analysis was carried out using STATISTICA software. Statistical significance was assumed to be p<0.05.Results. Sudden cardiac arrest in the analysed group applied to 62.9% of men. Return of spontaneous circulation was achieved only in 16 out of 105 cases (15.2%) of sudden cardiac arrest. The analysis has indicated that ROSC was successful among 66.67% of patients, who during the first analysis of the rhythm, represented cardiac arrest in VF/pVT, what constituted 75% of all ROSC cases in the analysed group. Comparison between ROSC and rhythm during the first evaluation of the rhythm showed statistical significance (p=0.00). Statistical significance was also shown in the relationship between ROSC and the average age of the patient (p=0.0155).Conclusions. Sudden cardiac arrest, when diagnosed in the first analysis of the rhythm VF/pVT, has bigger chances for return of spontaneous circulation than it has in other rhythms.

scholarly journals P058: Morbid obesity association with return of spontaneous circulation from sudden cardiac arrest treated in a large, urban EMS system in the United States

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S97-S98
Author(s):  
J.M. Goodloe ◽  
L.D. Vinson ◽  
M.L. Cox ◽  
B.D. Burns
Keyword(s):  
United States ◽  
Morbid Obesity ◽  
Cardiac Arrest ◽  
Adult Population ◽  
Sudden Cardiac Arrest ◽  
The United States ◽  
Spontaneous Circulation ◽  
Contributing Factors ◽  
Return Of Spontaneous Circulation ◽  
Specific Analysis

Introduction: Patient co-morbidities contribute to survivability from out-of-hospital sudden cardiac arrest. Many studies have been conducted regarding contributing factors to sudden cardiac arrest survival, though very few studies have been published detailing specific analysis of morbid obesity association with return of spontaneous circulation (ROSC) in adults treated by paramedics. Methods: Adults in sudden cardiac arrest with resuscitation initiated, including at least one defibrillation, between July 1, 2016 and December 1, 2016 were enrolled. Due to an increasing prevalence of morbid obesity in the United States adult population, a novel defibrillation strategy, involving weight-based joule settings and double sequential external defibrillation (DSED) was initiated in June 2016. As exact body weight is logistically difficult to obtain in the EMS care environment, a paramedic-estimated weight at the time of resuscitation to be 100 kg or greater was deemed representative of “morbid obesity” for this analysis. All resuscitations were reviewed from electronic medical records (EMRs) completed by treating paramedics, alongside telemetry and defibrillation events recorded, transmitted, and analyzed in proprietary software (CODE-STAT, Physio-Control Corporation, Redmond, WA). ROSC was determined from both paramedic and hospital clinician EMRs reviewed by a paramedic researcher. Results: During the 5 month study period, paramedics involved treated 133 adults in sudden cardiac arrest involving perceived ventricular fibrillation that was treated with at least one defibrillation. 49/90 (54.4%) with weight &lt;100 kg as estimated by paramedics at the time of resuscitative care achieved at least transient ROSC. Only 17/43 (39.5%) with estimated weight ≥100 kg achieved any ROSC, despite paramedics authorized to perform defibrillations at higher joule energy settings for such weight. The OR for ROSC if &lt;100 kg estimated weight is 1.83 (95% CI 0.87-3.83), though given limited sample size p=0.11. Conclusion: While survival from out-of-hospital sudden cardiac arrest in adults is multi-factorial, the presence of morbid obesity, defined as estimated weight ≥100 kg, trends towards less ROSC. Continued community health efforts to decrease the prevalence of morbid obesity in the adult population may confer improved ability to survive out-of-hospital sudden cardiac arrest.

scholarly journals An analysis of the relationship between the applied medical rescue actions and the return of spontaneous circulation in adults with out-of-hospital sudden cardiac arrest

Medicine ◽  
2018 ◽  
Vol 97 (30) ◽  
pp. e11607 ◽  
Author(s):  
Klaudiusz Nadolny ◽  
Lukasz Szarpak ◽  
Joanna Gotlib ◽  
Mariusz Panczyk ◽  
Maciej Sterlinski ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
The Relationship

scholarly journals EPIDEMIOLOGY OF OUT-OF-HOSPITAL SUDDEN CARDIAC ARREST HAPPENING IN BRZOZOW COUNTY – PILOT STUDY

2021 ◽  
Vol 8 (4) ◽  
pp. 240-243
Author(s):  
Sebastian Kowalski ◽  
Adrian Moskal ◽  
Mariusz Goniewicz
Keyword(s):  
Cardiac Arrest ◽  
Statistical Analysis ◽  
Pilot Study ◽  
Emergency Services ◽  
Statistical Significance ◽  
Sudden Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Public Place ◽  
Aim Analysis ◽  
Return Of Spontaneous Circulation

Aim: Analysis of out-of-hospital sudden cardiac arrest cases in Brzozow county. Material and methods: Analysis of 105 out-of-hospital sudden cardiac arrest cases in Brzozow county. Data was extracted between September 2016 to end of February 2018 from dispatch order cards and emergency medical services cards. Statistical analysis was conducted using STATISTICA 12 software. Statistical significance was set to p<0,05 level. Results: There were 66 men (62,9%) and 39 (37,1%) women in the analysed group. Average age was 70,5 (SD=15,8). In 88,6% cases sudden cardiac arrest happened at home and for the rest 11,4% cases it was a public place. Families called emergency services in 20% (n=21) cases, in 16,2% (n=17) cases people suffering from sudden cardiac arrest and in 63,8% (n=67) cases it was a person classified as “other”. Sudden cardiac arrest a most frequently happened between 6:00-11:59 among 39,1% (n=41) of all patients. Incidence rate in the specified region was 106,06/100 000/ year. ROSC occurred only in 15,3% (n=16 cases). Conclusions: Out-of-hospital cardiac arrests in the specified region indicate low occurrence of return of spontaneous circulation. The reason behind this might be associated with a small number of cardiopulmonary resuscitation trials. Results indicate that further analysis of this phenomenon is required.

scholarly journals Impact of telephone cardiopulmonary resuscitation on the return of spontaneous circulation in patients with out-of-hospital cardiac arrest

2020 ◽  
Vol 7 (4) ◽  
pp. 256-260
Author(s):  
Jerzy Jaskuła ◽  
Karolina Niemczyk
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Medical System ◽  
Quality Monitoring ◽  
Return Of Spontaneous Circulation ◽  
Live Instruction ◽  
Telephone Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

The aim: Research aim is the evaluation of return of spontaneous circulation (ROSC) ratio among the individuals with out-of-hospital sudden cardiac arrest (SCA), depending on the so-called Telephone Cardiopulmonary Resuscitation (TCPR). T-CPR is based on live instruction given by the dispatcher to incident witness, who is performing CPR efforts until the EMS team arrives on scene. Material and methods: Research was based on the analysis of 782 entries (from EMS documentation) which recorded SCA and CPR. Emergency call voice recording has been rehearsed for each case, in order to confirm the capability of recognizing SCA and providing T-CPR instructions. Data was divided into two groups and the results have been compared. The ROSC ratio for both groups (“T-CPR” and “No T-CPR”) were analyzed along with the type of incident location. Results: The research has shown that 26,4% of all SCA cases researched ended up with the ROSC. In 94% of cases the dispatcher had succeeded in encouraging the witness to perform CPR with telephone instruction (T-CPR) until the EMS team has arrived. In the “T-CPR” group, 28,7% of cases have ended with ROSC. In the “No T-CPR” group, 19,7% of cases have ended with ROSC (28,7% vs. 19,7%). Conclusions: The T-CPR should be utilized by dispatcher in the form of uniform protocol. In the process of training dispatchers there should be special emphasis on the skill of recognizing SCA upon receiving a call. The evaluation of SCA recognition, T-CPR undertaken and ROSC ratio may be an effective indicator of quality monitoring within the State Emergency Medical System.

Loperamide Induced Recurrent Torsades de Pointes: A Case Report

2021 ◽  
pp. 089719002110048
Author(s):  
Gregory G. Jackson ◽  
Christine R. Lopez ◽  
Elizabeth S. Bermudez ◽  
Nina E. Hill ◽  
Dan M. Roden ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Torsades De Pointes ◽  
Altered Mental Status ◽  
Spontaneous Circulation ◽  
Prior History ◽  
Common Phenomenon ◽  
Medical Providers ◽  
Return Of Spontaneous Circulation ◽  
History Of ◽  
Overdrive Pacing

Purpose: A case of loperamide-induced recurrent torsades de pointes is reported to raise awareness of an increasingly common phenomenon that could be encountered by medical providers during the current opioid epidemic. Summary: A 40 year-old-man with a prior history of opioid abuse who presented to the emergency department after taking up to 100 tablets of loperamide 2 mg daily for 5 years to blunt opioid withdrawal symptoms and was subsequently admitted to the intensive care unit for altered mental status and hyperthermia. The patient had prolonged QTc and 2 episodes of torsades de pointes (TdP) that resulted in cardiac arrest with return of spontaneous circulation. He was managed with isoproterenol, overdrive pacing, and methylnatrexone with no other events of TdP or cardiac arrest. Conclusion: A 40-year-old male who developed torsades de pointes from loperamide overdose effectively treated with overdrive pacing, isoproterenol, and methylnatrexone.

scholarly journals Knowledge and perceptions of cardiopulmonary resuscitation amongst New Zealand podiatrists: a web-based survey

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Angela Brenton-Rule ◽  
Daniel Harvey ◽  
Kevin Moran ◽  
Daniel O’Brien ◽  
Jonathon Webber
Keyword(s):  
New Zealand ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
Cross Sectional Study ◽  
Trial Registration ◽  
Cross Sectional ◽  
Web Based ◽  
The Past

Abstract Background Podiatrists in New Zealand have a duty of care to assist patients in an emergency, and current cardiopulmonary resuscitation (CPR) certification is a requirement for registration. However, it is unknown how competent and confident podiatrists are in administering CPR and how they would respond in an emergency. Having a health professional who has a competent knowledge of CPR and skills in basic life support, can improve survival rates from sudden cardiac arrest. Therefore, the aim of this study was to survey New Zealand podiatrists to determine their CPR knowledge and qualifications; beliefs about the application of CPR; and perceptions of their competency in CPR. Methods This cross-sectional study used a web-based survey. Participants were New Zealand registered podiatrists with a current annual practising certificate. The 31-item survey included questions to elicit demographic information, CPR practice and attitudes, and CPR knowledge. Responses were collected between March and August 2020. Results 171 podiatrists responded to the survey. 16 % of the podiatrists (n = 28) had performed CPR in an emergency, with a 50 % success rate. Participants were predominantly female (n = 127, 74 %) and working in private practice (n = 140,82 %). Nearly half of respondents were younger than 40 years (n = 75,44 %) and had less than 10 years of clinical experience (n = 73, 43 %). Nearly all (n = 169,97 %) participants had received formal CPR training in the past two years, with 60 % (n = 105) receiving training in the past 12 months. Most respondents (n = 167,98 %) self-estimated their CPR ability as being effective, very effective, or extremely effective. Participants’ knowledge of CPR was variable, with the percentage of correct answers for CPR protocol statements ranging between 20 and 90 %. Conclusions This study provides the first insight into New Zealand podiatrists’ CPR knowledge and perceptions. Podiatrists were found to have high levels of CPR confidence but demonstrated gaps in CPR knowledge. Currently, New Zealand registered podiatrists require biennial CPR re-certification. However, resuscitation authorities in New Zealand and overseas recommend an annual update of CPR skills. Based on this study’s findings, and in line with Australia and the United Kingdom, the authors recommend a change from biennial to annual CPR re-certification for podiatrists in New Zealand. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620001144909).

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