scholarly journals Cardiac Arrest Survival Post-Electrocution – Management in a Low-Resource Emergency Department in Ghana: A Case Series

2021 ◽  
Vol 2 (2) ◽  
pp. 69-73
Author(s):  
: Nana Serwaa Agyeman Quao
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Catchment Area ◽  
Early Recognition ◽  
Case Series ◽  
Protective Equipment ◽  
High Exposure ◽  
Supportive Management ◽  
Cardiac Arrest Survival ◽  
Electrical Injuries

Introduction The potential dangers of electrical injuries continue to increase since the commercial availability of electricity. Degrees of electrical injuries range from minor burns to cardiac arrest. Electrocution is cardiac arrest resulting from an electric shock. In Ghana, many electrocution cases are declared dead with little or no resuscitative measures. With the establishment of the emergency department (ED) at Komfo Anokye Teaching Hospital (KATH), such cases within the catchment area are being managed. We sought to describe the management of three (3) cases of electrocution admitted which were resuscitated at the KATH ED. Case Series We present three retrospective cases of electrocution involving two adults and one child presenting to the ED of KATH. None of them had any form of cardiopulmonary resuscitation (CPR) at the scene, or en route to the hospital, however, all cases received resuscitative measures of CPR, defibrillation, intubation and other supportive management, and were successfully discharged home in a few days with no major complications. Discussion Electrical injuries do occur; however, continuous education and caution should be taken especially whilst using electricity and electrical appliances. Workers with high exposure to electricity should emphasize maximum safety precautions and use of appropriate protective equipment. Home appliances should be well hidden and insulated to protect children. Early recognition of cardiac arrest, immediate initiation of CPR, availability of defibrillators improves outcomes in cardiac arrest post-electrocution.

scholarly journals Cardiac arrest survival post-resuscitation in-hospital (CASPRI)—a tool to predict neurological outcome after ROSC

2020 ◽  
Author(s):  
Bofu Liu ◽  
Yarong He ◽  
Peng Jiang ◽  
Jiachen Sun ◽  
Tianyong Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Roc Curve ◽  
Sofa Score ◽  
Test Group ◽  
Neurological Function ◽  
Neurological Prognosis ◽  
The Difference ◽  
Cardiac Arrest Survival

Abstract Objectives: To develop a cardiac arrest survival post-resuscitation in-hospital (CASPRI) scoring system evaluating the prognosis of neurological function in ROSC patients.Methods: This single-center, retrospective study reviewed the eligible patients admitted to the emergency department of West China Hospital of Sichuan University who received cardiopulmonary resuscitation and restored spontaneous circulation from January 1, 2014 00:00 to December 31, 2017 23:59. Clinical histories, blood test, biochemistry profile, coagulation indexes and other laboratory tests during emergency department visit were collected. The MEWS, sOHCA, APACHE II, and the highest SOFA scores were calculated during the period between emergency room admission and ROSC. The clinical data of ROSC patients in the test group were analyzed by univariate and multivariate logistic analysis. The possible risk factors related to the unfavorable prognosis of 90-day neurological function were screened and CASPRI score was constructed. The efficacy of CASPRI score on evaluating the neurological function of ROSC patients was analyzed by ROC curve and proved in the validation group.Main results: 503 patients were included in the test group. After correcting potential confounding factors, multivariate logistic regression analysis showed that TBIL, ALB at admission of emergency department, Lac at ROSC, resuscitation time, non-shockable rhythms were independent risk factors for poor neurological prognosis of ROSC patients (p<0.05). ROC curve showed that the CASPRI score was superior to the APACHE II score, SOFA score, MEWS score and sOHCA score, and the difference was statistically significant (p<0.05). In the validation group with 256 patients included, the incidence of poor neurological prognosis in high-risk, intermediate-risk, and low-risk groups based on CASPRI score were 97.89%, 85.59%, and 58.33%, respectively, and the difference was statistically significant (p<0.001). CASPRI score was superior to the SOFA score and MEWS score, the difference was statistically significant (p<0.05).Conclusions: CASPRI score is an effective tool for the early evaluation of the neurological prognosis of ROSC patients. Its efficacy exceeds the MEWS and SOFA scoring systems currently used in clinical practice.

scholarly journals Cardiac Arrest Survival Post-Electrocution – Management in a Low-Resource Emergency Department in Ghana

2017 ◽  
Vol 32 (S1) ◽  
pp. S189
Author(s):  
Nkechi O. Dike ◽  
Nana Serwaa A. Quao ◽  
Charles Ababio ◽  
Davidson Iroko ◽  
George Oduro
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Low Resource ◽  
Cardiac Arrest Survival

scholarly journals Evaluation of prognostic prediction models for out-of-hospital cardiac arrest

2020 ◽  
pp. 102490792096691
Author(s):  
Yat Hei Lo ◽  
Yuet Chung Axel Siu
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Prediction Models ◽  
Model Development ◽  
Spontaneous Circulation ◽  
Emergency Team ◽  
Survival Score ◽  
Prognostic Prediction ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Introduction: Accurate prognostic prediction of out-of-hospital cardiac arrest is challenging but important for the emergency team and patient’s family members. A number of prognostic prediction models specifically designed for out-of-hospital cardiac arrest are developed and validated worldwide. Objective: This narrative review provides an overview of the prognostic prediction models out-of-hospital cardiac arrest patients for use in the emergency department. Discussion: Out-of-hospital cardiac arrest prognostic prediction models are potentially useful in clinical, administrative and research settings. Development and validation of such models require prehospital and hospital predictor and outcome variables which are best in the standardised Utstein Style. Logistic regression analysis is traditionally employed for model development but machine learning is emerging as the new tool. Examples of such models available for use in the emergency department include ROSC After Cardiac Arrest, CaRdiac Arrest Survival Score, Utstein-Based Return of Spontaneous Circulation, Out-of-Hospital Cardiac Arrest, Cardiac Arrest Hospital Prognosis and Cardiac Arrest Survival Score. The usefulness of these models awaits future studies.

scholarly journals Serum Lactate for Predicting Cardiac Arrest in the Emergency Department

2022 ◽  
Vol 11 (2) ◽  
pp. 403
Author(s):  
Shu-Hsien Hsu ◽  
Po-Hsuan Kao ◽  
Tsung-Chien Lu ◽  
Chih-Hung Wang ◽  
Cheng-Chung Fang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Early Recognition ◽  
Multivariable Analysis ◽  
Lactate Clearance ◽  
Serum Lactate ◽  
Increased Risk ◽  
Lactate Levels ◽  
Hospital Cardiac Arrest ◽  
Elevated Lactate

Objectives: Early recognition and prevention of in-hospital cardiac arrest (IHCA) play an increasingly important role in the Chain of Survival. However, clinical tools for predicting IHCA in the emergency department (ED) are scanty. We sought to evaluate the role of serum lactate in predicting ED-based IHCA. Methods: Data were retrieved from 733,398 ED visits over a 7-year period in a tertiary medical centre. We selected one ED visit per person and excluded out-of-hospital cardiac arrest, children, or those without lactate measurements. Patient demographics, computerised triage information, and serum lactate levels were extracted. The initial serum lactate levels were grouped into normal (≤2 mmol/L), moderately elevated (2 < lactate ≤ 4), and highly elevated (>4 mmol/L) categories. The primary outcome was ED-based IHCA. Results: A total of 17,392 adult patients were included. Of them, 342 (2%) developed IHCA. About 50% of the lactate levels were normal, 30% were moderately elevated, and 20% were highly elevated. In multivariable analysis, the group with highly elevated lactate had an 18-fold increased risk of IHCA (adjusted odds ratio [OR], 18.0; 95% confidence interval [CI], 11.5–28.2), compared with the normal lactate group. In subgroup analysis, the poor lactate-clearance group (<2.5%/h) was associated with a 7.5-fold higher risk of IHCA (adjusted OR, 7.5; 95%CI, 3.7–15.1) compared with the normal clearance group. Conclusions: Elevated lactate levels and poor lactate clearance were strongly associated with a higher risk of ED-based IHCA. Clinicians may consider a more liberal sampling of lactate in patients at higher risk of IHCA with follow-up of abnormal levels.

scholarly journals Cardiac Arrest Survival Postresuscitation In-Hospital (CASPRI) Score Predicts Neurological Favorable Survival in Emergency Department Cardiac Arrest

2021 ◽  
Vol 10 (21) ◽  
pp. 5131
Author(s):  
Jeffrey Che-Hung Tsai ◽  
Jen-Wen Ma ◽  
Shih-Chia Liu ◽  
Tzu-Chieh Lin ◽  
Sung-Yuan Hu
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Neurological Status ◽  
Survival Group ◽  
Resuscitated Patients ◽  
Favorable Neurological Outcome ◽  
Utstein Style ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Background: This study was conducted to identify the predictive factors for survival and favorable neurological outcome in patients with emergency department cardiac arrest (EDCA). Methods: ED patients who suffered from in-hospital cardiac arrest (IHCA) from July 2014 to June 2019 were enrolled. The electronic medical records were retrieved and data were extracted according to the IHCA Utstein-style guidelines. Results: The cardiac arrest survival post-resuscitation in-hospital (CASPRI) score was associated with survival, and the CASPRI scores were lower in the survival group. Three components of the CASPRI score were associated with favorable neurological survival, and the CASPRI scores were lower in the favorable neurological survival group of patients who were successfully resuscitated. The independent predictors of survival were presence of hypotension/shock, metabolic illnesses, short resuscitation time, receiving coronary angiography, and TTM. Receiving coronary angiography and low CASPRI score independently predicted favorable neurological survival in resuscitated patients. The performance of a low CASPRI score for predicting favorable neurological survival was fair, with an AUROCC of 0.77. Conclusions: The CASPRI score can be used to predict survival and neurological status of patients with EDCA. Post-cardiac arrest care may be beneficial for IHCA, especially in patients with EDCA.

scholarly journals Discovery of predictors of sudden cardiac arrest in diabetes: rationale and outline of the RESCUED (REcognition of Sudden Cardiac arrest vUlnErability in Diabetes) project

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001554
Author(s):  
Laura H van Dongen ◽  
Peter P Harms ◽  
Mark Hoogendoorn ◽  
Dominic S Zimmerman ◽  
Elisabeth M Lodder ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Prognostic Model ◽  
Early Recognition ◽  
Sudden Cardiac Arrest ◽  
Clinical Genetic ◽  
Innovative Strategy ◽  
Rare Variant Analysis ◽  
Increased Risk ◽  
Gp Care

IntroductionEarly recognition of individuals with increased risk of sudden cardiac arrest (SCA) remains challenging. SCA research so far has used data from cardiologist care, but missed most SCA victims, since they were only in general practitioner (GP) care prior to SCA. Studying individuals with type 2 diabetes (T2D) in GP care may help solve this problem, as they have increased risk for SCA, and rich clinical datasets, since they regularly visit their GP for check-up measurements. This information can be further enriched with extensive genetic and metabolic information.AimTo describe the study protocol of the REcognition of Sudden Cardiac arrest vUlnErability in Diabetes (RESCUED) project, which aims at identifying clinical, genetic and metabolic factors contributing to SCA risk in individuals with T2D, and to develop a prognostic model for the risk of SCA.MethodsThe RESCUED project combines data from dedicated SCA and T2D cohorts, and GP data, from the same region in the Netherlands. Clinical data, genetic data (common and rare variant analysis) and metabolic data (metabolomics) will be analysed (using classical analysis techniques and machine learning methods) and combined into a prognostic model for risk of SCA.ConclusionThe RESCUED project is designed to increase our ability at early recognition of elevated SCA risk through an innovative strategy of focusing on GP data and a multidimensional methodology including clinical, genetic and metabolic analyses.

Peri-intubation cardiac arrest in the Emergency Department: A National Emergency Airway Registry (NEAR) study

Resuscitation ◽  
2021 ◽  
Author(s):  
Michael D. April ◽  
Allyson Arana ◽  
Joshua C. Reynolds ◽  
Jestin N. Carlson ◽  
William T. Davis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Emergency Airway ◽  
National Emergency
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