Sudden cardiac arrest requiring cardiopulmonary resuscitation during downhill skiing

Severe hyperkalemia is a potentially life threatening cardiac emergency, especially in patients with renal failure, and can lead to fatal arrhythmias such as ventricular fibrillation or asystole, leading to cardiac arrest. We report a case of a 39-year-old woman who developed sudden cardiac arrest secondary to hyperkalemia (9.95 mEq/L) with renal insufficiency. Despite 20 min of cardiopulmonary resuscitation (CPR) and conventional treatment for hyperkalemia, the cardiac arrest persisted. Hemodialysis was then initiated via the right femoral vein during CPR, and the patient restored spontaneous heartbeat 40 min later. Hemodialysis should be considered in the course of CPR in severe hyperkalemia induced cardiac arrest if conventional therapies fail.

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Telecommunicator Cardiopulmonary Resuscitation: A Policy Statement From the American Heart Association

Circulation ◽

10.1161/cir.0000000000000744 ◽

2020 ◽

Vol 141 (12) ◽

Cited By ~ 5

Author(s):

Michael Christopher Kurz ◽

Bentley J. Bobrow ◽

Julie Buckingham ◽

Jose G. Cabanas ◽

Mickey Eisenberg ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Sudden Cardiac Arrest ◽

The United States ◽

Hospital Environment ◽

Policy Statement ◽

Initial Care ◽

Chain Of Survival ◽

Lay Rescuer ◽

Hospital Cardiac Arrest

Every year in the United States, >350 000 people have sudden cardiac arrest outside of a hospital environment. Sudden cardiac arrest is the unexpected loss of heart function, breathing, and consciousness and is commonly the result of an electric disturbance in the heart. Unfortunately, only ≈1 in 10 victims survives this dramatic event. Early access to 9-1-1 and early cardiopulmonary resuscitation (CPR) are the first 2 links in the chain of survival for out-of-hospital cardiac arrest. Although 9-1-1 is frequently accessed, in the majority of cases, individuals with out-of-hospital cardiac arrest do not receive lay rescuer CPR and wait for the arrival of professional emergency rescuers. Telecommunicators are the true first responders and a critical link in the cardiac arrest chain of survival. In partnership with the 9-1-1 caller, telecommunicators have the first opportunity to identify a patient in cardiac arrest and provide initial care by delivering CPR instructions while quickly dispatching emergency medical services. The telecommunicator and the caller form a unique team in which the expertise of the telecommunicator is provided just in time to a willing caller, transforming the caller into a lay rescuer delivering CPR. The telecommunicator CPR (T-CPR) process, also previously described as dispatch CPR, dispatch-assisted CPR, or telephone CPR, represents an important opportunity to improve survival from sudden cardiac arrest. Conversely, failure to provide T-CPR in this manner results in preventable harm. This statement describes the public health impact of out-of-hospital cardiac arrest, provides guidance and resources to construct and maintain a T-CPR program, outlines the minimal acceptable standards for timely and high-quality delivery of T-CPR instructions, and identifies strategies to overcome common implementation barriers to T-CPR.

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Abstract 17127: Sports-Related Sudden Cardiac Arrest: Comparison of Survival Outcomes in Europe versus the United States

Circulation ◽

10.1161/circ.130.suppl_2.17127 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Eloi Marijon ◽

Audrey Uy-Evanado ◽

Florence Dumas ◽

Carmen Teodeorescu ◽

Kyndaron Reinier ◽

...

Keyword(s):

United States ◽

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Response Times ◽

Survival Rates ◽

Sudden Cardiac Arrest ◽

The United States ◽

Population Based ◽

Sports Activity ◽

Bystander Cardiopulmonary Resuscitation

Background: Sports-related sudden cardiac arrest (sport SCA) has always attracted attention and the United States and European Union have developed divergent strategies for prevention over the last decade; notably regarding screening of younger athletes but also for SCA prevention in middle-aged and senior individuals. In this context, the extent to which outcomes of sports SCA differ between Europe and the USA have not been characterized. Methods: SCA cases aged 15-75 years were identified in two large prospective, population-based SCA programs, one in the Paris region (Paris-SDEC) and the other in a Northwestern US metro region (Oregon-SUDS) between 2002 and 2012. Cases of SCA, occurring during sports activity were compared between the two regions. Results: Of the 7,357 cases studied, 290 (4%) occurred during sports, with very similar proportions in both regions: 86 out of 1,894 (4.5%) in Oregon and 204 out of 5,463 (3.8%) in Paris. Subjects’ characteristics of cases in both programs were very similar (Paris vs. Oregon, respectively, for all results following), regarding age (50.7±14 vs. 50.4±13 years, P=0.55), male proportion (94%vs. 92%, P=0.53), past medical history of ≥2 cardiovascular risk factors (16% vs. 23%, P=0.16) and/or heart disease (10% vs. 8%, P=0.55). There was a high proportion of witnessed events in both populations (89% vs. 90%, P=0.94). However, we observed significant differences with more bystander cardiopulmonary resuscitation in Paris (63% vs. 48%, P=0.02), faster response time in Oregon (8.3±6 vs. 6.9±4 min, P=0.05), and more initially shockable rhythms in Oregon (52% vs. 70%, P=0.006). Overall, resuscitation outcomes were very similar for return of spontaneous circulation (26% vs. 33%, P=0.21) and survival to hospital discharge (27% vs. 26%, P=0.80). Conclusions: On either side of the Atlantic, burden and characteristics of sports-related SCA are very similar. Survival rates are approximately one in four cases. Optimizing bystander cardiopulmonary resuscitation rates and emergency response times could further improve outcomes. Deployment of uniform, effective strategies for screening and prevention are likely to make the greatest impact on sports SCA.

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Circulatory Flow Restoration Versus Cardiopulmonary Resuscitation: New Therapeutic Approach in Sudden Cardiac Arrest

Artificial Organs ◽

10.1111/aor.12984 ◽

2017 ◽

Vol 41 (12) ◽

pp. E356-E366 ◽

Cited By ~ 2

Author(s):

Sayed Nour ◽

Daniel Carbognani ◽

Juan Carlos Chachques

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Therapeutic Approach ◽

Sudden Cardiac Arrest ◽

Flow Restoration ◽

Circulatory Flow

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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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Ultra-long cardiopulmonary resuscitation with thrombolytic therapy for a sudden cardiac arrest patient with pulmonary embolism

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2014.04.035 ◽

2014 ◽

Vol 32 (11) ◽

pp. 1443.e3-1443.e4 ◽

Cited By ~ 6

Author(s):

Tian Hsin ◽

Fang Wei Chun ◽

Hsieh Lu Tao

Keyword(s):

Pulmonary Embolism ◽

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Thrombolytic Therapy ◽

Sudden Cardiac Arrest ◽

Cardiac Arrest Patient

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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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