palpable pulse
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Author(s):  
Lamiaa Hamie ◽  
Mazen Kurban ◽  
Ossama Abbas ◽  
Amir Ibrahim ◽  
Shukrallah Zaynoun
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2021 ◽  
Vol 5 (4) ◽  
pp. 9-17
Author(s):  
Pete Gregory ◽  
Ben Mays ◽  
Tim Kilner ◽  
Ceri Sudron

<sec id="s1"> Introduction: Consciousness may occur during cardiopulmonary resuscitation despite the absence of a palpable pulse. This phenomenon, known as CPR-Induced Consciousness (CPR-IC), was first described over three decades ago and there has been an increase in case reports describing it. However, there remains limited evidence in relation to the incidence of CPR-IC and to practitioners’ experiences of it. </sec> <sec id="s2"> Methods: A mixed-methods, cross-sectional survey of paramedics who were registered with the Health and Care Professions Council (HCPC) and working in the United Kingdom (UK) at the time of the survey. Participants who had experienced CPR-IC were asked to provide details about the number of episodes, a description of how consciousness was manifested and whether or not it interfered with resuscitation. </sec> <sec id="s3"> Results: 293 eligible participants completed the study and 167 (57%) said that they had witnessed CPR-IC. Of those, over 56% reported that they had experienced it on at least two occasions. CPR-IC was deemed to interfere with resuscitation in nearly 50% of first experiences but this fell to around 31% by the third experience. The most common reasons for CPR-IC to interfere with resuscitation were: patient resisting clinical interventions, increased rhythm and pulse checks, distress, confusion and reluctance to perform CPR. </sec> <sec id="s4"> Conclusions: The prevalence of CPR-IC in our study was similar to that in earlier studies; however, unlike the other studies, we did not define what constituted interfering CPR-IC. Our findings suggest that interference may be related as much to the exposure of the clinician to CPR-IC as to any specific characteristic of the phenomenon itself. </sec>


2020 ◽  
Vol 7 (3) ◽  
pp. 125-131
Author(s):  
Maulidah Maulidah ◽  
Dhelya Widasmara ◽  
Titin Andri Wihastuti

Cardiac arrest is a condition where the heart stopped abruptly, and this condition usually occurs in someone who has had heart disease or has never experienced it. In terms of clinical, someone who is experiencing a state of cardiac arrest found no signs of a palpable pulse and other signs of circulation. Efforts in terms of handling cases of the cardiac arrest itself need the role of nurse, one cardiac arrest treatment efforts by nurses are implementing Basic Life Support. The factors that affect the implementation of BHD itself is knowledge and education. The purpose of this research is analizing the correlation between knowledge and education on the implementation of BHD in cardiac arrest patients by nurses in the Emergency Installation and ICU of the General Hospital of Dr. Soedarso Pontianak. This study uses a cross-sectional approach with descriptive corelational type. The population in this study are 56 nurses. Sampling technique using total sampling. The result of this study, based on two variables: the knowledge and education have the same p-value that is p=0.000 or α <0.05. It means that there is a correlation between knowledge and education on the implementation of BHD in patients with cardiac arrest in General Hospital of Dr. Soedarso Pontianak.


2020 ◽  
Vol 14 (6) ◽  
pp. 495-501
Author(s):  
Justin J. Ernat ◽  
Robert L. Wimberly ◽  
Christine A. Ho ◽  
Anthony I. Riccio

Purpose This article prospectively examines the functional outcome measures following management of vascular insult secondary to paediatric supracondylar humerus fractures (SCHFX) using validated outcome measures. Methods The three-year, prospective, IRB-approved study consecutively enrolled operative SCHFX patients. Clinical data included presence and symmetry of the radial pulse in injured and uninjured extremities, Doppler examination of non-palpable (NP) pulses and perfusion status of the hand. Pediatric Outcomes Data Collection Instruments (PODCI) and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) Measures were used to assess functional outcome at final follow-up. Multiple regression analysis was used to determine the relationship between the presence of a vascular abnormality and functional outcome while controlling for other injury parameters. Results A total of 146/752 enrolled patients (mean age 6.8 years; range 2 years to 13 years) completed functional outcome measures at final follow-up. Of these, 20 (14%) patients had abnormal vascular exams at presentation: nine (6%) with palpable asymmetric pulse and 11 (7.5%) with NP pulse. Of those with NP pulses, nine/11 (6%) were Dopplerable and two (1.5%) lacked identifiable Doppler signal. Patients with a symmetric, palpable pulse demonstrated better PODCI pain and comfort scores (95.2 versus 85.2) (p < 0.0001), and QuickDASH scores (10.9 versus 21.6) (p < 0.007) compared to those with any abnormal vascular examination. Patients with palpable pulses, regardless of symmetry, demonstrated ­significantly higher PODCI pain and comfort scores (94.6 versus 84.7) (p < 0.003) than NP pulses. Conclusions In children with operative SCHFX, an abnormal vascular examination at presentation is predictive of poorer outcomes in pain and upper extremity function. A palpable pulse, versus NP, is predictive of better pain and comfort at final follow-up. Level of evidence II


Sensors ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. 3052
Author(s):  
Heejin Kim ◽  
Ki Hong Kim ◽  
Ki Jeong Hong ◽  
Yunseo Ku ◽  
Sang Do Shin ◽  
...  

Monitoring cerebral circulation during cardiopulmonary resuscitation (CPR) is essential to improve patients’ prognosis and quality of life. We assessed the feasibility of non-invasive electroencephalography (EEG) parameters as predictive factors of cerebral resuscitation in a ventricular fibrillation (VF) swine model. After 1 min untreated VF, four cycles of basic life support were performed and the first defibrillation was administered. Sustained return of spontaneous circulation (ROSC) was confirmed if a palpable pulse persisted for 20 min. Otherwise, one cycle of advanced cardiovascular life support (ACLS) and defibrillation were administered immediately. Successfully defibrillated animals were continuously monitored. If sustained ROSC was not achieved, another cycle of ACLS was administered. Non-ROSC was confirmed when sustained ROSC did not occur after 10 ACLS cycles. EEG and hemodynamic parameters were measured during experiments. Data measured for approximately 3 s right before the defibrillation attempts were analyzed to investigate the relationship between the recovery of carotid blood flow (CBF) and non-invasive EEG parameters, including time- and frequency-domain parameters and entropy indices. We found that time-domain magnitude and entropy measures of EEG correlated with the change of CBF. Further studies are warranted to evaluate these EEG parameters as potential markers of cerebral circulation during CPR.


CJEM ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 431-434 ◽  
Author(s):  
Sarah McIsaac ◽  
Randy S. Wax ◽  
Brit Long ◽  
Christopher Hicks ◽  
Christian Vaillancourt ◽  
...  

Emergency medical services (EMS) is called for a 65-year-old man with a 1-week history of cough, fever, and mild shortness of breath now reporting chest pain. Vitals on scene were HR 110, BP 135/90, SpO2 88% on room air. EMS arrives at the emergency department (ED). As the patient is moved to a negative pressure room, he becomes unresponsive with no palpable pulse. What next steps should be discussed in order to protect the team and achieve the best possible patient outcome?


Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Heemun Kwok ◽  
Shiv Bhandari ◽  
Jennifer E Blackwood ◽  
Jason Coult ◽  
Peter Kudenchuk ◽  
...  

Objective: Currently, cardiac arrest resuscitation requires interruptions in CPR every 2 minutes to assess cardiac rhythm and pulse. A method which analyzed the ECG during CPR to predict whether or not an organized rhythm generated a pulse could help to direct care and limit CPR interruptions. We evaluated a real-time method to predict pulse status from organized rhythm ECG segments with and without CPR. Methods: The study cohort received attempted resuscitation by a metropolitan EMS system following out-of-hospital ventricular fibrillation arrest. Two-minute rhythm/pulse checks on the continuous defibrillator recordings were annotated for CPR, rhythm, and pulse status using the ECG, impedance, and accelerometer signals, the audio recording, and EMS record. Pulse was defined by the presence of a palpable pulse by EMS. Paired ECG segments with and without CPR were extracted at each rhythm/pulse check. Using organized rhythm segments from one-third of cases for training, we developed four ECG features using wavelet analysis (median power values in three frequency bands and QRS rate) and a logistic model to predict pulse status. Predictive performances of each ECG feature and the logistic model were measured by AUC in the remaining validation cases with and without CPR. Results: There were 238 cases and 911 paired segments with a median of 3 (IQR 2,5) paired segments per case. Among 319 organized rhythm segments in the validation set, AUC for pulse prediction ranged from 0.67 to 0.79 for the individual ECG features (Figure). The logistic model was more predictive than any individual feature (AUC 0.84, 95% CI 0.80-0.89, p < 0.05 for each comparison). The model predicted pulse similarly regardless of CPR activity (p = 0.2). Conclusion: ECG features extracted by wavelet analysis were predictive of pulse status among organized rhythm segments with and without ongoing CPR. Further study is required to understand how pulse prediction could guide rescuer actions in real-time.


2019 ◽  
Vol 35 (6) ◽  
pp. 484-490
Author(s):  
Julie White

Cardiac arrest is the absence of a centrally palpable pulse and no respiratory effort in an unresponsive patient. This often-lethal medical condition affects hundreds of thousands of people in the United States alone every year. Immediate intervention is crucial to provide the patient with any chance of survival. Advanced cardiac life support (ACLS) is the cornerstone therapy for cardiac arrest. Increased awareness and proper identification of life-threatening arrhythmias is critical, as it may lead to prompt medical treatment and improved mortality. The use of focused echocardiography, during a cardiac arrest, has been a developing area of interest over the past several years. The specific aim of this literature review was to emphasize the role of a focused echocardiogram and the valuable information that can be provided during a cardiac arrest.


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