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Navarro-Patón R, Freire-Tellado M, Basanta-Camiño S, Barcala-Furelos R, Arufe-Giraldez V, Rodriguez-Fernández J. Efecto de 3 métodos de enseñanza en soporte vital básico en futuros maestros de Educación Primaria. Un diseño cuasiexperimental. Med Intensiva 2018; 42:207-215. [DOI: 10.1016/j.medin.2017.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 05/09/2017] [Accepted: 06/12/2017] [Indexed: 11/28/2022]
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Determinants of unfavorable prognosis for out-of-hospital sudden cardiac arrest in Bielsko-Biala district. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2016; 13:217-223. [PMID: 27785135 PMCID: PMC5071583 DOI: 10.5114/kitp.2016.62195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 07/19/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The prognosis in out-of-hospital sudden cardiac arrest (OHCA) remains unfavorable and depends on a number of demographic and clinical variables, the reversibility of its causes and its mechanisms. AIM To investigate the risk factors of prehospital death in patients with OHCA in Bielsko County. MATERIAL AND METHODS The study analyzed all dispatch cards of the National Emergency Medical Services (EMS) teams in Bielsko-Biala for the year 2013 (n = 23 400). Only the cards related to sudden cardiac arrest in adults were ultimately included in the study (n = 272; 190 men, 82 women; median age: 71 years). RESULTS Sixty-seven victims (45 men, 22 women) were pronounced dead upon the arrival of the EMS team, and cardiopulmonary resuscitation (CPR) was not undertaken. In the remaining group of 205 subjects, CPR was commenced but was ineffective in 141 patients (97 male, 44 female). Although univariate analysis indicated 6 predictors of prehospital death, including OHCA without the presence of witnesses (odds ratio (OR) = 4.2), OHCA occurring in a public place (OR = 3.1), no bystander CPR (OR = 9.7), no bystander cardiac massage (OR = 13.1), initial diagnosis of non-shockable cardiac rhythm (OR = 7.0), and the amount of drugs used for CPR (OR = 0.4), logistic regression confirmed that only the lack of bystander cardiac massage (OR = 6.5) and non-shockable rhythm (OR = 4.6) were independent determinants of prehospital death (area under ROC curve = 0.801). CONCLUSIONS Non-shockable rhythm of cardiac arrest and lack of bystander cardiac massage are independent determinants of prehospital death in Bielsko-Biala inhabitants suffering from OHCA.
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Rosell Ortiz F, Mellado Vergel F, López Messa JB, Fernández Valle P, Ruiz Montero MM, Martínez Lara M, Vergara Pérez S, Vivar Díaz I, Caballero García A, García Alcántara Á, García del Águila J. Supervivencia y estado neurológico tras muerte súbita cardiaca extrahospitalaria. Resultados del Registro Andaluz de Parada Cardiorrespiratoria Extrahospitalaria. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2015.09.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Rosell Ortiz F, Mellado Vergel F, López Messa JB, Fernández Valle P, Ruiz Montero MM, Martínez Lara M, Vergara Pérez S, Vivar Díaz I, Caballero García A, García Alcántara Á, García Del Águila J. Survival and Neurologic Outcome After Out-of-hospital Cardiac Arrest. Results of the Andalusian Out-of-hospital Cardiopulmonary Arrest Registry. ACTA ACUST UNITED AC 2016; 69:494-500. [PMID: 26830720 DOI: 10.1016/j.rec.2015.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 09/30/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES There is a paucity of data on prehospital cardiac arrest in Spain. Our aim was to describe the incidence, patient characteristics, and outcomes of out-of-hospital emergency care for this event. METHODS We conducted a retrospective analysis of a prospective registry of cardiopulmonary arrest handled by an out-of-hospital emergency service between January 2008 and December 2012. The registry included all patients considered to have a cardiac etiology as the cause of arrest, with a descriptive analysis performed of general patient characteristics and factors associated with good neurologic outcome at hospital discharge. RESULTS A total of 4072 patients were included, with an estimated incidence of 14.6 events per 100000 inhabitants and year; 72.6% were men. The mean age was 62.0 ± 15.8 years, 58.6% of cases occurred in the home, 25% of patients had initial defibrillable rhythm, 28.8% of patients arrived with a pulse at the hospital (58.3% of the group with defibrillable rhythm), and 10.2% were discharged with good neurologic outcome. The variables associated with this recovery were: witnessed arrest (P=.04), arrest witnessed by emergency team (P=.005), previous life support (P=.04), initial defibrillable rhythm (P=.0001), and performance of a coronary interventional procedure (P=.0001). CONCLUSIONS More than half the cases of sudden cardiac arrest occur at home, and the population was found to be relatively young. Although recovery was satisfactory in 1 out of every 10 patients, there is a need for improvement in the phase prior to emergency team arrival. Coronary interventional procedures had an impact on patient prognosis.
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Affiliation(s)
- Fernando Rosell Ortiz
- Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain.
| | | | | | - Patricia Fernández Valle
- Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain
| | - María M Ruiz Montero
- Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain
| | - Manuela Martínez Lara
- Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain
| | - Santiago Vergara Pérez
- Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain
| | - Itziar Vivar Díaz
- Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain
| | - Auxiliadora Caballero García
- Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain
| | | | - Javier García Del Águila
- Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain
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Valero E, Martín J, Monmeneu JV. Aborted sudden death during a marathon race. Med Intensiva 2015; 40:316-9. [PMID: 26616839 DOI: 10.1016/j.medin.2015.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 09/28/2015] [Accepted: 10/01/2015] [Indexed: 11/28/2022]
Affiliation(s)
- E Valero
- Servicio de Cardiología, Hospital Clínico Universitario, Valencia, España.
| | - J Martín
- Servicio de Medicina Interna, Hospital de Sagunto, Sagunto, Valencia, España
| | - J V Monmeneu
- Unidad de Imagen Cardiovascular, ERESA, Valencia, España
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Zeiner S, Sulzgruber P, Datler P, Keferböck M, Poppe M, Lobmeyr E, van Tulder R, Zajicek A, Buchinger A, Polz K, Schrattenbacher G, Sterz F. Mechanical chest compression does not seem to improve outcome after out-of hospital cardiac arrest. A single center observational trial. Resuscitation 2015; 96:220-5. [PMID: 26303569 DOI: 10.1016/j.resuscitation.2015.07.051] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 07/29/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
AIM Recently three large post product placement studies, comparing mechanical chest compression (cc) devices to those who received manual cc, found equivalent outcome results for both groups. Thus the question arises whether those results could be replicated using the devices on a daily routine. METHODS We prospectively enrolled 948 patients over a 12 months period. Chi-Square test and Mann-Whitney-U test were used to assess differences between "manual" and "mechanical" cc subgroups. Uni- and multivariate Cox regression hazard analysis were used to assess the influence of cc type on survival. RESULTS A mechanical cc device was used in 30.1% (n=283) cases. Patients who received mechanical cc had a significantly worse neurological outcome - measured in cerebral performance category (CPC) - than the manual cc group (56.8% vs. 78.6%, p=0.009). Patients receiving mechanical cc were significantly younger, more were male and were more likely to have bystander CPR and an initially shock-able ECG rhythm. There was no difference in the quality of CPR that might explain the worse outcome in mechanical cc patients. CONCLUSION Even with high quality CPR in both, manual and mechanical cc groups, outcome in patients who received mechanical cc was significantly worse. The anticipated benefits of a higher compression ratio and a steadier compression depth of a mechanical cc device remain uncertain. In this study selection for mechanical cc was not standardized, and was non-random. This merits further investigation. Further research on how mechanical cc is chosen and used should be considered. CLINICAL TRIAL REGISTRATION https://ekmeduniwien.at/core/catalog/2013/ (EK-Nr:1221/2013).
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Affiliation(s)
- Sebastian Zeiner
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Patrick Sulzgruber
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Philip Datler
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Markus Keferböck
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Michael Poppe
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Lobmeyr
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Raphael van Tulder
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | | | - Karl Polz
- Municipal Ambulance Service of Vienna, Vienna, Austria
| | | | - Fritz Sterz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
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