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Culp WC, Stevens TD, Davis P. Advanced airway management in drowning: Pre-hospital tracheal intubation as compared to supraglottic airway device. Resuscitation 2024; 199:110179. [PMID: 38821689 DOI: 10.1016/j.resuscitation.2024.110179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 06/02/2024]
Affiliation(s)
- William C Culp
- Professor of Anesthesiology, Associate Dean of Faculty Affairs & Faculty Development, Baylor College of Medicine, Vice Chair of Academic Affairs, Baylor Scott & White Medical Center, 2401 South 31st Street, Temple, TX 76508, USA.
| | - Troy D Stevens
- Chief CRNA, Seton Medical Center, 850 W Central Texas Expressway, Harker Heights, TX 76548, USA.
| | - Peter Davis
- President, United States Lifesaving Association, Chief, Galveston Island Beach Patrol, 601 West Tremont, Galveston, TX, 77554, USA.
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Morgan P. Airway management in resuscitation following drowning - Is drowning research "in hot water"? Resuscitation 2024; 197:110157. [PMID: 38431074 DOI: 10.1016/j.resuscitation.2024.110157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Paddy Morgan
- North Bristol NHS Trust, Bristol, UK; Extreme Environments Laboratory, University of Portsmouth, Portsmouth, UK; HM Coastguard, Southampton, UK.
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3
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Yoshimura S, Kiguchi T, Nishioka N, Ikeda N, Takegawa M, Miyamae N, Sumida Y, Kitamura T, Iwami T. Association of pre-hospital tracheal intubation with outcomes after out-of-hospital cardiac arrest by drowning comparing to supraglottic airway device: A nationwide propensity score-matched cohort study. Resuscitation 2024; 197:110129. [PMID: 38280506 DOI: 10.1016/j.resuscitation.2024.110129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 01/29/2024]
Abstract
AIM OF THE STUDY This study aimed to compare the survival outcomes of adult patients with out-of-hospital cardiac arrest (OHCA) by drowning who were treated with either endotracheal intubation (ETI) or a supraglottic airway (SGA) device. METHODS We compared the outcomes of patients with OHCA by drowning according to airway management using a Japanese nationwide population-based registry (All-Japan Utstein Registry). Adult patients with OHCA treated in 2014-2020 with advanced airway management (ETI or SGA) were included. Patients who received ETI during cardiopulmonary resuscitation were matched with those treated with SGA based on propensity scores in a 1:1 ratio with a 0.2 calliper width. The outcome measures were the return of spontaneous circulation (ROSC), survival at one month, and favourable neurological outcomes defined as a Cerebral Performance Category Scale score of 1 or 2. RESULTS Of the 11,703 eligible patients, 4,467 (38.2%) and 7,236 (61.8%) underwent ETI and SGA, respectively. A total of 3,566 patients in each cohort were matched. The ROSC rate was higher in those treated with ETI versus SGA (207/3,566 [5.8%] versus 167/3,566 [4.7%], respectively; adjusted odds ratio, 1.25; 95% confidence interval [CI], 1.02-1.55). There was no intergroup difference in one-month survival or favourable neurological outcome (32/3566 [0.90%] versus 34/3566 [0.95%]; odds ratio, 0.94; 95% CI, 0.58-1.53; and 9/3566 [0.25%] versus 8/3566 [0.22%]; odds ratio, 1.13; 95% CI, 0.43-2.92), respectively. CONCLUSIONS In this propensity score-matched study of adult OHCA by drowning, ETI compared to SGA was associated with ROSC but not associated with survival and favourable neurological outcomes at one month.
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Affiliation(s)
- Satoshi Yoshimura
- Department of Emergency Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan; Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeyuki Kiguchi
- Critical Care and Trauma Center, Osaka General Medical Center, Osaka, Japan
| | - Norihiro Nishioka
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Nobuhiro Ikeda
- Department of Emergency Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Masayasu Takegawa
- Department of Emergency Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Nobuhiro Miyamae
- Department of Emergency Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Yasuyuki Sumida
- Department of Emergency Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Taku Iwami
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan.
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, Fernanda de Almeida M, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Daripa Kawakami M, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, John Madar R, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Gene Ong YK, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Resuscitation 2024; 195:109992. [PMID: 37937881 DOI: 10.1016/j.resuscitation.2023.109992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
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Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, de Almeida MF, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Ong YKG, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2023; 148:e187-e280. [PMID: 37942682 PMCID: PMC10713008 DOI: 10.1161/cir.0000000000001179] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
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Bierens J, Bray J, Abelairas-Gomez C, Barcala-Furelos R, Beerman S, Claesson A, Dunne C, Fukuda T, Jayashree M, T Lagina A, Li L, Mecrow T, Morgan P, Schmidt A, Seesink J, Sempsrott J, Szpilman D, Thom O, Tobin J, Webber J, Johnson S, Perkins GD. A systematic review of interventions for resuscitation following drowning. Resusc Plus 2023; 14:100406. [PMID: 37424769 PMCID: PMC10323217 DOI: 10.1016/j.resplu.2023.100406] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 07/11/2023] Open
Abstract
Objectives The International Liaison Committee on Resuscitation, in collaboration with drowning researchers from around the world, aimed to review the evidence addressing seven key resuscitation interventions: 1) immediate versus delayed resuscitation; (2) compression first versus ventilation first strategy; (3) compression-only CPR versus standard CPR (compressions and ventilations); (4) ventilation with and without equipment; (5) oxygen administration prior to hospital arrival; (6) automated external defibrillation first versus cardiopulmonary resuscitation first strategy; (7) public access defibrillation programmes. Methods The review included studies relating to adults and children who had sustained a cardiac arrest following drowning with control groups and reported patient outcomes. Searches were run from database inception through to April 2023. The following databases were searched Ovid MEDLINE, Pre-Medline, Embase, Cochrane Central Register of Controlled Trials. Risk of bias was assessed using the ROBINS-I tool and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. The findings are reported as a narrative synthesis. Results Three studies were included for two of the seven interventions (2,451 patients). No randomised controlled trials were identified. A retrospective observational study reported in-water resuscitation with rescue breaths improved patient outcomes compared to delayed resuscitation on land (n = 46 patients, very low certainty of evidence). The two observational studies (n = 2,405 patients), comparing compression-only with standard resuscitation, reported no difference for most outcomes. A statistically higher rate of survival to hospital discharge was reported for the standard resuscitation group in one of these studies (29.7% versus 18.1%, adjusted odds ratio 1.54 (95% confidence interval 1.01-2.36) (very low certainty of evidence). Conclusion The key finding of this systematic review is the paucity of evidence, with control groups, to inform treatment guidelines for resuscitation in drowning.
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Affiliation(s)
- Joost Bierens
- Extreme Environments Laboratory, University of Portsmouth, Portsmouth, UK
| | - Janet Bray
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cristian Abelairas-Gomez
- CLINURSID Research Group and Faculty of Education Sciences, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Roberto Barcala-Furelos
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo. Pontevedra, Spain
| | | | - Andreas Claesson
- Centre for Resuscitation Science, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Cody Dunne
- Department of Emergency Medicine, University of Calgary, Canada
| | - Tatsuma Fukuda
- Department of Emergency and Critical Care Medicine, Toranomon Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Tokyo, Japan
| | - Muralidharan Jayashree
- Department of Pediatrics. Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anthony T Lagina
- School of Emergency Medicine, Wayne State University, Detroit, USA
| | - Lei Li
- School of Emergency Medicine, Wayne State University, Detroit, USA
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tom Mecrow
- Royal National Lifeboat Institution, West Quay Road, Poole, Dorset, UK
| | - Patrick Morgan
- Extreme Environments Laboratory, University of Portsmouth, Portsmouth, UK
| | - Andrew Schmidt
- Department of Emergency Medicine, University of Florida-Jacksonville, Jacksonville, USA
| | - Jeroen Seesink
- Erasmus MC University Medical Center, Department of Anaesthesiology, Rotterdam, the Netherlands
| | | | - David Szpilman
- Brazilian Lifesaving Society, SOBRASA, Rio de Janeiro, Brazil
| | - Ogilvie Thom
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Joshua Tobin
- UT Health San Antonio, Dept of Anesthesiology, San Antonio, USA
| | - Jonathon Webber
- Department of Anaesthesiology, The University of Auckland, Auckland, New Zealand
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Ryan K, Bui MD, Johnson B, Eddens KS, Schmidt A, Ramos WD. Drowning in the United States: Patient and Scene Characteristics using the novel CARES Drowning Variables. Resuscitation 2023; 187:109788. [PMID: 37030551 DOI: 10.1016/j.resuscitation.2023.109788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/22/2023] [Accepted: 03/25/2023] [Indexed: 04/10/2023]
Abstract
INTRODUCTION Drowning results in more than 360,000 deaths annually, making it the 3rd leading cause of unintentional injury death worldwide. Prior studies examining drowning internationally have reviewed factors surrounding drowning however in the U.S. limited data exists. This study evaluated the novel drowning elements collected in the Cardiac Arrest Registry to Enhance Survival (CARES) during the first 2 years of data collection. METHODS A retrospective analysis of the CARES database identified cases of drowning etiology for the two years 2020 and 2021. Demographics and incident characteristics were collected. Characteristics included items such as body of water, precipitating event, and who extracted patients. Survival to hospital discharge and neurological outcomes were compared between groups based on who initiated CPR using Pearson's Chi-Squared tests. RESULTS Among 1,767 drowning cases, 69.7% were male, 47.1% white and 11.9% survived to hospital discharge. Body of water was often natural body (36.2%) or swimming pool (25.9%) and bystanders removed the patient in 42.7% of incidents. Swimming was the most common activity at time of submersion (18.6%) however in 50.2% of cases, activity was unknown or missing. When compared to EMS/First Responder initiating CPR, odds of neurologically favorable survival were significantly higher in the Bystander initiated CPR group (OR=2.85, 95% confidence interval [CI] 2.02-4.01). CONCLUSION In this national cohort of drowning patients in cardiac arrest, the novel CARES drowning elements provide additional detail of epidemiological factors. Bystander CPR was associated with improved neurological outcomes. Future studies utilizing the drowning elements can inform injury prevention strategies.
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Affiliation(s)
- Kevin Ryan
- Assistant Professor of Emergency Medicine, Boston Medical Center/Chobanian and Avedisian School of Medicine, 785 Albany Street, 5(th) Floor, Boston, MA 02118
| | - Matthew D Bui
- Boston Medical Center/Chobanian and Avedisian School of Medicine, Department of Emergency Medicine, BCD Building, 800 Harrison Ave, Boston, MA 02118
| | - Brett Johnson
- University of Massachusetts Medical Center/UMASS Chan School of Medicine, Department of Emergency Medicine, 55 Lake Ave North, Worcester, MA 01655
| | - Katherine S Eddens
- Associate Research Scientist, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, 1025 E 7th St, C101, Bloomington, IN 47405
| | - Andrew Schmidt
- Associate Professor of Emergency Medicine, University of Florida College of Medicine -Jacksonville, 655 W 8TH ST C506, Jacksonville, FL 32209
| | - William D Ramos
- Associate Professor, Director - Aquatics Institute, Indiana University School of Public Health-Bloomington, Dept. of Health & Wellness Design, 1025 E 7th St, Bloomington, IN 47405
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Bierens JJLM. Drowning survival: Do differences in EMT airway management matter? Resuscitation 2021; 163:186-188. [PMID: 33864875 DOI: 10.1016/j.resuscitation.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/02/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Joost J L M Bierens
- Research Group Emergency and Disaster Medicine, Vrije Universiteit Brussel, Belgium.
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