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Heringhaus C, Bosch J, Oosterveer D, de Visser M. System-based interventions to improve outcome in out-of-hospital cardiac arrest patients: a Dutch experience. Eur J Emerg Med 2021; 28:416-417. [PMID: 34714813 DOI: 10.1097/mej.0000000000000887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | - Jan Bosch
- Department of Research and Development, Regional Ambulance Services Hollands Midden (RAVHM)
| | - Daniëlla Oosterveer
- Department of Rehabilitation, Basalt Rehabilitation Centre, Leiden, The Hague, the Netherlands
| | - Matthijs de Visser
- Department of Research and Development, Regional Ambulance Services Hollands Midden (RAVHM)
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Han MX, Yeo ANWT, Ong MEH, Smith K, Lim YL, Lin NH, Tan B, Arulanandam S, Ho AFW, Ng QX. Cardiac Arrest Occurring in High-Rise Buildings: A Scoping Review. J Clin Med 2021; 10:jcm10204684. [PMID: 34682806 PMCID: PMC8539960 DOI: 10.3390/jcm10204684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Out-of-hospital cardiac arrests (OHCAs) occurring in high-rise buildings are a challenge to Emergency Medical Services (EMS). Contemporary EMS guidelines lack specific recommendations for systems and practitioners regarding the approach to these patients. This scoping review aimed to map the body of literature pertaining to OHCAs in high-rise settings in order to clarify concepts and understanding and to identify knowledge gaps. Databases were searched from inception through to 6 May 2021 including OVID Medline, PubMed, Embase, CINAHL, and Scopus. Twenty-three articles were reviewed, comprising 8 manikin trials, 14 observational studies, and 1 mathematical modelling study. High-rise settings commonly have lower availability of bystanders and automatic external defibrillators (AEDs), while height constraints often lead to delays in EMS interventions and suboptimal cardiopulmonary resuscitation (CPR), scene access, and extrication. Four studies found return of spontaneous circulation (ROSC) rates to be significantly poorer, while seven studies found rates of survival-to-hospital discharge (n = 3) and neurologically favourable survival (n = 4) to be significantly lower in multistorey settings. Mechanical chest compression devices, transfer sheets, and strategic defibrillator placement were suggested as approaches to high-rise OHCA management. A shift to maximising on-scene treatment time, along with bundling novel prehospital interventions, could ameliorate some of these difficulties and improve clinical outcomes for patients.
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Affiliation(s)
- Ming Xuan Han
- Emergency Medical Services Department, Singapore Civil Defence Force, Singapore 408827, Singapore; (M.X.H.); (Y.L.L.); (B.T.); (S.A.)
| | - Amelia Natasha Wen Ting Yeo
- Engineering Product Development Pillar, Singapore University of Technology and Design, Singapore 487372, Singapore;
| | - Marcus Eng Hock Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore; (M.E.H.O.); (A.F.W.H.)
- SingHealth Emergency Medicine Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
| | - Karen Smith
- Department of Community Emergency Health and Paramedic Practice, Monash University, Clayton, VIC 3800, Australia;
| | - Yu Liang Lim
- Emergency Medical Services Department, Singapore Civil Defence Force, Singapore 408827, Singapore; (M.X.H.); (Y.L.L.); (B.T.); (S.A.)
- MOH Holdings Pte Ltd., Singapore 099253, Singapore;
| | | | - Bobo Tan
- Emergency Medical Services Department, Singapore Civil Defence Force, Singapore 408827, Singapore; (M.X.H.); (Y.L.L.); (B.T.); (S.A.)
| | - Shalini Arulanandam
- Emergency Medical Services Department, Singapore Civil Defence Force, Singapore 408827, Singapore; (M.X.H.); (Y.L.L.); (B.T.); (S.A.)
| | - Andrew Fu Wah Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore; (M.E.H.O.); (A.F.W.H.)
- SingHealth Emergency Medicine Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore 169857, Singapore
| | - Qin Xiang Ng
- Emergency Medical Services Department, Singapore Civil Defence Force, Singapore 408827, Singapore; (M.X.H.); (Y.L.L.); (B.T.); (S.A.)
- MOH Holdings Pte Ltd., Singapore 099253, Singapore;
- Correspondence: ; Tel.: +65-6794-5502
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