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Search Results: 1 - 10 of 3339 matches for " Cardiac arrest "
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Preventable In-Hospital Cardiac Arrests― Are We Monitoring the Wrong Organ?  [PDF]
Lakshmipathi Chelluri
Open Journal of Emergency Medicine (OJEM) , 2014, DOI: 10.4236/ojem.2014.23007

Pulseless Electrical Activity (PEA) and aystole are the most common initial rhythms in patients with in-hospital cardiac arrest. Respiratory failure is the most common cause for Rapid Response Team alert, and may be the initial cause for in-hospital cardiac arrests. Although cardiac monitoring is shown to be ineffective in identifying patients at risk for cardiac arrest, it is the most common monitoring used on the wards. As many of the cardiac arrests may have a respiratory origin, respiratory monitoring could identify patients at risk to develop cardiac arrest. Reclassifying cardiac arrests as primary cardiac and secondary would help in identifying secondary causes, and monitoring that could help in early identification of deterioration.

Intrahospital Dissemination of Automatic External Defibrillators Decrease Time to Defibrillation of In-Hospital Cardiac Arrests  [PDF]
D. Fredman, Leif Svensson, M. Jonsson, J. Beltzikoff, M. Ringh, P. Nordberg, J. Hollenberg, M. Rosenqvist
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.52015

Background: Survival rates for in-hospital cardiac (IHCA) arrest are low. Early defibrillation is vital and international guidelines, which requests defibrillation within three minutes. Can dissemination of automatic external defibrillators (AED) at hospital wards shorten time to defibrillation compared to standard care, calling for medical emergency team (MET)? Material & Methods: Forty-eight (48) units at S?dersjukhuset, Sweden, were included in the study. They were divided into the intervention group (24 units equipped with AEDs) and the standard care group (24 units with no AEDs). Intervention group staff were trained in CPR to use AEDs and standard care group staff were trained in just CPR. Data were gathered from patient records, AEDs and the Swedish National Registry of Cardiopulmonary Resuscitation (NRCR). Results: 126 IHCA patients were included, 47 in the standard care group, 79 in the intervention group. AEDs in the intervention group were connected to a defibrillator and it was ready to shock before arrival of MET in 83.5% of all cases. AEDs were ready to be used on average 96 seconds (14-427 s) before arrival of MET. Seven (15%) patients were defibrillated in the control group and Twenty (25%) in the intervention group. Defibrillation within three minutes occurred in 67% in the intervention group (11/17), compared with none (0/7) in the control group (p = 0.02). Conclusion: A systematic implementation of AEDs in hospital wards decrease time to defibrillation compared to a standard MET response system. Larger studies are needed to evaluate the impact on the

Cardiopulmonary Resuscitation in the Prone Position  [PDF]
Daiana de Souza Gomes, Carlos Darcy Alves Bersot
Open Journal of Anesthesiology (OJAnes) , 2012, DOI: 10.4236/ojanes.2012.25045
Abstract: Cardiac arrest in unusual positions represents an additional challenge for anesthesiologists. This paper reports a successful cardiopulmonary resuscitation during neurosurgical procedure in which high-quality chest compressions was performed in the prone position. The aim of this report is disclose the knowledge of resuscitation maneuvers in a position other than supine. A 77-year-old female patient presented for excision of parietal-occipital meningioma in the prone position with the head fixed on a Mayfield head-holder. During the surgical procedure the sagittal sinus was disrupted. The patient presented an abrupt hemorrhagic shock leading to a cardiac arrest by hypovolemia despite vigorous volume replacement. Cardiac massage was promptly initiated in the prone position. After two minutes, there was a return of spontaneous circulation. The patient was discharged without sequelae. We concluded that high-quality chest compressions in the prone position were able to generate sufficient cardiac output.
Sudden Death as the Outcome of Cardiac Arrest, in a Portuguese Region: Where Do Resuscitation Manoeuvres Stand?  [PDF]
Rosa Henriques de Gouveia, Adriana Martins, Duarte Nuno Vieira
World Journal of Cardiovascular Diseases (WJCD) , 2015, DOI: 10.4236/wjcd.2015.58026
Abstract: Cardiac Arrest (CA) is a major health problem, due to short and long-term sequel? and to associated mortality. Despite the improvement of out-of-hospital and in-hospital resuscitation manoeuvres, unexpected sudden fatal events occur. The authors reported the features of a series of sudden death (SD) cases where cardiopulmonary resuscitation (CPR) was performed. Files of 1053 medico-legal autopsies, from victims aged ≥18 years-old, were reviewed. Cardiac Arrest leading to Sudden Death were found in 477 cases (45.3%), but only 199 (42%) of these had been submitted to resuscitation manoeuvres. There was an elderly male predominance. Both non-cardiac and cardiac CA/SD causes were present, despite the higher coronary artery disease incidence. Both out-of-hospital and in-hospital events took place. Age, severity of the disease, comorbidities and predominance of out-of-hospital CA were obstacles to successful CPR, leading to SD. Knowing the population characteristics may help to improve Emergency Assistance.
Percutaneous Coronary Intervention Reduces Mortality in Out-of-Hospital Cardiac Arrest after Acute Coronary Syndrome: An Outcomes-Based Study from the Nationwide Inpatient Sample Database  [PDF]
Christine S. M. Lau, Mahyar Pourriahi, Amanda Ward, Kedar P. Kulkarni, Krishnaraj Mahendraraj, Ronald S. Chamberlain
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.81004
Abstract: Introduction: Mortality following cardiac arrest (CA) is extremely high, with rates as high as 91.5% after out-of-hospital cardiac arrest (OHCA) and 76.1% after in-hospital cardiac arrest (IHCA). This study assessed the clinical profile and outcomes of a large cohort of patients undergoing primary percutaneous coronary intervention (PCI) for OHCA to determine its effect on clinical outcomes and mortality. Methods: 247,456 patients with OHCA due to acute coronary syndrome (ACS) were abstracted from the Nationwide Inpatient Sample database (2001-2011). Results: Among 247,456 OHCA patients, 11,111 (4.5%) had PCI while 236,345 (95.5%) did not. Patients who underwent PCI were younger than those who did not receive PCI (64 vs. 66 years), p < 0.001. Caucasians (79.6%) and males (66.5%) were more likely to undergo PCI, while significantly fewer African Americans (AA) (7.7%) and Hispanics (6.5%) received PCI, p < 0.001. A significantly greater percentage of patients with private insurance (35.5%) or Medicare (47.4%) underwent PCI, p < 0.001. Overall mortality was significantly lower among those undergoing PCI (28.3% vs. 65.4%), p < 0.001. Multivariate analysis identified age >65 years, female gender, AA or Hispanic race, advanced cancer, and liver dysfunction as independent factors associated with increased mortality, while PCI conferred a survival advantage in OHCA, p < 0.001. Conclusion: Treatment with PCI was associated with a significant decrease in mortality. PCI was performed most often in Caucasians, males, patients > 50 years old, and those with Medicare. PCI significantly reduces mortality in OHCA patients and should be considered in all OHCA patients. Further investigation and development of methods to overcome the apparent socioeconomic barriers to PCI is required.
Mismatch between Sites of Incidence of Out-of-Hospital Cardiac Arrest and Locations of Installed Automated External Defibrillator in the Tokyo Metropolitan Area  [PDF]
Kyoko Tsukigase, Hideharu Tanaka, Hiroshi Takyu
World Journal of Cardiovascular Diseases (WJCD) , 2017, DOI: 10.4236/wjcd.2017.76017
Background: Since 2004, the number of installed Automated External Defibrillator (AED) has been increased in Japan annually, the cumulative number of sold AED more than 600,000 units by 2016. Despite there have been about 130,000 out of hospital cardiac arrest annually, there have only 1302 cases delivered defibrillation by bystanders at the scene. Therefore, we investigate that number of AED installation and usage rate for Out of Hospital Cardiac Arrest (OHCA) patients. Methods: Retrospective metropolitan wide cohort study. Subject: Total 13,364 OHCA patients in the Tokyo Metropolitan area from Jan. 1 through Dec. 31 in 2012 were eligible for theses analyses. Also, OHCA occurrence place and AED usage rate were studied. Results: 82.8% of OHCA occurred at residences, 10% at outdoors, 6.4% at indoors, only 0.7% at schools. In the other hand, highest bystander’s CPR rates were found in sports facilities and schools (71.4%). The installation rate of AEDs in residences was 9.6%, instead of highest incidence for OHCA patients, school and sports institute made up 21.4% of AED installations, but only 1.0% of the incidences of cardiac arrest. We found that there is a mismatch between incidence sites of cardiac arrest and locations of installed AED. Discussion: It is essential to increase the number of AED installations. Furthermore, it is desirable to install AEDs in locations where cardiac arrest is liable to occur following guidelines for the proper placement of AEDs, and important to further spread BLS education among the general citizens.
Epidemiología del paro cardiaco intraoperatorio en Cuba: Epidemiology
Vallongo Menéndez,Marina Beatriz; León Alonso,Dania; Cordoví de Armas,Lucas; Abela Lazo,Alba; Cordero Escobar,Idoris;
Revista Cubana de Anestesiolog?-a y Reanimaci?3n , 2009,
Abstract: introduction: cardio-respiratory arrest (cra) is an incident present in the surgical patient. in our country, despite, it is in a subjective way, decreasing in the operating theatres, until now there isn't papers published in the website of the cuban journals of telematic network. objective: to offer results of a research on this topic to identify: incidence in elective surgical procedures, and of emergence, main causes and patient group where it was more frequent, and in a indirect way, not to know how these variable behaviors in the remainder of the country. methods: authors made a prospective-descriptive study of cras occurred in surgical unit of "hermanos ameijeiras" surgical clinical hospital from may 1998 to december 2000, present in operating theatres after arrival of patient with vital signs present. we excluded the multiple organ donors. in a special model it was registered: demographic and anamnestic elements of each patient and results. results: there were 23 cras. they were more frequent in emergence surgery, in patient older than 60 years, in iii-iv-v groups according asa classification, and surgical risk, regular or poor. main causes: results obtained not differ from those reported by other authors until moment of this report.
Anestesia regional y paro cardiaco.Una vez más para no olvidar
Vallongo Menéndez,M. Beatriz;
Revista Cubana de Anestesiolog?-a y Reanimaci?3n , 2010,
Abstract: in general, we belief that the regional anesthesia has less risks than the general anesthesia and that the accidents during its conduction are "uncommon", "unusual" and "unexpected"; however, with some frequency these events are present in its more severe means. thus, it is mandatory for anesthesiologists the frequent study of this subject. objective: in present paper authors identify the risk factors, the pathophysiology leading to the cardiac arrest during the regional anesthesia and the prevention methods and treatment. development: after the review of the related bibliography, it is offered an abstract of leading causes of the cardiac arrest during the regional anesthesia including the patients with a greater risk of bradycardia, arterial hypotension and the physiological changes during the neural-axial anesthesia, toxicity of local anesthetics in peripheral nerves blocks, the human mistake role related to these complications, as well as the essential measures of prevention and treatment. conclusions: the regional anesthesia is not free from the severe complications. the appropriate choice of patients, of local anesthetics and its dose as well as the technique used decrease its incidence. the close monitoring and surveillance of patients under these circumstances are essential since they allow an early diagnosis and the timely treatment of the concerned eventualities.
Images in Emergency Medicine: Tension Pyothorax Causing Cardiac Arrest
Ahern, Terence L,Miller, Gregg A
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2009,
Cardiac arrest in intensive care unit: Case report and future recommendations
Mohammad A,Zafar N,Feerick A
Saudi Journal of Anaesthesia , 2010,
Abstract: Initiation of hemofiltration in a patient in septic shock can cause hemodynamic compromise potentially leading to cardiac arrest. We propose that the standard ′4Hs and 4Ts′ approach to the differential diagnosis of a cardiac arrest should be supplemented in critically ill patients with anaphylaxis and human and technical errors involving drug administration (the 5 th H and T). To illustrate the point, we report a case where norepinephrine infused through a central venous catheter (CVC) was being removed by the central venovenous hemofiltration (CVVH) catheter causing the hemodynamic instability. CVVH has this potential of interfering with the systemic availability of drugs infused via a closely located CVC.
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