Emergency Interhospital Transfer of Patients With ST-Segment-Elevation Myocardial Infarction: Call 9-1-1-The American Heart Association Mission: Lifeline Program.

The American Heart Association Mission: Lifeline program objectives are to improve the quality of care and outcomes for patients with ST-segment-elevation myocardial infarction. Every minute of delay in treatment adversely affects 1-year mortality. Transfer of patients safely and timely to hospitals with primary percutaneous coronary intervention capability is needed to improve outcomes.

Observed survival benefit of mild therapeutic hypothermia reanalysing the Circulation Improving Resuscitation Care trial.

Background: Mild therapeutic hypothermia is argued being beneficial for outcome after cardiac arrest.

Materials And Methods: Retrospective analysis of Circulation Improving Resuscitation Care (CIRC) trial data to assess if therapeutic cooling to 33 ± 1 °C core temperature had an association with survival. Of 4231 adult, out-of-hospital cardiac arrests of presumed cardiac origin initially enrolled, eligibility criteria for therapeutic hypothermia were met by 1812.

Why do some studies find that CPR fraction is not a predictor of survival?

Introduction: An 80% chest compression fraction (CCF) during resuscitation is recommended. However, heterogeneous results in CCF studies were found during the 2015 Consensus on Science (CoS), which may be because chest compressions are stopped for a wide variety of reasons including providing lifesaving care, provider distraction, fatigue, confusion, and inability to perform lifesaving skills efficiently.

Objective: The effect of confounding variables on CCF to predict cardiac arrest survival.

Defibrillation success during different phases of the mechanical chest compression cycle.

Introduction: Animal studies indicate higher termination of VF/VT (TOF) rates after shocks delivered during the decompression phase of the compression cycle for manual and mechanical CPR. We investigated TOF for shocks delivered in different compression cycle phases during load distributing band (LDB) mechanical CPR in the CIRC trial.

Methods: Shocks were retrospectively categorized as delivered during the compression, decompression, or relaxation phase of LDB compressions using transthoracic impedance data.

Pre-shock chest compression pause effects on termination of ventricular fibrillation/tachycardia and return of organized rhythm within mechanical and manual cardiopulmonary resuscitation.

Background: Shorter manual chest compression pauses prior to defibrillation attempts is reported to improve the defibrillation success rate. Mechanical load-distributing band (LDB-) CPR enables shocks without compression pause. We studied pre-shock pause and termination of ventricular fibrillation/pulseless ventricular tachycardia 5s post-shock (TOF) and return of organized rhythm (ROOR) with LDB and manual (M-) CPR.

Minimizing pre-shock chest compression pauses in a cardiopulmonary resuscitation cycle by performing an earlier rhythm analysis.

Background: Guidelines recommend 2min of CPR after defibrillation attempts followed by ECG analysis during chest compression pause. This pause may reduce the likelihood of return of spontaneous circulation (ROSC) and survival. We have evaluated the possibility of analysing the rhythm earlier in the CPR cycle in an attempt to replace immediate pre-shock rhythm analysis.

Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial.

Objective: To compare integrated automated load distributing band CPR (iA-CPR) with high-quality manual CPR (M-CPR) to determine equivalence, superiority, or inferiority in survival to hospital discharge.

Methods: Between March 5, 2009 and January 11, 2011 a randomized, unblinded, controlled group sequential trial of adult out-of-hospital cardiac arrests of presumed cardiac origin was conducted at three US and two European sites. After EMS providers initiated manual compressions patients were randomized to receive either iA-CPR or M-CPR.

Contrails reduce daily temperature range.

The potential of condensation trails (contrails) from jet aircraft to affect regional-scale surface temperatures has been debated for years, but was difficult to verify until an opportunity arose as a result of the three-day grounding of all commercial aircraft in the United States in the aftermath of the terrorist attacks on 11 September 2001. Here we show that there was an anomalous increase in the average diurnal temperature range (that is, the difference between the daytime maximum and night-time minimum temperatures) for the period 11-14 September 2001. Because persisting contrails can reduce the transfer of both incoming solar and outgoing infrared radiation and so reduce the daily temperature range, we attribute at least a portion of this anomaly to the absence of contrails over this period.