Chest compression-only CPR by lay rescuers and survival from out-of-hospital cardiac arrest.

Context: Chest compression-only bystander cardiopulmonary resuscitation (CPR) may be as effective as conventional CPR with rescue breathing for out-of-hospital cardiac arrest.

Objective: To investigate the survival of patients with out-of-hospital cardiac arrest using compression-only CPR (COCPR) compared with conventional CPR.

Design, Setting, And Patients: A 5-year prospective observational cohort study of survival in patients at least 18 years old with out-of-hospital cardiac arrest between January 1, 2005, and December 31, 2009, in Arizona.

Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest.

Context: Out-of-hospital cardiac arrest is a major public health problem.

Objective: To investigate whether the survival of patients with out-of-hospital cardiac arrest would improve with minimally interrupted cardiac resuscitation (MICR), an alternate emergency medical services (EMS) protocol.

Design, Setting, And Patients: A prospective study of survival-to-hospital discharge between January 1, 2005, and November 22, 2007.

Pediatric defibrillation doses often fail to terminate prolonged out-of-hospital ventricular fibrillation in children.

Background: The recommended dose for pediatric defibrillation is 2 J/kg, based on animal studies of brief duration ventricular fibrillation (VF) and a single pediatric study of short duration in-hospital VF. In a piglet model of out-of-hospital (prolonged) cardiac arrest, this recommended dose was usually ineffective at terminating VF. We, therefore, hypothesized that pediatric dose defibrillation may be less effective for prolonged out-of-hospital pediatric VF.

Interruptions of chest compressions during emergency medical systems resuscitation.

Background: Survival after nontraumatic out-of-hospital (OOH) cardiac arrest in Tucson, Arizona, has been flat at 6% (121/2177) for the decade 1992 to 2001. We hypothesized that interruptions of chest compressions occur commonly and for substantial periods during treatment of OOH cardiac arrest and could be contributing to the lack of improvement in resuscitation outcome.

Methods And Results: Sixty-one adult OOH cardiac arrest patients treated by automated external defibrillator (AED)-equipped Tucson Fire Department first responders from November 2001 through November 2002 were retrospectively reviewed.

Post-shock chest compression delays with automated external defibrillator use.

Primary Objective: In a swine model of out-of-hospital ventricular fibrillation (VF) cardiac arrest, we established that automated external defibrillator (AED) defibrillation could worsen outcome from prolonged VF compared with manual defibrillation. Worse outcomes were due to substantial interruptions and delays in chest compressions for AED rhythm analyses and shock advice. In particular, the mean interval from first AED shock to first post-shock compressions was 46+/-6s.

An alternative approach to advancing resuscitation science.

Stagnant survival rates in out-of-hospital cardiac arrest remain a great impetus for advancing resuscitation science. International resuscitation guidelines, with all their advantages for standardizing resuscitation therapeutic protocols, can be difficult to change. A formalized evidence-based process has been adopted by the International Liason Committee on Resuscitation (ILCOR) in formulating such guidelines.