Pediatric Out-of-Hospital Cardiac Arrest: The Role of the Telecommunicator in Recognition of Cardiac Arrest and Delivery of Bystander Cardiopulmonary Resuscitation.

Background: Telecommunicator CPR (T-CPR), whereby emergency dispatch facilitates cardiac arrest recognition and coaches CPR over the telephone, is an important strategy to increase early recognition and bystander CPR in adult out-of-hospital cardiac arrest (OHCA). Little is known about this treatment strategy in the pediatric population. We investigated the role of T-CPR and related performance among pediatric OHCA.

Out of hospital cardiac arrest: Past, present, and future.

Advances in resuscitation following out-of-hospital cardiac arrest (OHCA) provide an opportunity to improve public health. This review reflects on past developments, present status, and future possibilities using the science-education-implementation framework of the Utstein Formula and the clinical framework of the links in the chain of survival. With the discovery of CPR and defibrillation in the mid 20th century, resuscitation developed a scientific construct for progress.

Association between functional status at hospital discharge and long-term survival after out-of-hospital-cardiac-arrest.

Background: Out-of-hospital cardiac arrest (OHCA) causes brain injury. Functional status of survivors at hospital discharge is a core resuscitation measure, frequently using the Cerebral Performance Category (CPC) or modified Rankin Scale (mRS). Which scale better predicts long-term survival following OHCA is not known.

Merits of expanding the Utstein case definition for out of hospital cardiac arrest.

Background: The Utstein population is defined by non-traumatic, bystander-witnessed out-of-hospital cardiac arrest (OHCA) presenting with ventricular fibrillation (VF). It is used to compare resuscitation performance across emergency medical services (EMS) systems. We hypothesized a system-specific survival correlation between the current Utstein population and other VF populations defined by unwitnessed VF OHCA and VF OHCA after EMS arrival (EMS-witnessed).

Telecommunicator Cardiopulmonary Resuscitation: A Policy Statement From the American Heart Association.

Every year in the United States, >350 000 people have sudden cardiac arrest outside of a hospital environment. Sudden cardiac arrest is the unexpected loss of heart function, breathing, and consciousness and is commonly the result of an electric disturbance in the heart. Unfortunately, only ≈1 in 10 victims survives this dramatic event.

Strategy to Address Private Location Cardiac Arrest: A Public Safety Survey.

Objective: Most cardiac arrests occur in the private setting where response is often delayed and outcomes are poor. We surveyed public safety personnel to determine if they would volunteer to respond into private locations and/or be equipped with a personal automated external defibrillator (AED) as part of a vetted responder program that would use smart geospatial technology.

Methods: We conducted an anonymized survey among personnel from fire-based emergency medical services (EMS) and search and rescue organizations from Washington State.

Syringe Administration of Epinephrine by Emergency Medical Technicians for Anaphylaxis.

Objective: In recent years, the costs of epinephrine autoinjectors (EAIs) in the United States have risen substantially. King County Emergency Medical Services implemented the "Check and Inject" program to replace EAIs by teaching emergency medical technicians (EMTs) to manually aspirate epinephrine from a single-use 1 mg/mL epinephrine vial using a needle and syringe followed by prehospital intramuscular administration of the correct adult or pediatric dose of epinephrine for anaphylaxis or serious allergic reaction. Treatment was guided by an EMT protocol that required a trigger and symptoms.

Determining witnessed status for out-of-hospital cardiac arrest.

Objective: Witnessed status is considered a core variable in reporting cardiac arrest data and can be ascertained from either the emergency dispatch recording or the pre-hospital record. The purpose of this study is to compare and assess the quality and consistency of these information sources.

Methods: This retrospective analysis included 1896 cases of out-of-hospital cardiac arrest occurring between September 1, 2012 and December 31, 2014.

Treatment and outcome of out-of-hospital cardiac arrest in outpatient health care facilities.

Aim: We evaluated the frequency and effectiveness of basic and advanced life support (ALS) interventions by medical professionals when out-of-hospital cardiac arrest (OHCA) occurred in ambulatory healthcare clinics before emergency medical services (EMS) arrival.

Methods: Non-traumatic OHCAs in adults were systematically characterized over a 15 year period by their occurrence in clinics, at home, or in non-medical public locations, and outcomes compared between matched cohorts from each group.

Results: Among 7784 patients, 6098 OHCA occurred at home, 1612 in non-medical public locations and 74 in clinics.

Treatment of cardiac arrest with rapid defibrillation by police in King County, Washington.

Background: Improving survival from out-of-hospital cardiac arrest is an ongoing challenge for emergency medical services (EMS). Various strategies for shortening the time from collapse to defibrillation have been used, and one is to equip police officers with defibrillators. Objective.

Dispatcher-assisted cardiopulmonary resuscitation: time to identify cardiac arrest and deliver chest compression instructions.

Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR), in which 9-1-1 dispatchers provide CPR instructions over the telephone, has been shown to nearly double the rate of bystander CPR. We sought to identify factors that hampered the identification of cardiac arrest by 9-1-1 dispatchers and prevented or delayed the provision of dispatcher-assisted CPR chest compressions.

Methods And Results: We reviewed dispatch recordings for 476 out-of-hospital cardiac arrests occurring between January 1, 2011, and December 31, 2011.

Cardiac arrest at exercise facilities: implications for placement of automated external defibrillators.

Objectives: This study sought to characterize the relative frequency, care, and survival of sudden cardiac arrest in traditional indoor exercise facilities, alternative indoor exercise sites, and other indoor sites.

Background: Little is known about the relative frequency of sudden cardiac arrest at traditional indoor exercise facilities versus other indoor locations where people engage in exercise or about the survival at these sites in comparison with other indoor locations.

Methods: We examined every public indoor sudden cardiac arrest in Seattle and King County from 1996 to 2008 and categorized each event as occurring at a traditional exercise center, an alternative exercise site, or a public indoor location not used for exercise.

The formula for survival in resuscitation.

The International Liaison Committee on Resuscitation (ILCOR) Advisory Statement on Education and Resuscitation in 2003 included a hypothetical formula--'the formula for survival' (FfS)--whereby three interactive factors, guideline quality (science), efficient education of patient caregivers (education) and a well-functioning chain of survival at a local level (local implementation), form multiplicands in determining survival from resuscitation. In May 2006, a symposium was held to discuss the validity of the formula for survival hypothesis and to investigate the influence of each of the multiplicands on survival. This commentary combines the output from this symposium with an updated illustration of the three multiplicands in the FfS using rapid response systems (RRS) for medical science, therapeutic hypothermia (TH) for local implementation, and bystander cardiopulmonary resuscitation (CPR) for educational efficiency.