Publications by authors named "Ronald Stickney"

Rapid prehospital identification of patients with ST-elevation myocardial infarction (STEMI) is a critical step to reduce time to treatment. Broad screening with field 12-lead ECGs can lead to a high rate of false positive STEMI activations due to low prevalence. One strategy to reduce false positive STEMI interpretations is to limit acquisition of 12-lead ECGs to patients who have symptoms strongly suggestive of STEMI, but this may delay care in patients who present atypically and lead to disparities in populations with more atypical presentations.

View Article and Find Full Text PDF

Purpose: Automated external defibrillators (AED) prompt the rescuer to stop chest compressions (CC) for ECG analysis during out-of-hospital cardiac arrest (OHCA). We assessed the diagnostic accuracy and clinical benefit of a new AED algorithm (cprINSIGHT), which analyzes ECG and impedance signals during CC, allowing rhythm analysis with ongoing chest compressions.

Methods: Amsterdam Police and Fire Fighters used a conventional AED in 2016-2017 (control) and an AED with cprINSIGHT in 2018-2019 (intervention).

View Article and Find Full Text PDF

Objectives: To determine the causes of software misinterpretation of ST elevation myocardial infarction (STEMI) compared to clinically identified STEMI to identify opportunities to improve prehospital STEMI identification.

Methods: We compared ECGs acquired from July 2011 through June 2012 using the LIFEPAK 15 on adult patients transported by the Los Angeles Fire Department. Cases included patients ≥18 years who received a prehospital ECG.

View Article and Find Full Text PDF

Objectives: The purpose of this study is to present a new and improved method for translating the electrocardiographic changes of acute myocardial ischemia into a display which reflects the location and extent of the ischemic area and the associated culprit coronary artery. This method could be automated to present a graphic image of the ischemic area in a manner understandable by all levels of caregivers; from emergency transport personnel to the consulting cardiologist.

Background: Current methods for the ECG diagnosis of ST elevated myocardial infarction (STEMI) are criteria driven, and complex, and beyond the interpretive capability of many caregivers.

View Article and Find Full Text PDF

External mechanical forces can cause ventricular capture and fibrillation (i.e., commotio cordis).

View Article and Find Full Text PDF

Background: Increasing evidence indicates that health professionals often may not achieve guideline standards for cardiopulmonary resuscitation (CPR). Little is known about layperson CPR performance.

Methods: The investigation was a retrospective cohort study of cardiac arrest patients treated by layperson CPR and one model of automated external defibrillator (AED) as part of the Public Access Defibrillation Trial (n=26).

View Article and Find Full Text PDF

Aim: We hypothesized that a unique tock and voice metronome could prevent both suboptimal chest compression rates and hyperventilation.

Methods: A prospective, randomized, parallel design study involving 34 pairs of paid firefighter/emergency medical technicians (EMTs) performing two-rescuer CPR using a Laerdal SkillReporter Resusci Anne manikin with and without metronome guidance was performed. Each CPR session consisted of 2 min of 30:2 CPR with an unsecured airway, then 4 min of CPR with a secured airway (continuous compressions at 100 min(-1) with 8-10 ventilations/min), repeated after the rescuers switched roles.

View Article and Find Full Text PDF

Introduction: There is a need to measure cardiopulmonary resuscitation (CPR) in order to document whether ambulance personnel follow CPR guidelines. Our goal was to do this using defibrillator technology based on changes in transthoracic impedance (TTI) produced by chest compressions and ventilations.

Methods: 122 incidents of out-of-hospital cardiac arrest between May 2003 and February 2004 were analysed based on data recorded from defibrillators in Oslo EMS.

View Article and Find Full Text PDF

Study Objectives: The rhythm detection algorithms of automated external defibrillators have been derived from adult rhythms, and their ability to discriminate between shockable and nonshockable rhythms in children is largely unknown. This study evaluates the performance of 1 automated external defibrillator algorithm in infants and children and evaluates algorithm performance with anterior-posterior versus sternal-apex lead placement.

Methods: We enrolled pediatric patients in a critical care unit, an electrophysiology laboratory, and a cardiac operating room.

View Article and Find Full Text PDF

Introduction: Cardiac arrest due to chest wall blows (commotio cordis) has been reported with increasing frequency in children, and only about 15% of victims survive. Automated external defibrillators (AEDs) have been shown to be life saving in adults with cardiac arrest, but data on their use in children are limited. In a swine model of commotio cordis designed to be most relevant to young children, we assessed the efficacy of a commercially available AED for recognition and termination of ventricular fibrillation.

View Article and Find Full Text PDF