Introduction of performance coaching during cardiopulmonary resuscitation improves compression depth and time to defibrillation in out-of-hospital cardiac arrest.

Introduction: Quality cardiopulmonary resuscitation (CPR) and timely defibrillation are associated with increasing survival to hospital discharge from out-of-hospital cardiac arrest (OHCA). The objective of this study was to demonstrate that performance coaching during an OHCA would improve compression depth and time to defibrillation (TTD).

Methods: This study was conducted in a single emergency medical services (EMS) agency and utilized data collected from 815 patients treated between 1/1/2012 and 12/31/2013.

The association between patients' perception of their overall quality of care and their perception of pain management in the prehospital setting.

Objective: Our objective was to determine whether there is an association between a patient's impression of his or her overall quality of care and his or her satisfaction with the pain management provided. We hypothesized that satisfaction with pain management would show a significant positive association with a patient's impression of overall quality of care.

Methods: This was a retrospective review of patient satisfaction data initially collected by a third-party company from January 1, 2007, to September 1, 2010.

Assessing the influence of insulation on intravenous fluid infusion temperature.

Objectives: Inducing therapeutic hypothermia using chilled saline in resuscitated cardiac arrest patients has been shown to be feasible and effective. Limited research exists assessing the efficiency of this cooling method. The objective of this study was to assess the change in temperature of 4°C saline upon exiting an infusion set in the laboratory setting while varying conditions of fluid delivery.

Intraosseous versus intravenous vascular access during out-of-hospital cardiac arrest: a randomized controlled trial.

Study Objective: Intraosseous needle insertion during out-of-hospital cardiac arrest is rapidly replacing peripheral intravenous routes in the out-of-hospital setting. However, there are few data directly comparing the effectiveness of intraosseous needle insertions with peripheral intravenous insertions during out-of-hospital cardiac arrest. The objective of this study is to determine whether there is a difference in the frequency of first-attempt success between humeral intraosseous, tibial intraosseous, and peripheral intravenous insertions during out-of-hospital cardiac arrest.

King LT-D use by urban basic life support first responders as the primary airway device for out-of-hospital cardiac arrest.

Objective: The objective of this study was to compare the frequency of first attempt success between basic life support (BLS) first responder initiated King LT-D placement and paramedic initiated endotracheal intubation (ETI) among patients experiencing out-of-hospital cardiac arrest (OOHCA).

Methods: In 2009 a large, urban EMS agency modified their out-of-hospital, non-traumatic, cardiac arrest protocol from paramedic initiated ETI to first responder initiated King LT-D placement. This retrospective analysis of all adult, non-traumatic cardiac arrests occurred four months before and four months after protocol implementation.

Comparison of first-attempt success between tibial and humeral intraosseous insertions during out-of-hospital cardiac arrest.

Background: Intraosseous (IO) needle insertion is often utilized in the adult population for critical resuscitation purposes. Standard insertion sites include the proximal humerus and proximal tibia, for which limited comparison data are available.

Objective: This study compared the frequencies of IO first-attempt success between humeral and tibial sites in out-of-hospital cardiac arrest.

The association between intra-arrest therapeutic hypothermia and return of spontaneous circulation among individuals experiencing out of hospital cardiac arrest.

Introduction: Therapeutic hypothermia has been shown to improve both mortality and neurologic outcomes following pulseless ventricular tachycardia and fibrillation. Animal data suggest intra-arrest induction of therapeutic hypothermia (IATH) improves frequency of return of spontaneous circulation (ROSC). Our objective was to evaluate the association between IATH and ROSC.

Association between prehospital time intervals and ST-elevation myocardial infarction system performance.

Background: Among individuals experiencing an ST segment-elevation myocardial infarction, current guidelines recommend that the interval from first medical contact to percutaneous coronary intervention be ≤90 minutes. The objective of this study was to determine whether prehospital time intervals were associated with ST-elevation myocardial infarction system performance, defined as first medical contact to percutaneous coronary intervention.

Methods And Results: Study patients presented with an acute ST-elevation myocardial infarction diagnosed by prehospital ECG between May 2007 and March 2009.