Publications by authors named "Taku Iwami"
Background: Detailed characteristics of those who experience an out-of-hospital cardiac arrest (OHCA) with public-access defibrillation (PAD) are unknown.
Methods And Results: A prospective, population-based observational study involving consecutive OHCA patients with emergency responder resuscitation attempts was conducted from July 1, 2004 through December 31, 2008 in Osaka City. We extracted data for OHCA patients shocked by a public-access automated external defibrillator (AED) and evaluated the patients' and rescuers' characteristics.
Objective: We assessed out-of-hospital cardiac arrests (OHCAs) for various pediatric age groups.
Methods: This prospective, population-based, observational study included all emergency medical service-treated OHCAs in Osaka, Japan, between 1999 and 2006 (excluding 2004). Patients were grouped as adults (>17 years), infants (<1 year), younger children (1-4 years), older children (5-12 years), and adolescents (13-17 years).
New guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) were released in October 2010. The 2010 Guidelines changed a core concept of basic life support from traditional A-B-C (Airway, Breathing, Chest compressions) procedure to C-A-B (Chest compressions, Airway, Breathing) procedure. In the change of concept, it is emphasized that rescuer should start CPR with chest compression immediately.
View Article and Find Full Text PDFObjective: Little is known about triggers of sudden cardiac arrest. This study aimed to analyze the association of the occurrence of out-of-hospital cardiac arrest (OHCA) with patient activities just before the arrest and ambient temperature as one of the major environmental factors.
Methods: This prospective, population-based cohort study enrolled all person aged 18 years or older with OHCA of presumed cardiac origin in Osaka Prefecture, Japan, from 2005 through 2007.
Objective: To determine the most important indicators of prognosis in patients with return of spontaneous circulation (ROSC) following out-of-hospital cardiopulmonary arrest (OHCA) and to develop a best outcome prediction model.
Design And Patients: All patients were prospectively recorded based on the Utstein Style in Osaka over a period of 3 years (2005-2007). Criteria for inclusion were a witnessed cardiac arrest, age greater than 17 years, presumed cardiac origin of the arrest, and successful ROSC.
Background: This study aimed to evaluate the association of cardiopulmonary resuscitation (CPR) training with bystander resuscitation performance and patient outcomes after out-of-hospital cardiac arrest (OHCA).
Methods: This was a prospective, population-based cohort study of all persons aged 18 years or older with OHCA of presumed intrinsic origin and their rescuers from January through December 2008 in Takatsuki, Osaka prefecture, Japan. Data on resuscitation of OHCA patients were obtained by emergency medical service (EMS) personnel in charge based on the Utstein style.
Background: Little is known about the effect of the type of bystander-initiated cardiopulmonary resuscitation (CPR) for prolonged out-of-hospital cardiac arrest (OHCA).
Objectives: To evaluate the time-dependent effectiveness of chest compression-only and conventional CPR with rescue breathing for witnessed adult OHCA of cardiac origin.
Methods: A nationwide, prospective, population-based, observational study of the whole population of Japan included consecutive OHCA patients with emergency responder resuscitation attempts from 1 January 2005 to 31 December 2007.
Background: Although early shock with an automated external defibrillator (AED) is one of the several key elements to save out-of-hospital cardiac arrest (OHCA) victims, it is not always easy to find and retrieve a nearby AED in emergency settings. We developed a cell phone web system, the Mobile AED Map, displaying nearby AEDs located anywhere. The simulation trial in the present study aims to compare the time and travel distance required to access an AED and retrieve it with and without the Mobile AED Map.
View Article and Find Full Text PDFObjectives: This study aimed to compare the time-dependent deterioration of chest compressions between chest compression-only cardiopulmonary resuscitation (CPR) and conventional CPR.
Methods: This study involved 106 and 107 participants randomly assigned to chest compression-only CPR training and conventional CPR training, respectively. Immediately after training, participants were asked to perform CPR for 2 min and the quality of their CPR skills were evaluated.
Background: The increasing survival rates after out-of-hospital cardiac arrests (OHCA) are due mainly to improvements in the first 3 steps of the chain of survival. The aim of this study was to describe the temporal trends of OHCA incidence and outcomes with shock-resistant ventricular fibrillation (VF) requiring advanced life support procedures.
Methods: All our subjects were persons aged 18 years or more who had suffered OHCA of presumed cardiac etiology, were witnessed by bystanders, treated by emergency medical service (EMS), and had VF as initial rhythm.
Background: Although chest compression-only cardiopulmonary resuscitation (CPR) is effective for adult out-of-hospital cardiac arrest (OHCA) of cardiac origin, it remains uncertain whether bystander-initiated rescue breathing has an incremental benefit for OHCA of noncardiac origin.
Methods And Results: A nationwide, prospective, population-based, observational study covering the whole population of Japan and involving consecutive OHCA patients with emergency responder resuscitation attempts was conducted from January 2005 through December 2007. The primary outcome was neurologically intact 1-month survival.
Background: Post-resuscitation care has emerged as an important predictor of survival from out-of-hospital cardiac arrest (OHCA). In Japan, selected hospitals are certified as Critical Care Medical Centers (CCMCs) based on their ability and expertise.
Hypothesis: Outcome after OHCA is better in patients transported to a CCMC compared a non-critical care hospital (NCCH).
Background: It is unclear whether dissemination of automated external defibrillators (AEDs) in public places can improve the rate of survival among patients who have had an out-of-hospital cardiac arrest.
Methods: From January 1, 2005, through December 31, 2007, we conducted a prospective, population-based, observational study involving consecutive patients across Japan who had an out-of-hospital cardiac arrest and in whom resuscitation was attempted by emergency responders. We evaluated the effect of nationwide dissemination of public-access AEDs on the rate of survival after an out-of-hospital cardiac arrest.
Aims: The aim of this study was to determine relative risk (RR) of incidence and fatality of out-of-hospital cardiac arrest (OHCA) by gender and oestrogen status.
Methods And Results: In a prospective, population-based observational study from 1998 through 2007, incidence and neurologically intact 1-month survival after OHCA were compared by gender after grouping: 0-12 years, 13-49 years, and > or =50 years according to menarche and menopause age. Among 26 940 cardiac arrests, there were 11 179 females and 15 701 males.
Background: The American Heart Association recommends cardiopulmonary resuscitation (CPR) by bystanders with chest compression only for adults who have cardiac arrests, but not for children. We assessed the effect of CPR (conventional with rescue breathing or chest compression only) by bystanders on outcomes after out-of-hospital cardiac arrests in children.
Methods: In a nationwide, prospective, population-based, observational study, we enrolled 5170 children aged 17 years and younger who had an out-of-hospital cardiac arrest from Jan 1, 2005, to Dec 31, 2007.
Objectives: To evaluate the effectiveness of 1-h practical chest compression-only cardiopulmonary resuscitation (CPR) training with or without a preparatory self-learning video.
Methods: Participants were randomly assigned to either a control group or a video group who received a self-learning video before attending the 1-h chest compression-only CPR training program. The primary outcome measure was the total number of chest compressions during a 2-min test period.
Aim: In order to elucidate the factors for willingness to perform CPR, we evaluated the responses of college students to questionnaires before and after basic life support (BLS) training.
Methods: Before and after participating in a small group BLS course, 259 students completed questionnaires. A logistic regression model was used to elucidate independent factors for their willingness to attempt resuscitation.
Background: The impact of ongoing efforts to improve the "chain of survival" for out-of-hospital cardiac arrest (OHCA) is unclear. The objective of this study was to evaluate the incremental effect of changes in prehospital emergency care on survival after OHCA.
Methods And Results: This prospective, population-based observational study involved consecutive patients with OHCA from May 1998 through December 2006.
Background: The prognostic implications of conversion to ventricular fibrillation (VF) in out-of-hospital cardiac arrest (OHCA) patients with an initial non-shockable rhythm are unclear.
Hypothesis: Among OHCA patients with an initial non-shockable rhythm, survival is better in individuals who subsequently develop VF and are defibrillated.
Design: Utstein style population-based cohort study.
Objectives: To compare the quality of resuscitation between those with a simplified chest compression-only cardiopulmonary resuscitation (CPR) program and those with a conventional CPR program.
Methods: The participants were randomly assigned to either the 120-min training program of chest compressions (chest compression-only CPR) or the 180-min training program of chest compressions and ventilations (conventional CPR). Main outcome measures were the net number of appropriate chest compressions during the 2-min test period and the proportion of appropriate chest compressions over the theoretically attainable number one month after the training.
Objective: We reassessed 1-month survival of patients with witnessed out-of-hospital cardiac arrest (OHCA) of cardiac origin with ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) in Osaka, Japan, and identified factors associated with 1-month survival using updated data from 1998 to 2004 collected based on the Utstein Style.
Methods: Using the Utstein Osaka Project database, we analyzed 1028 cases which met the following criteria: (1) patient age 18 years or older; (2) presumed cardiac origin based on the definition of the Utstein Style; (3) witnessed by citizens; (4) VF or pulseless VT at the time of arrival of the ambulance. The main outcome measure was survival at 1 month after collapse.
Background: Previous animal and clinical studies suggest that bystander-initiated cardiac-only resuscitation may be superior to conventional cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrests. Our hypothesis was that both cardiac-only bystander resuscitation and conventional bystander CPR would improve outcomes from out-of-hospital cardiac arrests of < or = 15 minutes' duration, whereas the addition of rescue breathing would improve outcomes for cardiac arrests lasting > 15 minutes.
Methods And Results: We carried out a prospective, population-based, observational study involving consecutive patients with emergency responder resuscitation attempts from May 1, 1998, through April 30, 2003.
Objective: To evaluate the outcome and the factors concerned with of out-of-hospital cardiac arrest patients according to the location of the collapse.
Methods: From May 1st, 1998 to April 30th, 2001, 15,211 consecutive out-of-hospital cardiac arrest cases considered for resuscitation were recorded. Of these cases 7540 arrests in subjects aged 18 years or older with cardiac aetiology were analyzed.
Objective: To analyze the longitudinal changes in the treatment of out-of-hospital cardiac arrests. These analyses have focused on the time interval from the receipt of call until defibrillation of patients with ventricular fibrillation.
Design: Population-based, prospective longitudinal study according to the Utstein style.