Objective: The primary purpose of this study was to compare the percentage of return of spontaneous circulation of in-flight cardiac arrest (IFCA) patients on admission to the emergency department (ED) who received in-flight standard cardiopulmonary resuscitation (s-CPR) versus automated cardiopulmonary resuscitation (a-CPR).
Setting: EMS helicopter (HEMS) service in Midwest USA.
Methods: This was a prospective, consecutive case series of adult patients who had IFCA of any cause managed with a-CPR between October 1, 2012, and February 8, 2016 (40 months), at a helicopter emergency medical service (HEMS) in the Midwestern United States. The series was compared with a historical control of patients who had IFCA managed by s-CPR between June 1, 2009, and September 30, 2012 (40 months).
Results: Ninety-five runs (39 s-CPR and 54 a-CPR) were included. There was no significant difference in survival between the 2 groups upon HEMS leaving the ED. Cardiopulmonary resuscitation was performed for a significantly longer period of time in the a-CPR cohort than in the s-CPR cohort, and a significantly higher percentage of patients were undergoing active compressions upon loading into the aircraft in the a-CPR cohort.
Conclusion: There was no difference in return of spontaneous circulation on ED admission between the 2 compression methodologies. In-flight use of a-CPR allows HEMS providers to be safe and compliant with Federal Aviation Administration regulations. It also meets the public and medical profession's expectations of the treatment of IFCA with high-quality cardiopulmonary resuscitation by HEMS.
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http://dx.doi.org/10.1016/j.amj.2022.02.002 | DOI Listing |
Sci Rep
January 2025
Division of Critical Care Medicine, Department of Emergency Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Gyeonggi-do, Republic of Korea.
The optimal duration of on-scene cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients remains uncertain. Determining this critical time period requires outweighing the potential risks associated with intra-arrest transport while minimizing delays in accessing definitive hospital-based treatments. This study evaluated the association between on-scene CPR duration and 30-day neurologically favorable survival based on the transport time interval (TTI) in patients with OHCA.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India.
Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.
View Article and Find Full Text PDFRev Esp Anestesiol Reanim (Engl Ed)
January 2025
Hospital Universitario Gregorio Marañón, Madrid, Spain.
Liver transplantation (LT) has an incidence of intraoperative cardiopulmonary arrest (CPA) of around 5%. Patients who experience CPA during this procedure have a reduced survival rate of approximately 50%. Most CPAs occur during the neohepatic phase due to reperfusion syndrome, but this is not always the underlying cause, and a broad differential diagnosis must be performed.
View Article and Find Full Text PDFBraz J Anesthesiol
January 2025
Zhongshan City People's Hospital, Department of Anesthesiology, Zhongshan, China.
Background: Extracorporeal Cardiopulmonary Resuscitation (ECPR) is an effective intervention for restoring adequate circulatory perfusion after cardiac arrest. Ensuring high-quality Cardiopulmonary Resuscitation (CPR) before initiating Extracorporeal Membrane Oxygenation (ECMO) is critical to mitigate tissue hypoxia and ischemia. This study aimed to evaluate the effect of End-Tidal Carbon Dioxide (ETCO) Goal-Directed CPR (GDCPR) on neurological function before ECMO using a retrospective case-control analysis.
View Article and Find Full Text PDFBr J Hosp Med (Lond)
January 2025
Chemical Pathology and Metabolic Medicine, The Lister Hospital, Stevenage, UK.
Advanced life support certification has traditionally been the gold standard of resuscitation training for doctors and has been shown to improve outcomes from cardiac arrest. In 2021, Health Education England removed named courses from mandatory Foundational Programme competencies, which has resulted in capping of reimbursement and reduced access to courses. This represents a drop in educational standards which is particularly concerning when the medical school curriculum has been shown to deliver inconsistent, poor-quality resuscitation training.
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