Guidelines recommend epinephrine as the primary medical intervention for cardiac arrest. However, no randomized trial data are available to support this recommendation. In this observational study from the American Heart Association’s Get With The Guidelines – Resuscitation multi-center registry of in-hospital cardiac arrest, the authors sought to determine if timing of epinephrine administration in the […]
Tag: cardiac arrest
Pre-hospital cooling with saline infusion does not improve cardiac arrest outcomes
Prior randomized trials have established hypothermia as a promising therapy to improve outcomes of cardiac arrest. It has been suggested that the benefit of hypothermia may be increased through early initiation of cooling in the field prior to hospital arrival. In this trial, 1,364 patients with out-of-hospital cardiac arrest were randomized to usual care or […]
Target cooling temperatures in cardiac arrest – should we just focus on avoiding fever instead?
Prior trials of out-of-hospital cardiac arrest of presumed cardiac etiology have demonstrated improved survival and neurologic function when patients are treated with therapeutic hypothermia. Questions remain as to the optimal target temperature for therapeutic hypothermia. In this international study of patients with out-of-hospital cardiac arrest, 950 patients were randomly assigned to therapeutic hypothermia at a […]
Epinephrine Use and Cardiac Arrest Survival
Whist epinephrine (adrenaline) is commonly used during cardiopulmonary resuscitation (CPR), both in and out of hospital, its effectiveness is poorly established. Although some animal studies have suggested a short term benefit due to increased cerebral and coronary perfusion, an increase in myocardial oxygen consumption and ventricular arrhythmias has also been documented. The purpose of this […]
Cardiac arrest in marathon runners investigated
Despite the increasingly sedentary nature of society, one participation sport that is thriving is long-distance running with approximately 2 million people participating in marathon or half-marathons in the United States annually. Tragically, this increase in participants has led to an increase in reports of race-related cardiac arrests and in this study by Kim et al […]
Improving CPR outcomes – querying the role of a “rapid response” team
Following cardiac arrest, delays in treatment are associated with poor neurological outcomes and lower survival rates. A rapid response team – also known as a medical emergency team – is a multidisciplinary team designed to diagnose, evaluate and treat non intensive-care patients showing signs of clinical deterioration, the aim being to decrease the chances of […]
Breaking the rules – when to terminate cardiac arrest
Reported rates of survival following cardiac arrest range from 0.2% to 23%, with a median of 6.4% in the United States. The majority of patients who survive an out of hospital cardiac arrest (OHCA) are resusucitated at the scene of the arrest. For those who cannot be immediately resuscitated, deciding whether to terminate resuscitation efforts […]
No additional benefit from thrombolysis during out-of-hospital cardiac arrest
Myocardial infarction and pulmonary embolism account for approximately 70% of out of hospital cardiac arrests. Cardiac arrest itself activates systemic coagulation hence thrombolytic therapy delivered during cardiopulmonary resuscitation can dissolve intravascular blood clots and has beneficial effects on microcirculatory reperfusion, improving survival and neurological recovery. […]