Complications of Cardiac Resuscitation

Krischer, Jeffrey P.; Fine, Ellen; Davis, Joseph H.; Nagel, Eugene L.

doi:10.1378/chest.92.2.287

Cited by 379 publications

(253 citation statements)

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“…The risk of bystander CPR for patients not in cardiac arrest needs to be considered [35][36][37][38]. In this study, we did not determine how frequently telephone-CPR was attempted on patients who were not in cardiac arrest [39].…”

Section: Discussionmentioning

confidence: 96%

“…While tracheal intubation was not an independent factor associated with a favourable 1-Y survival, adrenaline administration was a potent independent factor related to unfavourable 1-Y survival. These effects of ACLS procedures were carefully interpreted because the procedures were performed only by specially trained paramedics in Japan.The risk of bystander CPR for patients not in cardiac arrest needs to be considered [35][36][37][38]. In this study, we did not determine how frequently telephone-CPR was attempted on patients who were not in cardiac arrest [39].…”

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confidence: 96%

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The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests

et al. 2012

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(CQI) project for telephone-assisted cardiopulmonary resuscitation (telephone-CPR), which included instruction on chest-compression-only CPR, education on how to recognise out-of-hospital cardiac arrests (OHCAs) with agonal breathing, emesis and convulsion, recommendations for on-line or redialling instructions, and feedback from emergency physicians. This study aimed to investigate the effect of this project on the incidence of bystander CPR and the outcomes of OHCAs.Materials and Methods: The baseline data were prospectively collected on 4995 resuscitation-attempted OHCAs, which were recognised or witnessed by citizens rather than emergency medical technicians during the period of February 2004 to March 2010. The incidence of telephone-CPR and bystander CPR, as well as the outcomes of the OHCAs, were compared before and after the project.Results: The incidence of telephone-CPR and bystander CPR significantly increased after the project (from 42% to 62% and from 41% to 56%, respectively). The incidence of failed telephone-CPR due to human factors significantly decreased from 30% to 16%. The outcomes of OHCAs significantly improved after the projects. A multiple logistic regression analysis revealed that the CQI project is one of independent factors associated with one-year (1-Y) survival with favourable neurological outcomes (odds ratio = 1.81, 95% confidence interval = 1.20-2.76).Conclusions: The CQI project for telephone-CPR increased the incidence of bystander CPR and improved the outcome of OHCAs. A CQI project appeared to be essential to augment the effects of telephone-CPR.Keywords: Telephone-CPR; Continuous quality improvement; Cardiopulmonary resuscitation; Dispatcher; Emergency medical service; Out-of-hospital cardiac arrest INTRODUCTION Currently, medical control (MC) for the emergency medical service system (EMS) is active in Japan.However, MC, including education, is mainly targeted to emergency medical technicians (EMTs) and is rarely targeted to dispatchers in Japan. Since February 2004, the Ishikawa MC Council has requested that fire departments collect the reasons why dispatchers failed to provide telephone-assisted instruction on cardiopulmonary resuscitation (telephone-CPR). Telephone-CPR has been shown to increase the incidence of bystander CPR and is expected to improve the outcomes of out-of-hospital cardiac arrests (OHCAs) [1][2][3][4][5].There are no special qualifications or authorisations required for fire department staff to be dispatchers in Japan. Some dispatchers have no experience as EMTs. An educational program for dispatchers has not been established. In some fire departments, the actual condition of the OHCA patient, discovered by EMTs during a post-arrival interview, is not relayed back to the dispatchers.In March of 2007, the Ishikawa MC Council initiated the Continuous Quality Improvement (CQI) project for telephone-CPR. The project included the following: 1) a standardized manual for instruction on chest-compression-only CPR (CC-only CPR), 2) education on how to recognise OH...

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Section: Discussionmentioning

confidence: 96%

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confidence: 96%

The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests

et al. 2012

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“…Rettungskräften soll jedoch bewusst sein, dass die Gefahr von Sternum-sowie Rippenfrakturen größer ist [821][822][823]. Die Inzidenz CPRassoziierter Verletzungen steigt mit der Dauer der CPR an [823].…”

Section: Management Des Kreislaufstillstandsunclassified

Kreislaufstillstand in besonderen Situationen

Truhlář

Deakin

Soar

et al. 2015

Notfall Rettungsmed

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“…A study where rescue units detected and treated a VF during resuscitation was reported to have an 11% incidence of aspiration (Liberthson et al 1974). A prospective autopsy study of 705 cases concerning complications after unsuccessful resuscitation reported an incidence of oropharyngeal vomitus in 10.1% and tracheal vomitus in 9.4% (Krischer et al 1987). A group of patients who were resuscitated after OHCA and who died within 24h after admission were studied retrospectively to determine the incidence of pulmonary aspiration.…”

Section: Regurgitation and Aspiration In Cardiac Arrestmentioning

confidence: 99%

Out‐of‐hospital cardiac arrest: studies on aetiology, treatment and outcome

Virkkunen¹

2009

Acta Anaesthesiol Scand

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Complications of Cardiac Resuscitation

Cited by 379 publications

References 10 publications

The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests

The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests

Kreislaufstillstand in besonderen Situationen

Out‐of‐hospital cardiac arrest: studies on aetiology, treatment and outcome

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