The presence of pacing artifacts may impede diagnosis of ventricular fibrillation during cardiac arrest

Timler, Dariusz; Zyśko, Dorota; Koźluk, Edward; Piątkowska, Agnieszka; Grzebieniak, Tomasz; Gajek, Jacek; Melander, Olle; Fedorowski, Artur

doi:10.1016/j.resuscitation.2014.04.034

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…The detection of pseudospikes may be erroneously diagnosed as PEA, masking the diagnosis of underlying ventricular fibrillation, leading to abstention from potentially life-saving defibrillation. 1 On the other hand, an unrecognized pseudo-PEA may lead, as in our case, to continuation of futile resuscitation, as asystole in the field is usually required as an indication for termination of resuscitation if there is no obvious reversible cause. 2 Interpreting the ECG tracing as a PEA led in our case to time-consuming, futile reanimation efforts, and came close to putting the rescue team at some risk, as the evacuation would have required patient and physician winching.…”

Section: Discussionmentioning

confidence: 76%

An unusual cause of pseudo-pulseless electrical activity

Pasquier¹,

Beysard²,

Feiner³

et al. 2019

EP Europace

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Section: Discussionmentioning

confidence: 76%

An unusual cause of pseudo-pulseless electrical activity

Pasquier¹,

Beysard²,

Feiner³

et al. 2019

EP Europace

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“…A previous case study documented the challenges of managing a cardiac arrest in a patient with a pacemaker, as the epicardial pacemaker spikes caused the patient to be incorrectly treated for pulseless electrical activity, when retrospective analysis found it was fine‐wave ventricular fibrillation. 37 , 38 While rare, systems need to ensure that EMS personnel are adequately trained and equipped to respond to these events. Neither of these circumstances are addressed in current standard ACLS training.…”

Section: Discussionmentioning

confidence: 99%

Factors Impacting Treatment of Out‐of‐Hospital Cardiac Arrest: A Qualitative Study of Emergency Responders

Missel,

Dowker,

Dzierwa

et al. 2023

JAHA

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Background Of the more than 250 000 emergency medical services‐treated out‐of‐hospital cardiac arrests that occur each year in the United States, only about 8% survive to hospital discharge with good neurologic function. Treatment for out‐of‐hospital cardiac arrest involves a system of care that includes complex interactions among multiple stakeholders. Understanding the factors inhibiting optimal care is fundamental to improving outcomes. Methods and Results We conducted group interviews with emergency responders including 911 telecommunicators, law enforcement officers, firefighters, and transporting emergency medical services personnel (ie, emergency medical technicians and paramedics) who responded to the same out‐of‐hospital cardiac arrest incident. We used the American Heart Association System of Care as the framework for our analysis to identify themes and their contributory factors from these interviews. We identified 5 themes under the structure domain, which included workload, equipment, prehospital communication structure, education and competency, and patient attitudes. In the process domain, 5 themes were identified focusing on preparedness, field response and access to patient, on‐scene logistics, background information acquisition, and clinical interventions. We identified 3 system themes including emergency responder culture; community support, education, and engagement; and stakeholder relationships. Three continuous quality improvement themes were identified, which included feedback provision, change management, and documentation. Conclusions We identified structure, process, system, and continuous quality improvement themes that may be leveraged to improve outcomes for out‐of‐hospital cardiac arrest. Interventions or programs amenable to rapid implementation include improving prearrival communication between agencies, appointing patient care and logistical leadership on‐scene, interstakeholder team training, and providing more standardized feedback to all responder groups.

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“…It has been previously shown that emergency medicine students and specialists may have difficulty with recognizing rare ECGs in the emergency environment [20,21]. *The numbers indicate how many responders selected the specific answer out of the total number of registered responses, and may differ from the total number of distributed questionnaires (n = 71).…”

Section: Discussionmentioning

confidence: 99%