Resuscitation plus最新文献

{"title":"Predictors of response to peri-arrest bolus epinephrine in children","authors":"Jill L. Sorcher ,&nbsp;Harshannie Kundun ,&nbsp;Shivani Mehta ,&nbsp;Anne V. Grossestreuer ,&nbsp;Michael W. Donnino ,&nbsp;Monica E. Kleinman ,&nbsp;Catherine E. Ross","doi":"10.1016/j.resplu.2025.101020","DOIUrl":"10.1016/j.resplu.2025.101020","url":null,"abstract":"<div><h3>Aim</h3><div>To explore clinical characteristics associated with hemodynamic response to initial dosing of peri-arrest bolus epinephrine (PBE) for acute hypotension in the PICU.</div></div><div><h3>Methods</h3><div>Single center retrospective cohort study of patients &lt; 19 years old who received PBE for acute hypotension in the pediatric intensive care units at our institution from April 2017 to September 2023. Change in systolic blood pressure (SBP) was measured within 5 min before and after PBE. Patients were categorized as non-responders if the change in SBP was ≤ 10 mmHg. The primary analysis used a multivariate logistic regression model to determine factors associated with responder status via manual backward stepwise regression. Post-hoc analyses using Pearson correlation assessed the relationship of age, PBE dose, and SBP and DBP response as continuous variables.</div></div><div><h3>Results</h3><div>Of the 180 patients analyzed, 121 (67 %) were classified as responders and 59 (33%) as non-responders. In the multivariate analysis, non-responder status was independently associated with presence of invasive mechanical ventilation (aOR 5.00; 95 % CI: 1.33, 20; <em>p</em> = 0.017) and acute cardiogenic shock preceding PBE administration (aOR 2.94; 95 % CI:,1.14, 7.69; <em>p</em> = 0.025). In the post hoc analyses, change in SBP was significantly correlated with increasing age (<em>r</em> = 0.27, <em>p</em> = 0.004), and age was inversely correlated with PBE dose by weight (<em>r</em> = −0.50, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Presence of invasive mechanical ventilation and cardiogenic shock were associated with poor response to PBE. As a continuous variable, SBP response to PBE improved with increasing age despite lower weight-based PBE dosing.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101020"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing bystander cardiopulmonary resuscitation training in China: A narrative review of current situation and strategic recommendations to improve survival outcomes in out-of-hospital cardiac arrest","authors":"Zhuoping Chen ,&nbsp;Baojia Zheng ,&nbsp;Qing Lu,&nbsp;Sang Huang,&nbsp;Kailan Lai","doi":"10.1016/j.resplu.2025.101019","DOIUrl":"10.1016/j.resplu.2025.101019","url":null,"abstract":"<div><div>The overall incidence of out-of-hospital cardiac arrest (OHCA) in China showed an upward trend compared to 10  years ago. Bystander cardiopulmonary resuscitation (CPR) is an important contributing factor for improved OHCA survival. However, huge challenges remained in China: The rate of public CPR training, bystander CPR rates, and OHCA survival were all &lt; 1 %. The purpose of this review was to conduct a comprehensive analysis of the current situation of CPR training in China and put forward strategic suggestions to improve the survival outcomes of OHCA.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101019"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial","authors":"Grace C. Sullivan ,&nbsp;Henry E. Wang ,&nbsp;Christopher B. Gage ,&nbsp;Jonathan R. Powell ,&nbsp;Elisabete Aramendi ,&nbsp;Xabier Jaureguibeitia ,&nbsp;Andoni Elola ,&nbsp;Ahamed Idris ,&nbsp;Mohamud R. Daya ,&nbsp;Shannon W. Stephens ,&nbsp;Jestin N. Carlson ,&nbsp;Graham Nichol ,&nbsp;Tom P. Aufderheide ,&nbsp;Ashish R. Panchal ,&nbsp;Michelle M.J. Nassal","doi":"10.1016/j.resplu.2025.101018","DOIUrl":"10.1016/j.resplu.2025.101018","url":null,"abstract":"<div><h3>Background</h3><div>Advanced airway devices facilitate ventilation and oxygenation during out-of-hospital cardiac arrest (OHCA). Differences in gas exchange between advanced airway devices are unknown.</div></div><div><h3>Objective</h3><div>Characterize arterial blood gases (ABG) in laryngeal tube (LT) or endotracheal intubation (ETI) cases in the Pragmatic Airway Resuscitation Trial (PART).</div></div><div><h3>Methods</h3><div>We included adult OHCAs with ABG collected ≤ 1.5 h after emergency department (ED) arrival. We collected 1) last prehospital airway technique used 2) ABG measurements (pH, PaO₂, PaCO₂), and 3) average prehospital end-tidal capnography (EtCO₂) values for the last five minutes. We compared airway types, ABG values, and PaCO₂-EtCO₂ absolute difference (PaCO₂-EtCO₂) using the Mann-Whitney test, stratifying by circulation status. We also determined prehospital EtCO₂ and ED PaCO₂ correlation.</div></div><div><h3>Results</h3><div>Of 3004 cases, 401 met inclusion with 272 LT and 129 ETI. Among cases achieving return of spontaneous circulation (ROSC), pH (7.1 vs. 7.2, <em>p</em> = 0.10) and PaO₂ (142 vs 170 mmHg, <em>p</em> = 0.08) did not differ. PaCO₂ was higher in LT than ETI (58 vs 50 mmHg, <em>p</em> = 0.003). Among cases without ROSC, pH (7.0 vs. 7.0, <em>p</em> = 0.55) and PaCO₂ (64 vs. 61 mmHg, <em>p</em> = 0.58) did not differ, but PaO₂ was lower in LT than ETI (85 vs. 123 mmHg, <em>p</em> = 0.03). EtCO₂ did not correlate with PaCO₂ in any airway device/ROSC combination. PaCO₂-EtCO₂ difference was wider in both LT and ETI non-ROSC cases compared to ROSC cases (27 vs 18 mmHg, <em>p</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>ABG values may vary by prehospital advanced airway management methods. The correlation between EtCO₂ and PaCO₂ in OHCA patients remains unclear.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101018"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young ERC Masterclass journal club article: the TOMAHAWK trial","authors":"Alanowd Alghaith ,&nbsp;Jan Pupkes ,&nbsp;Kristin Alm-Kruse ,&nbsp;Godwin Awuni Anafo ,&nbsp;Enrico Baldi","doi":"10.1016/j.resplu.2025.101015","DOIUrl":"10.1016/j.resplu.2025.101015","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101015"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital cardiac arrest resuscitation practices differ around the globe","authors":"Jeannett Kjær ,&nbsp;Louise Milling ,&nbsp;Anne Craveiro Brøchner ,&nbsp;Freddy Lippert ,&nbsp;Stig Nikolaj Blomberg ,&nbsp;Helle Collatz Christensen ,&nbsp;Robyn Holgate ,&nbsp;Laurie J. Morrison ,&nbsp;Abdullah Bakhsh ,&nbsp;Søren Mikkelsen","doi":"10.1016/j.resplu.2025.101017","DOIUrl":"10.1016/j.resplu.2025.101017","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) is a major public health problem. This study aims to describe the international variations in the practices related to the initiation, termination, and refraining from resuscitation of adult patients (≥18 years) with a non-traumatic OHCA.</div></div><div><h3>Methods</h3><div>An exploratory descriptive study was conducted using a cross-sectional online survey. The respondents were recruited using snowball sampling technique. Framework analysis was used to identify key themes in responses, with descriptive statistics summarising data trends.</div></div><div><h3>Results</h3><div>The study collected responses from 59 countries. Our findings reveal that respondents from 59.3% of countries reported that they initiate resuscitation in all cases where the patients do not show obvious signs of irreversible death or do not have confirmed advance directives. Respondents from 15.3% of countries reported that once started, prehospital resuscitation attempts are not terminated. Prehospitally respondents from 20.3% of the countries reported that they rely exclusively on specific criteria to decide when to terminate resuscitation efforts while in 45.8%, these decisions are made at the discretion of the provider. Respondents from most countries (91.5%) reported that they refrain from resuscitation in the presence of obvious signs of irreversible death. Respondents from 57.6% of countries, reported that they refrained from resuscitation if the patient had a confirmed do-not-attempt-cardiopulmonaryresuscitation (DNACPR), while 15.3% mentioned staff safety as a reason to abstain from attempting resuscitation.</div></div><div><h3>Conclusion</h3><div>This study reveals global variation in EMS resuscitation practices, reflecting disparities in resources, healthcare infrastructure, EMS system design, community acceptability given cultural and societal norms, and legislation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101017"},"PeriodicalIF":2.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of abdominal thrusts and back blows for patients with foreign body airway obstruction: MOCHI registry analysis","authors":"Yutaka Igarashi ,&nbsp;Tatsuya Norii ,&nbsp;Ryuta Nakae ,&nbsp;Takashi Tagami ,&nbsp;David P Sklar ,&nbsp;Shoji Yokobori","doi":"10.1016/j.resplu.2025.101016","DOIUrl":"10.1016/j.resplu.2025.101016","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to evaluate the effectiveness of abdominal thrusts and back blows as initial bystander interventions compared to the absence of bystander intervention in patients with foreign body airway obstruction (FBAO).</div></div><div><h3>Methods</h3><div>This was a prospective, observational study conducted at 25 hospitals in Japan (April 2020–March 2023), including patients aged ≥ 18 years presenting emergency departments with FBAO. The primary outcome was a favorable neurological outcome at 30 days, defined as a Cerebral Performance Category 1 or 2. Secondary outcomes were 30-day survival and success of obstruction relief. We used propensity scores with inverse probability of treatment weighting (IPTW) to adjust for confounding. Logistic regression and Cox proportional hazards models were applied for outcome analysis.</div></div><div><h3>Results</h3><div>Among 407 patients, 24 received abdominal thrusts, 76 received back blows, and 175 received no bystander intervention. Median age was 81. After IPTW adjustment, favorable neurological outcomes were significantly more frequent in patient receiving abdominal thrusts (38% vs. 16%; difference 22%, 95% CI 14%–31%) and back blows (31% vs. 16%; difference 15%, 95% CI 8%–23%) compared to no intervention. Back blows were also associated with higher survival (adjusted HR 0.52, 95% CI, 0.35–0.78), while abdominal thrusts were not (adjusted HR 0.73, 95% CI, 0.40–1.35).</div></div><div><h3>Conclusion</h3><div>Abdominal thrusts and back blows were both associated with significantly favorable neurological outcomes compared to no intervention. Back blows were additionally associated with higher survival.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101016"},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of online CPR training on the knowledge and practice of the Red Crescent Student Association Volunteers during the COVID‐19 pandemic: A randomized clinical trial study","authors":"Mohammad Salehpoor-Emran ,&nbsp;Shahzad Pashaeypoor ,&nbsp;Zahra Amrollah Majdabadi ,&nbsp;Bernd W. Böttiger ,&nbsp;Sarieh Poortaghi ,&nbsp;Shima Haghani","doi":"10.1016/j.resplu.2025.101010","DOIUrl":"10.1016/j.resplu.2025.101010","url":null,"abstract":"<div><h3>Background</h3><div>The propagation of basic cardiopulmonary resuscitation (CPR) training can increase patient survival and reduce brain injury; however, the conventional educational approach has shifted towards e-learning during the COVID-19 pandemic. Therefore, this study aimed to determine the effect of online CPR training on the knowledge and performance of the Red Crescent Student Association Volunteers.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted on 70 Red Crescent Student Association Volunteers. The participants were allocated to intervention and control groups using a simple random allocation method. The primary study outcomes were measured using a validated knowledge assessment and a CPR performance checklist, both validated according to the 2020 American Heart Association (AHA) guidelines. These tools were administered to all participants before and one month after the intervention. The intervention group received one-hour online training sessions per day over three days. The educational content, including the topics related to basic adult CPR training, was formulated according to the 2020 AHA guidelines; however, the control group didn’t receive any online educational program. The collected data were analyzed using the SPSS16 software at a significance level of <em>P</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>There was no significant difference in demographic variables between the two groups (<em>P</em> &gt; 0.05). Also, after online CPR training, the mean scores of the knowledge (9.84 ± 1.88 vs. 7.94 ± 2.17; <em>P</em> = 0.009; effect size = 0.104) and the practice (31.38 ± 6.98 vs. 20.58 ± 7.20; <em>P</em> &lt; 0.001; effect size = 0.345) were significantly higher in the intervention group compared to the control group.</div></div><div><h3>Conclusion</h3><div>Booster CPR training with e-learning was associated with improved knowledge and practice of the Red Crescent Student Association Volunteers. Therefore, this method may be considered as a supplementary training approach, especially in emergencies like emerging pandemics, where traditional training methods are limited<em>.</em></div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101010"},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteomic analysis of serum samples after cardiac arrest: Rationale and design of a TTM-trial substudy","authors":"Gabriele Lileikyte ,&nbsp;Anahita Bakochi ,&nbsp;Marc Isaksson ,&nbsp;Filip Årman ,&nbsp;Marion Moseby-Knappe ,&nbsp;Johan Malmström ,&nbsp;Niklas Nielsen","doi":"10.1016/j.resplu.2025.101014","DOIUrl":"10.1016/j.resplu.2025.101014","url":null,"abstract":"<div><h3>Background</h3><div>A pilot study investigating proteomic profiles from 78 patients from the Target Temperature Management after Out-of-hospital Cardiac arrest (TTM) trial revealed 35 proteins associated to functional outcome, and six proteins associated to targeted temperature management at 33 °C. We present the protocol for a study investigating proteomic profiles in the full cohort of the TTM-trial biobank. The aim is to stratify protein profiles based on survival, functional outcome, targeted temperature management, and MIRACLE2 score in order to search for potential novel biomarkers.</div></div><div><h3>Methods</h3><div>All patients with available serum samples at 24, 48, and/or 72 h after return of spontaneous circulation (<em>N</em> = 682 patients and <em>N</em> = 1882 samples) will be included in the liquid chromatography and tandem mass spectrometry analysis using <em>diaPASEF</em>, combining data-independent-acquisition of spectra with parallel accumulation-serial fragmentation. Statistical analysis will include data normalisation, exploratory principal component analysis, and differential expression analysis. Changes in serum protein abundance will be analysed according to survival and binary functional outcome (modified Rankin Scale 0–3 vs. 4–6) at six-months after randomisation, randomisation to target temperature of 33 °C or 36 °C, and the MIRACLE2 score. Secondary stratifications will include sex, age, time to return of spontaneous circulation, shockable vs. non-shockable initial rhythm, circulatory shock on admission, and presumed cause of death.</div></div><div><h3>Conclusion</h3><div>This prospective study will provide information about proteomic profiles after cardiac arrest and may give insight for identification of novel biomarkers for prediction of outcome.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101014"},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative end-expiratory versus zero end-expiratory pressure flow-controlled ventilation in a porcine hemorrhagic shock model","authors":"Julia Abram ,&nbsp;Patrick Spraider ,&nbsp;Julian Wagner ,&nbsp;Manuela Ranalter ,&nbsp;Alexandra Gratl ,&nbsp;Daniela Lobenwein ,&nbsp;Sabine Wipper ,&nbsp;Gabriel Putzer ,&nbsp;Tobias Hell ,&nbsp;Pia Tscholl ,&nbsp;Judith Martini","doi":"10.1016/j.resplu.2025.101013","DOIUrl":"10.1016/j.resplu.2025.101013","url":null,"abstract":"<div><h3>Background</h3><div>Hemorrhagic shock is a life-threatening event whereby low flow may lead to end-organ dysfunction. This is aggravated by mechanical ventilation, where a positive intrathoracic pressure further deteriorates venous filling of the heart. The aim of this study was to evaluate the effects of a mild negative end-expiratory pressure (NEEP) on mean arterial pressure compared to zero end-expiratory pressure (ZEEP) in a porcine hemorrhagic shock model.</div></div><div><h3>Methods</h3><div>In anesthetized pigs, hemorrhagic shock was induced by a standardized lesion in the common femoral artery. After achieving half of baseline arterial pressure, hemorrhage was stopped. Ventilation was then switched to either flow-controlled ventilation with ZEEP (0 cmH₂O, <em>n</em> = 6) or NEEP (−5 cmH₂O, <em>n</em> = 6). After 5 min, fluid resuscitation was initiated (30 ml/kg) over 60 min and the observation period ended after 120 min.</div></div><div><h3>Results</h3><div>The primary outcome parameter mean arterial pressure was significantly improved within the first 15 min with NEEP compared to ZEEP (49 vs 40 mmHg, MD 9 (95% CI 2 to 15); <em>p</em> = 0.031), but this effect diminished throughout fluid resuscitation. The cardiac index was similar in both groups. Evaluation of lung mechanics revealed a decrease in dynamic compliance (29 vs 44 ml/cmH₂O, MD −14 (95% CI −20 to −9); <em>p</em> &lt; 0.001) in the NEEP group without differences in gas exchange.</div></div><div><h3>Conclusions</h3><div>Application of −5 cmH₂O NEEP improved mean arterial pressure but not cardiac index during hemorrhagic shock and the first 15 min of fluid resuscitation compared to ZEEP. Thereby gas exchange performance was similar.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101013"},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemothorax and needle thoracostomies in prehospital traumatic cardiac arrest: An autopsy series of 172 cases","authors":"Johannes von Vopelius-Feldt ,&nbsp;Anthony Persaud ,&nbsp;Sasha Jones ,&nbsp;Ian Drennan ,&nbsp;Sheldon Cheskes","doi":"10.1016/j.resplu.2025.101012","DOIUrl":"10.1016/j.resplu.2025.101012","url":null,"abstract":"<div><h3>Background</h3><div>Trauma is an important cause of death worldwide, and the majority of deaths from trauma occur in the prehospital setting. The presence of hemothorax contributes to this mortality and is most frequently treated with needle thoracostomies, despite concerns about the effectiveness of this intervention. We present the results of an autopsy series of prehospital traumatic cardiac arrest, describing the frequency of hemothorax in this population and the estimated failure rate of needle thoracostomies.</div></div><div><h3>Methods</h3><div>We used basic demographic data from Emergency Medical Services (EMS) records covering a mixed urban/suburban area in Ontario, Canada, to identify corresponding coroner’s reports of cases of prehospital traumatic cardiac arrest. Demographics, injury details, presence and size of hemothorax and prehospital interventions were extracted.</div></div><div><h3>Results</h3><div>Over a 5-year study period, we successfully identified 172 cases of prehospital traumatic cardiac arrest where resuscitation was provided on scene by paramedics. There was a predominantly blunt mechanism of injury (66%) and 96% of patients were in cardiac arrest on EMS arrival. The overall incidence of traumatic hemothorax was 70%. Needle thoracostomies were performed in 40 cases (23%) of traumatic cardiac arrest. Needle thoracostomy failed to decompress a massive hemothorax in 14 out of 33 cases (42%).</div></div><div><h3>Conclusions</h3><div>We identified a high incidence of hemothorax in traumatic cardiac arrest and a high failure rate of needle thoracostomies for decompression of massive hemothorax. Further research is required to explore the feasibility and potential benefits of finger thoracostomy in prehospital traumatic cardiac arrest.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101012"},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}