Resuscitation plus最新文献

{"title":"Database and geospatial mapping study of those eligible for extracorporeal cardiopulmonary resuscitation in the Thames Valley Region, England","authors":"Oscar Millerchip ,&nbsp;Jasper Eddison ,&nbsp;Alex Rosenberg ,&nbsp;Jon Bailey ,&nbsp;James Raitt","doi":"10.1016/j.resplu.2025.100879","DOIUrl":"10.1016/j.resplu.2025.100879","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest survival remains low. Extracorporeal-cardiopulmonary resuscitation (ECPR) is a therapy for refractory out-of-hospital cardiac arrest that can improve survivability by decreasing the time a patient is without adequate perfusion, the low-flow time. Access to ECPR is limited by the number, location and delivery approach of centres offering this therapy.</div></div><div><h3>Aims</h3><div>This study aims to identify how many patients are eligible for ECPR in the Thames Valley area and provide geographical analysis to appraise the specialist-centre approach of ECPR delivery in the region.</div></div><div><h3>Methods</h3><div>Data from out-of-hospital cardiac arrests attended by the Thames Valley Air Ambulance from 1st Jan 2022 to 1st Jan 2024 were reviewed for eligibility to receive ECPR against inclusion criteria. Eligible cases were modelled using Geographic Information System software, and spatial autocorrelation analysis was performed to identify any significant ‘hotspots’, ‘cold spots’, or significant geographical distribution of eligible cases.</div></div><div><h3>Results</h3><div>Of some 1,182 cardiac arrests attended, 188 (16%) cases were eligible under inclusion criteria for ECPR. In 2023 seven patients received ECPR, all focussed in a small area of the Thames Valley. The majority of eligible cases fall outside of the catchment of any one hospital when utilising the hospital-based or rendez-vous models of ECPR. Global Moran’s analysis of the entire region found no significant clustering or dispersal, suggesting a near-random distribution despite some evidence of hotspots.</div></div><div><h3>Conclusion</h3><div>ECPR can improve survival for out-of-hospital cardiac arrest, but time constraints preclude access to this therapy for many, which affects equitability across a geographical area. Geospatial analysis techniques can aid in reviewing the optimal delivery methods of ECPR and improve equitable geographical access to services. The methodology described may aid other organisations in planning the delivery of ECPR.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100879"},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143316517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of team culture and learning organization in the resuscitation of neonates with congenital anomalies: A single center experience","authors":"Anna Bostwick ,&nbsp;Anne Ades ,&nbsp;Carolina Rodriguez-Paras ,&nbsp;Madeline Dombroski ,&nbsp;Charis Lim ,&nbsp;Maria Ordoñez Paredes ,&nbsp;Lauren Heimall ,&nbsp;Leane Soorikian ,&nbsp;Sara C. Handley ,&nbsp;Heidi M. Herrick","doi":"10.1016/j.resplu.2025.100877","DOIUrl":"10.1016/j.resplu.2025.100877","url":null,"abstract":"<div><h3>Aim</h3><div>Delivery room resuscitation of neonates with congenital anomalies is complex. This study aimed to assess survey psychometrics and measure learning organization culture among resuscitation team members in a pediatric hospital delivery room dedicated to neonates with congenital anomalies.</div></div><div><h3>Methods</h3><div>We administered the Short-Form Learning Organization Survey with the addition of an open-ended question to all delivery room resuscitation team members from 5/2023 to 7/2023. Psychometric properties were assessed to confirm the survey’s reliability and validity in the delivery room context. Total and subscale scores were calculated, and differences were assessed by clinical role. The open-ended qualitative data were analyzed using an inductive approach and coded for theme and valence (positive, negative, neutral).</div></div><div><h3>Results</h3><div>The response rate was 52% (159/307) with all roles represented. Psychometric assessment produced a 25-item survey with high reliability and validity. There were no differences in total scores across roles. Nurses had higher scores compared to attending physicians (<em>p</em> &lt; 0.01) and advanced practice providers (<em>p</em> &lt; 0.05) for the supportive learning environment subscale, and advanced practice providers (<em>p</em> &lt; 0.05) for the training subscale after multiple comparisons adjustment. Qualitative analysis revealed seven themes: time constraint, environment, adequate staffing, different opinions, care deviations, leadership, and training. Valence analysis showed variation by role, with more positive nursing responses.</div></div><div><h3>Conclusion</h3><div>The refined 25-item Short-Form Learning Organization Survey is a reliable and valid measure of learning organization culture for neonatal resuscitation teams. Differences in subscale scores and qualitative valence across roles highlight opportunities to improve interprofessional learning organization and team culture.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100877"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of chain of survival for out-of-hospital-cardiac-arrest (OHCA) in resource limited countries: A systematic review","authors":"Mirza Noor Ali Baig ,&nbsp;Zafar Fatmi ,&nbsp;Nadeem Ullah Khan ,&nbsp;Uzma Rahim Khan ,&nbsp;Ahmed Raheem ,&nbsp;Junaid Abdul Razzak","doi":"10.1016/j.resplu.2025.100874","DOIUrl":"10.1016/j.resplu.2025.100874","url":null,"abstract":"<div><h3>Aim</h3><div>Given the critical disparities in survival for out-of-hospital-cardiac-arrest (OHCA) in resource limited countries and the lack of context-specific evidence to guide resuscitation practices, we aimed to systematically evaluate the effectiveness of the chain of survival components including bystander response, emergency medical services (EMS) response, advanced life support, and post-resuscitation care on outcomes such as return of spontaneous circulation, survival to admission, survival to hospital discharge, and neurological outcomes in these settings.</div></div><div><h3>Methods</h3><div>This systematic review, following PRISMA guidelines, included observational and interventional studies on OHCA management from low, lower-middle, and upper-middle-income countries, published in English (2004–2023). PubMed, Embase, CINAHL, and Cochrane Library were searched using predefined terms. Two reviewers independently screened studies, extracted data using the Utstein template, and resolved conflicts with a third reviewer. Data included pre-hospital, patient, and post-resuscitation care factors, as well as short and long-term outcomes. Descriptive analysis and narrative synthesis were conducted, with return of spontaneous circulation (ROSC) rates compared across income groups using <em>t</em>-tests.</div></div><div><h3>Results</h3><div>Sixteen (16) eligible studies were included. No study was found from low-income countries. ROSC rates ranged from 0.7% to 44%, survival to discharge from 0.6% to 14.1%, and good neurological outcomes (CPC 1–2) from 0.6% to 53.8%. While upper-middle-income countries showed slightly higher ROSC rates, differences were not statistically significant. Risk of bias was moderate to high due to selection bias, inadequate confounding control, and inconsistent reporting. These findings emphasize the need for standardized reporting and further research to improve outcomes in resource limited countries.</div></div><div><h3>Conclusion</h3><div>This review highlights low survival rates for OHCA in resource limited countries, with significant variability and gaps in evidence. Strengthening EMS systems, adopting context-specific strategies, and standardizing reporting are critical to improving outcomes.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100874"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential benefits and challenges of simulation-based neonatal resuscitation competition: A survey analysis of provincial competition in China","authors":"Chenguang Xu ,&nbsp;Qianshen Zhang ,&nbsp;Fang Lin ,&nbsp;Yihua Chen ,&nbsp;Yin Xue ,&nbsp;Wenjie Yan ,&nbsp;Rong Zhou ,&nbsp;Yuqian Yang ,&nbsp;Po-Yin Cheung","doi":"10.1016/j.resplu.2025.100875","DOIUrl":"10.1016/j.resplu.2025.100875","url":null,"abstract":"<div><h3>Background</h3><div>Simulation-based neonatal resuscitation training has been implemented worldwide with good educational and clinical results. Simulation-based competition (SBC), as an innovative derivative of neonatal resuscitation training, has been practiced recently but its potential effectiveness and challenges of competition are rarely studied. We tested the hypothesis that after SBC, participants could improve compliance with NRP® algorithm and teamwork, achieve lower stress and higher confidence in neonatal resuscitation.</div></div><div><h3>Methods</h3><div>In February 2023, 108 health care providers in 27 teams from different regional centres participated in provincial SBC. Each team consisted of 4 members (NICU physician [lead], NICU nurse, midwife and obstetrician). The teams were to complete a resuscitation scenario (16 min) and their performance was evaluated. All participants were encouraged to take part in a post-resuscitation questionnaire survey voluntarily immediately after the scenarios finished. Demographic characteristics and questionnaire results of participants were collected, including the confidence and perceived stress levels before and after the competition.</div></div><div><h3>Results</h3><div>Ninety-eight (90.7%) participants completed the survey with 114 post-resuscitation questionnaire surveys. Participants perceived top benefits of SBC including improved compliance with NRP® algorithm, technical skills and teamwork, with the least benefit in improving self-confidence (vs. other benefits, <em>P</em> &lt; 0.001). The confidence level did not change before and after the competition, whereas stress was reduced after the competition.</div></div><div><h3>Conclusions</h3><div>Participants in SBC might be benefited with improved compliance with NRP® algorithm, technical skills and teamwork. However, the impact, influence and sustainability of these benefits are uncertain. Further research is needed to explore ways to improve self-confidence and decrease stress in neonatal resuscitation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100875"},"PeriodicalIF":2.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143159798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exoskeletons as potential devices to support and enhance rescuers’ chest compression performance during out-of-hospital cardiac arrest","authors":"Seamus Thierry ,&nbsp;Cyran Le Guennec ,&nbsp;Alexandre Le Falher ,&nbsp;Lola Lauby ,&nbsp;Laure Boyer ,&nbsp;Lucia Vicente Martinez ,&nbsp;Alexis Paillet ,&nbsp;Willy Allegre","doi":"10.1016/j.resplu.2025.100871","DOIUrl":"10.1016/j.resplu.2025.100871","url":null,"abstract":"<div><div>Exoskeletons are wearable structures that support and assist movement, or augment the capabilities of the human body. These functionalities could theoretically assist bystanders or rescuers performing manual chest compressions during out-of-hospital cardiac arrest, as this emergency procedure is prone to physical exhaustion. Compressions are an intense muscular effort involving a dynamic muscular pattern with conflicting postural constraints. Rescuer fatigue sets in rapidly, leading to postural instability and a lack of mechanical power delivered by the arms to the patient’s torso, which affects hemodynamic efficiency.</div><div>Physical augmentation and postural stabilization are two functions that could be provided by an exoskeleton during cardiopulmonary resuscitation. This device would combine the advantages of manual and mechanical chest compressions, bypassing anthropometric parameters such as the rescuer’s aerobic capacity and muscle mass to maintain efficient chest compressions, and avoiding the negative issues associated with over-assistance through a servomotor function. This concept paper examines the specifications of an ideal theoretical device in this context, noting the potential technical difficulties and barriers to implementation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100871"},"PeriodicalIF":2.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early amiodarone or lidocaine administration during in-hospital cardiac arrest caused by shockable rhythms","authors":"Rafael C. Paganoni ,&nbsp;Jack C. Pluenneke ,&nbsp;Adham M. Mohamed ,&nbsp;Charles H. Hayes III ,&nbsp;Carole E. Freiberger-O’Keefe ,&nbsp;Paul S. Chan","doi":"10.1016/j.resplu.2025.100872","DOIUrl":"10.1016/j.resplu.2025.100872","url":null,"abstract":"<div><h3>Introduction</h3><div>Published data investigating a time-dependent effect of initiation of antiarrhythmic therapy for shockable in-hospital cardiac arrest (IHCA) is lacking. We aimed to evaluate the association between time of intravenous amiodarone or lidocaine administration and return of spontaneous circulation (ROSC) in patients with IHCA caused by ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT).</div></div><div><h3>Methods</h3><div>This was a retrospective, multi-center, single health system, observational cohort study of patients with an IHCA caused by VF/pVT and who received amiodarone or lidocaine during 2014–2024. The primary outcome was ROSC, and the secondary outcome was survival to hospital discharge. A multivariable logistic regression model was constructed to evaluate the association between (1) time to drug administration and (2) drug administration prior to the second defibrillator shock on both survival outcomes.</div></div><div><h3>Results</h3><div>A total of 88 patients with a shockable IHCA were identified. Longer time to amiodarone or lidocaine administration was associated with lower likelihood of ROSC (adjusted odds ratio [aOR] 0.91; 95% CI: 0.83–0.99, P = 0.04) but not with survival to discharge (aOR 0.99; CI 0.90–1.10P = 0.90). Administration of antiarrhythmic therapy prior to the second defibrillator shock was associated with higher likelihood of ROSC (aOR 6.48; CI 2.08–20.21, P = 0.001) and survival to discharge (aOR 2.82; CI 1.03–7.77, P = 0.04).</div></div><div><h3>Conclusion</h3><div>Early administration of amiodarone or lidocaine, particularly prior to the second defibrillator shock, was associated with an increased odds of survival outcomes in IHCA with shockable rhythms.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100872"},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective study","authors":"Nicolas Beysard ,&nbsp;Tara Agudo ,&nbsp;Peter Serfozo ,&nbsp;Tobias Zingg ,&nbsp;Perrine Truong ,&nbsp;Roland Albrecht ,&nbsp;Vincent Darioli ,&nbsp;Mathieu Pasquier","doi":"10.1016/j.resplu.2025.100870","DOIUrl":"10.1016/j.resplu.2025.100870","url":null,"abstract":"<div><h3>Objectives</h3><div>The management of traumatic cardiac arrest (TCA) focuses on the immediate treatment of reversible causes, including bilateral thoracostomy. In our prehospital emergency service, bilateral thoracostomy has been recommended since 2012 for the management of TCA. We sought to analyse the prehospital management and clinical course of patients with TCA, focusing on changes over time in the use of thoracostomy.</div></div><div><h3>Methods</h3><div>In this single-centre retrospective observational study, we included patients with TCA managed by physicians of the prehospital service of Lausanne University Hospital from 2012 to 2024. The primary outcome was the annual rate of bilateral thoracostomy. Secondary outcomes included the rate of additional on-site measures, such as pelvic binder placement and airway management, and follow-up at 48 h.</div></div><div><h3>Results</h3><div>Among 3206 cardiac arrests during the study period, 473 (15%) were TCAs. Among the 247 patients with resuscitation attempts, thoracostomy was judged as indicated in 223 (90%) and performed in 148 (66%). Twenty-seven (18%) patients who had a thoracostomy were alive on arrival at hospital, with 9 (6.1%) still alive at 48 h. The mean annual proportion of patients in whom a thoracostomy was performed was 68% (range 0–100%) and increased significantly over the years (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The annual rate of thoracostomy in TCA patients increased significantly in the period 2012 to 2024. Larger studies are required to determine the impact of thoracostomy on survival.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100870"},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated external defibrillator: Rhythm analysis and defibrillation on paediatric out-of-hospital cardiac arrest","authors":"Emma Menant ,&nbsp;Delphine Lavignasse ,&nbsp;Sarah Ménétré ,&nbsp;Jean-Philippe Didon ,&nbsp;Xavier Jouven","doi":"10.1016/j.resplu.2025.100873","DOIUrl":"10.1016/j.resplu.2025.100873","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to quantify the reliability of automated external defibrillators (AED) in paediatric out-of-hospital cardiac arrests (pOHCA) by evaluating the defibrillation and the shock advisory system efficacy. Furthermore, the relationship between the initial energy dose and patient outcomes is analysed.</div></div><div><h3>Methods</h3><div>We studied data from all pOHCA cases (age &lt; 18 years) treated by the Paris Fire Brigade between January 2010 and December 2018, limited to those with available AED signals. The efficacy of shocks is the primary outcome. The secondary outcomes are the shock advisory system performance, pre-hospital return of a spontaneous circulation (ROSC), survival and energy dose. Energy dose, weight and age are compared using a Wilcoxon test according to the outcome’s values.</div></div><div><h3>Results</h3><div>A total of 1,990 electrocardiogram strips extracted from 349 pOHCA cases were included in the study. Shock advisory system had a sensitivity of 89.4% and a specificity of 99.8% for the detection of shockable rhythms. Shock efficacy observed for all patients who received a shock was 83.1% and first shock efficacy for patients in initial ventricular fibrillation was 96%. Patients who received a shock had a pre-hospital ROSC rate of 74.3%, a survival rate at hospital admission of 71.4% and 34.3% at hospital discharge.</div></div><div><h3>Conclusion</h3><div>This study shows that AED detect shockable rhythm with a good sensitivity and specificity and that shocks are associated with a very high rates of termination of shockable rhythms in pOHCA.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100873"},"PeriodicalIF":2.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and pediatric out-of-hospital cardiac arrest using U.S. registry database","authors":"Christopher Schmitt ,&nbsp;Gary Beasley ,&nbsp;Karine Guerrier ,&nbsp;Jennifer Kramer ,&nbsp;Maryam Y. Naim ,&nbsp;Heather Griffis ,&nbsp;Bryan McNally ,&nbsp;Paul S. Chan ,&nbsp;Rabab Al-Araji ,&nbsp;Joseph Rossano","doi":"10.1016/j.resplu.2025.100869","DOIUrl":"10.1016/j.resplu.2025.100869","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrests (OHCA) increased in the adult population during the COVID pandemic.^{1,2,3,4,5,6,7,8}</div></div><div><h3>Objectives</h3><div>We aimed to determine if OHCAs increased in the pediatric population during the COVID pandemic and whether the pandemic exacerbated pre-existing racial and socio-economic disparities.^{13,17,18,19,20}</div></div><div><h3>Methods</h3><div>Utilizing data from 2015 to 2020 from the Cardiac Arrest Registry to Enhance Survival (CARES) database, 13,513 pediatric OHCAs were analyzed. Age categories included infants (0–&lt;1 year), children (1–12 years) and adolescents (13–18 years). This included information on patient demographics, use of CPR (cardiopulmonary resuscitation) or AED (automatic external defibrillator), outcomes, COVID prevalence, and socioeconomic variables.</div></div><div><h3>Results</h3><div>In the pediatric population, there was no increase in OHCAs during the COVID pandemic, however in the adolescent population there was an increase in OHCA incidence from 0.29 to 0.40 arrests per 1 million total residents (<em>p</em> &lt; 0.0001), and a decrease in the infant population from 0.861 to 0.803 events per 1 million total residents (<em>p</em> = 0.02). The pandemic worsened the burden of OHCAs in communities with lower socioeconomic status and in which COVID was more prevalent. Disparities of CPR or AED use and survival outcomes were seen based on race, sex, and socioeconomic factors, however none of these disparities were further augmented by the COVID pandemic.</div></div><div><h3>Conclusions</h3><div>Adolescent populations showed higher rates of OHCAs during the COVID pandemic, especially in areas with higher COVID incidence. Infants, however, had slightly decreased rates, which may be related to changes in other respiratory infections, and parental behavioral changes during the pandemic.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"22 ","pages":"Article 100869"},"PeriodicalIF":2.1,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and outcomes of out-of-hospital-cardiac-arrest in rural and suburban areas of Sindh, Pakistan: A cross-sectional study","authors":"Mirza Noor Ali Baig ,&nbsp;Zafar Fatmi ,&nbsp;Nadeem Ullah Khan ,&nbsp;Uzma Rahim Khan ,&nbsp;Ahmed Raheem ,&nbsp;Junaid Abdul Razzak","doi":"10.1016/j.resplu.2024.100840","DOIUrl":"10.1016/j.resplu.2024.100840","url":null,"abstract":"<div><h3>Background</h3><div>Despite extensive research on OHCA in urban centres worldwide, there is a significant gap in knowledge regarding these events in less urbanized regions, especially in Low-Middle-Income Countries (LMICs).</div></div><div><h3>Aim</h3><div>To determine the characteristics and outcomes of adult out-of-hospital cardiac arrest (OHCA) in rural and suburban districts of Sindh, Pakistan.</div></div><div><h3>Methods</h3><div>Data of OHCA patients (&gt;18 years) was collected retrospectively from January 2020 to December 2022, from the medical records of district and tehsil hospitals of the province of Sindh<strong>.</strong> Data analysis was performed using the Statistical Package Software for the Social Sciences (SPSS) Statistics 29.</div></div><div><h3>Results</h3><div>Out of 139 OHCA patients, 75.5 % were males, and 24.5 % were females, with a mean age of 52.78 ± 13.1 years. Most cardiac arrests occurred at home (54.75 %). Only 0.7 % of patients were transported by emergency medical services (EMS), while 59 % arrived via private transport, such as cars or vans. An additional 4.3 % were brought by other ambulance services, including private and philanthropic organizations, and for 36 % of patients, the mode of transportation was undocumented. Cardiac arrests were witnessed in 43.2 % of cases. CPR (either in-hospital or pre-hospital) was performed on 59 % of patients, but only 6.1 % received pre-hospital CPR (Bystander: 1.22 %, Ambulance Staff: 2.44 %, Family Member: 2.44 %). Return of spontaneous circulation (ROSC) was achieved in 14.63 % of patients, while 4.88 % were alive at hospital admission.</div></div><div><h3>Conclusion</h3><div>This study highlights significant gaps in the chain of survival for OHCA patients in rural and suburban Sindh, Pakistan, including inadequate EMS utilization, low bystander CPR rates, and delayed hospital care, contributing to poor outcomes. The findings may underestimate true rates due to missing and inconsistent data, emphasizing the need for improved documentation and prospective studies.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"21 ","pages":"Article 100840"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}