Resuscitation plus最新文献

{"title":"Cardiac arrest while using the toilet: not uncommon and associated with adverse resuscitation profile","authors":"Elizabeth D. Paratz ,&nbsp;Carl Johann Hansen ,&nbsp;Andre La Gerche ,&nbsp;Dion Stub ,&nbsp;Ziad Nehme ,&nbsp;Ashanti Dantanarayana ,&nbsp;Kelila Freedman ,&nbsp;Andreas Pflaumer ,&nbsp;Jodie Ingles ,&nbsp;Bo Gregers Winkel ,&nbsp;Jacob Tfelt-Hansen","doi":"10.1016/j.resplu.2025.101047","DOIUrl":"10.1016/j.resplu.2025.101047","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) on the toilet has been reported to be common and possibly driven by straining or vagal stimulus. Toilet-associated OHCA may also create a challenging resuscitation environment.</div></div><div><h3>Methods</h3><div>The national Danish sudden death registry and state-wide Australian End Unexplained Cardiac Death (EndUCD) registry were examined<strong>.</strong> Persons with a fatal OHCA aged 5–50 years with autopsy-confirmed cardiac or unascertained aetiology were included. Resuscitation-related, aetiological and forensic factors were compared between persons experiencing fatal toilet-associated OHCA versus elsewhere. A composite variable of physiological conditions creating pressure-load or pressure-sensitivity was created, comprising hypertrophic cardiomyopathy, aortic stenosis/coarctation, and aortic aneurysm/dissection.</div></div><div><h3>Results</h3><div>Of 2,463young persons, 75 (3.0 %) experienced toilet-associated fatal OHCA while 2,388 (97.0 %) experienced out-of-toilet OHCA. Australians experienced toilet-associated OHCA 1.7 times more frequently than Danes (4.1 % vs 2.4 %, <em>p</em> = 0.016). Toilet-associated OHCA was less frequently witnessed (13.3 % vs 32.1 %, <em>p</em> = 0.001), with lower rates of bystander cardiopulmonary resuscitation (32.0 % vs 55.7 %, <em>p</em> &lt; 0.0001) and shockable rhythm (5.9 % vs 23.8 %, <em>p</em> = 0.003) compared to non-toilet OHCA. Toxicological results were more frequently positive for illicit substances in toilet-associated OHCA (32.8 % vs 16.3 %, <em>p</em> &lt; 0.0001). No differences were identified in OHCA aetiology, including rates of the composite variable of aetiologies such as hypertrophic cardiomyopathy and aortic dissection.</div></div><div><h3>Conclusion</h3><div>3.0 % of young fatal OHCA of cardiac aetiology is toilet-associated, with almost double the rates of toilet-associated OHCA in Australia compared to Denmark. No differences in OHCA aetiology were identified in toilet-associated OHCA. Resuscitation-related factors were adverse in toilet-related OHCA, highlighting the need for innovative ways to recognise and respond to toilet-associated OHCA.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101047"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810578","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":"Mechanical differences between standard arm and foot chest compressions: a randomised crossover study","authors":"Damjan Slabe,&nbsp;Eva Dolenc Šparovec,&nbsp;Miha Fošnarič","doi":"10.1016/j.resplu.2025.101050","DOIUrl":"10.1016/j.resplu.2025.101050","url":null,"abstract":"<div><h3>Introduction</h3><div>The standard method of resuscitation chest compression (CC) is the two-handed chest compression (HCC), whereas the quality of foot chest compressions (FCCs) has not yet been sufficiently investigated. This study aimed to compare the mechanical characteristics of foot and two-handed chest compressions to identify differences in quality and potential safety concerns between HCCs and FCCs.</div></div><div><h3>Methods</h3><div>This was a randomised crossover manikin study. The outcomes measured included the time course of the magnitude and direction of the force exerted by the manikin on the force plate during resuscitation and components of high-quality CCs.</div></div><div><h3>Results</h3><div>While the maximal force exerted during FCCs was approximately 5 % lower than during HCCs, the angle of this maximal force from the vertical was nearly twice as large in FCCs (<em>p</em> &lt; 0.0001). Participants performing FCCs achieved a lower mean CC depth (<em>p</em> &lt; 0.001), consistent with the smaller maximal force. The rate of FCCs was slower than that of HCCs (<em>p</em> &lt; 0.001), and the total number of compressions performed differed significantly between the two methods (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The method of compression influences both the magnitude and angle of the force applied. FCCs were associated with significantly lower quality metrics. Nevertheless, on average, participants in both groups achieved CC parameters that were within or close to the recommended guideline ranges.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101050"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810580","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":"Is it possible to conduct on-site emergency training with a remote expert on an oceanographic vessel? A just-in-place/time proof of concept using smart glasses","authors":"Silvia Aranda-García ,&nbsp;Roberto Barcala-Furelos ,&nbsp;Jordi Sorribas ,&nbsp;Roberto González ,&nbsp;Marc Darné ,&nbsp;Antonio Rodríguez-Núñez","doi":"10.1016/j.resplu.2025.101049","DOIUrl":"10.1016/j.resplu.2025.101049","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101049"},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860590","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":"Galectin-3 as a marker to characterize post-cardiac arrest syndrome in initially survived out-of-hospital cardiac arrest: a prospective two-center study.","authors":"Swantje Nickelsen, Eleonore Grosse Darrelmann, Lea Seidlmayer, Katrin Fink, Simone Britsch, Daniel Duerschmied, Ruediger E Scharf, Albrecht Elsaesser, Thomas Helbing","doi":"10.1016/j.resplu.2025.101048","DOIUrl":"10.1016/j.resplu.2025.101048","url":null,"abstract":"<p><strong>Background: </strong>Survivors after out-of-hospital cardiac arrest (OHCA) experience post-cardiac arrest syndrome (PCAS), which encompasses cerebral edema, hemodynamic instability and systemic inflammation and causes high in-hospital mortality rates. Galectin (GAL) 3 is a predictor of mortality and unfavorable neurological outcome following OHCA. This study aims to investigate the relationship between GAL3 levels and key features of PCAS including in-hospital mortality, cerebral edema, post-cardiac arrest shock and systemic inflammation in OHCA patients.</p><p><strong>Methods: </strong>This prospective, two-center study included 71 adults after non-traumatic OHCA. Blood samples were taken on hospital admission (day 0) and day 2 after return of spontaneous circulation (ROSC). Serum GAL3 concentrations were quantified by enzyme-linked immunosorbent assay and compared with serum levels of 39 patients with coronary artery disease (CAD).</p><p><strong>Results: </strong>Serum GAL3 levels were highest on day 0 and declined on day 2 after ROSC to levels comparable to CAD controls. GAL3 levels were higher in non-survivors at both time- points. Admission GAL3 concentrations positively correlated with lactate on admission, a marker for no-flow/low-flow time and were elevated in patients with cerebral edema on cerebral computed tomography. Furthermore, admission GAL3 was higher in patients with inadequate lactate clearance and GAL3 levels on day 2 were significantly elevated in OHCA patients who required prolonged vasopressor/inotropic medication, both indicators of persistent hypoperfusion and shock. Moreover, a positive correlation was observed between GAL3 and interleukin-6 on admission.</p><p><strong>Conclusion: </strong>Serum GAL3 levels are associated with in-hospital mortality and distinct features of PCAS including cerebral edema, persistent shock and systemic inflammation following OHCA.\u2028\u2028<i>German Clinical Trials Register No. DRKS00020250; DRKS00009684.</i></p>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"101048"},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877701","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":"Cerebral oxygen saturation in relation to end-tidal CO2 in cardiopulmonary resuscitation – Separate views of brain and body?","authors":"Andrea Kornfehl ,&nbsp;Roman Brock ,&nbsp;Christoph Veigl ,&nbsp;Veronique Firich ,&nbsp;Mathias Gatterbauer ,&nbsp;Michael Girsa ,&nbsp;Daniel Grassmann ,&nbsp;Andreas Zajicek ,&nbsp;Alexander Spiel ,&nbsp;Christoph Testori ,&nbsp;Michael Holzer ,&nbsp;Mario Krammel ,&nbsp;Thomas Uray ,&nbsp;Sebastian Schnaubelt","doi":"10.1016/j.resplu.2025.101044","DOIUrl":"10.1016/j.resplu.2025.101044","url":null,"abstract":"<div><h3>Background</h3><div>An increase in both regional cerebral oxygen saturation (rSO₂) measured by near-infrared spectroscopy (NIRS) and end-tidal carbon dioxide (etCO₂) during advanced life support for out-of-hospital cardiac arrest (OHCA) is associated with a higher likelihood of return of spontaneous circulation (ROSC) and may predict neurological outcome. However, it remains unclear which marker is more predictive for which outcome parameter.</div></div><div><h3>Methods</h3><div>In this prospective observational study, we assessed rSO₂ and etCO₂ in patients treated for OHCA in the metropolitan area of Vienna between 05/2017 and 02/2022. Follow-up was performed for survival and neurological performance at hospital discharge and at six and 12 months after OHCA. rSO₂ and etCO₂ were compared between individuals with favourable and unfavourable outcomes, and cut-off values using ROC analyses were identified.</div></div><div><h3>Results</h3><div>Median rSO₂ and etCO₂ values of the included 176 patients during CPR were higher in those achieving sustained ROSC (rSO₂: 59 % (IQR 16.1) vs 46 % (IQR 14.3), p &lt; 0.001; etCO₂: 40 (IQR 18.7) vs. 25 (IQR 20.9) mmHg, p &lt; 0.001) and in patients with cerebral performance category (CPC) 1 or 2 (rSO₂: 66 % (IQR 15.5) vs 48 % (IQR 14.8), p &lt; 0.001; etCO₂: 50 (IQR 16.1) vs. 28 mmHg, p = 0.013). ROC analysis for median rSO₂ values yielded an optimal cutoff of 60 % (sensitivity 86 %, specificity 87 %) for CPC 1/2, and for median etCO₂ values 49 mmHg (sensitivity 67 %, specificity 94 %) for CPC 1/2. In ROC analyses, etCO₂ trends achieved better results for sustained ROSC prediction than rSO₂. In contrast, rSO₂ outperformed etCO₂ for the prediction of neurological outcome.</div></div><div><h3>Conclusion</h3><div>Measuring RSO₂ and etCO₂ during advanced life support is associated with critical clinical outcomes. Our findings suggest that these two parameters reflect different physiological aspects of resuscitation and may provide complementary information. Further research should examine the potential of using rSO₂ alongside etCO₂ in CPR algorithms.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101044"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757041","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":"Temporal trends and hospital variation in post-resuscitation fever for in-hospital cardiac arrest","authors":"Mohammad Abdel Jawad ,&nbsp;John A. Spertus ,&nbsp;Kensey L. Gosch ,&nbsp;Evan O’Keefe ,&nbsp;Nobuhiro Ikemura ,&nbsp;Paul S. Chan","doi":"10.1016/j.resplu.2025.101042","DOIUrl":"10.1016/j.resplu.2025.101042","url":null,"abstract":"<div><h3>Background</h3><div>A goal of post-resuscitation care among patients successfully resuscitated from in-hospital cardiac arrest (IHCA) is fever avoidance. However, the incidence of post-resuscitation fever after the initial therapeutic hypothermia trials in 2002 and after the Targeted Temperature Management (TTM) trial in 2013 is unknown.</div></div><div><h3>Methods</h3><div>Within the U.S. Get With The Guidelines-Resuscitation registry for IHCA, we identified adults with return of spontaneous circulation (ROSC). Patients with sepsis or COVID-19 were excluded. Temporal trends in post-resuscitation fever (≥100 °F) within 24 h of ROSC following the initial hypothermia trials (2005–2013) and after the TTM trial (2014–2022) were described. Hospital-level variation in post-resuscitation fever rates was assessed for the latter period.</div></div><div><h3>Results</h3><div>Among 41,155 patients, mean age was 64.8 ± 15.0 years, 40.0 % were women, and 68.6 % were White. Overall, 11,745 (28.5 %) had post-resuscitation fever. Annual rates of post-resuscitation fever decreased from 39.1 % in 2005 to 29.0 % in 2013 (<em>P for trend</em> &lt;0.001), and modestly from as high as 29.0 % in 2015 to 26.0 % in 2022 (<em>P for trend</em> of 0.003). Among 127 hospitals since the publication of the TTM trial, the rate of post-resuscitation fever varied widely from 3.4 % to 46.0 %, with a median OR of 1.81 (95 % CI: 1.72–1.91), indicating that, on average, the odds of post-resuscitation fever for patients with identical characteristics from two randomly selected hospitals varied by 81 %.</div></div><div><h3>Conclusions</h3><div>Post-resuscitation fever rates have decreased among patients with IHCA after the initial therapeutic hypothermia trials, but substantial hospital-level variation remains. Our findings highlight potential opportunities for improvement in post-resuscitation care.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101042"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757043","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 impact of additional special emergency medical service units on non-traumatic adult out-of-hospital cardiac arrest outcomes in a high-resource metropolitan area","authors":"Andrea Kornfehl ,&nbsp;Mario Krammel ,&nbsp;Daniel Grassmann ,&nbsp;Maximilian de Zordo ,&nbsp;Roman Brock ,&nbsp;Christoph Veigl ,&nbsp;Rene Adler ,&nbsp;Sabine Dunkl ,&nbsp;Mathias Gatterbauer ,&nbsp;Philipp Gonzo ,&nbsp;Bertram Schadler ,&nbsp;Patrick Aigner ,&nbsp;Michael Girsa ,&nbsp;Patrick Glaninger ,&nbsp;Andreas Zajicek ,&nbsp;Patrick Sulzgruber ,&nbsp;Thomas Uray ,&nbsp;Sebastian Schnaubelt","doi":"10.1016/j.resplu.2025.101046","DOIUrl":"10.1016/j.resplu.2025.101046","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest (OHCA) requires an effective cardiopulmonary resuscitation (CPR) and emergency medical service (EMS) response, yet survival rates remain low at 8.0–11.3 %. Factors such as team size, training and leadership influence outcomes, but optimal strategies are debated. The Vienna EMS routinely deploys field supervisors (FISU) to improve the quality of care. The aim of this study was to assess their impact on OHCA outcomes.</div></div><div><h3>Methods</h3><div>This retrospective observational study analyzed all consecutive adult non-traumatic OHCA cases in Vienna between 01/2019 and 12/2023, focusing on the impact of additional specialised units (FISU or supervising senior emergency physician) on cardiac arrest outcomes (ROSC rates, survival to hospital discharge, neurological performance). Statistical analysis used descriptive statistics, group tests, and logistic regression.</div></div><div><h3>Results</h3><div>A FISU was present in 45.7 % of cases, and its presence improved outcomes significantly including any ROSC (40.6 % vs 26.3 %; OR 1.963, CI 1.773–2.172, p &lt; 0.001), survived event (sustained ROSC) (30.6 % vs 20.6 %; OR 1.720, CI 1.542–1.918, p &lt; 0.001), survival to discharge (10.6 % vs 8.3 %; OR 1.263, 1.072–1.487, p = 0.005) and CPC 1/2 (7 % vs 6.4 %; OR 1.034, CI 1.152–1.253, p = 0.037). Multivariate analysis confirmed that the presence of FISU had an independently positive effect (any ROSC: OR 1.616, CI 1.440–1.813, p &lt; 0.001; survived event: OR 1.335, CI 1.180–1.510, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The presence of additional EMS special units like field supervisors can improve outcomes of non-traumatic out-of-hospital cardiac arrest in a high-resource metropolitan area.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101046"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757042","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 use of drone-delivered Automated External Defibrillators in the emergency response for out-of-hospital cardiac arrest. A simulation study.","authors":"Christopher M Smith, Carl Powell, Celia J Bernstein, Harry Howe, Mark Holt, Mary O'Sullivan, Keith Couper, Nigel Rees","doi":"10.1016/j.resplu.2025.101045","DOIUrl":"10.1016/j.resplu.2025.101045","url":null,"abstract":"<p><strong>Background: </strong>Drones are now being used to deliver Automated External Defibrillators (AEDs) for out-of-hospital cardiac arrest. Delays occur before (between emergency call and drone take-off) and after drone flight itself (related to bystander interaction with drone/AED). The emergency call-handler may have an important role in helping bystanders retrieve and use an AED.</p><p><strong>Methods: </strong>Following an emergency (999) call for simulated out-of-hospital cardiac arrests, a remote drone was activated and made autonomous Beyond Visual Line of Sight flights to the scene. Real-time communications between drone operator and call-handler allowed participants to receive updates about drone progress. Outcomes included hands-off CPR time, time away from patient's side retrieving the AED, time from emergency call to start of drone flight, and time from drone arrival to AED shock. We used video-recording, emergency-call audio and post-simulation interviews to gather additional information about participants' experiences.</p><p><strong>Results: </strong>We conducted 11 single bystander simulations and successfully delivered an AED on 9 occasions. It took (median) 2:18 min (interquartile range, IQR 2:13-2:38 min) from emergency call to drone take-off, and a further 4:35 min (3:39-4:46 min) once the drone had arrived on scene until first shock. Hands-off CPR time was 2:32 min (2:01-2:46 min); 0:16 min (0:13-0:21 min) of this was spent retrieving the AED. Bystanders retrieved the AED safely and interacted well with the drone, but often struggled with AED use.</p><p><strong>Conclusion: </strong>We demonstrated effective real-time communication during simulations. Drone start-up procedures were quick but there were delays once the drone arrived on scene. Bystanders and call-handlers need more support to effectively use drone-delivered AEDs.</p>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"101045"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877702","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":"Artificial intelligence as a virtual dispatcher: Decision support for lay responders in simulated cardiac arrest scenarios","authors":"Bálint Bánfai,&nbsp;József Betlehem,&nbsp;Henrietta Bánfai-Csonka","doi":"10.1016/j.resplu.2025.101043","DOIUrl":"10.1016/j.resplu.2025.101043","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101043"},"PeriodicalIF":2.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738301","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":"Protocol for a parallel-group, superiority randomized controlled trial of the PulsePoint mobile application to increase bystander resuscitation in out-of-hospital cardiac arrest","authors":"Steven C. Brooks ,&nbsp;John M. Tallon ,&nbsp;Sandra Jenneson ,&nbsp;Ashish R. Panchal ,&nbsp;Robert Grierson ,&nbsp;Laurie J. Morrison ,&nbsp;Damon C. Scales ,&nbsp;Andrew Day ,&nbsp;Lindsay O’Donnell ,&nbsp;Randy S. Wax ,&nbsp;Helen Connolly ,&nbsp;Jennie Helmer ,&nbsp;Heidi Corneil ,&nbsp;Jim Christenson","doi":"10.1016/j.resplu.2025.101036","DOIUrl":"10.1016/j.resplu.2025.101036","url":null,"abstract":"<div><div>Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality. Despite public awareness campaigns, widespread cardiopulmonary resuscitation (CPR) training initiatives, and deployment of public access defibrillators, potentially life-saving bystander intervention occurs inconsistently. Mobile technologies that alert nearby lay responders or off-duty professionals to OHCA events have emerged as a strategy to increase bystander CPR and AED use. The PulsePoint Randomized Controlled Trial (RCT) is a multi-centre pragmatic RCT designed to evaluate whether alerts sent via the PulsePoint Respond mobile application increase the likelihood of bystander resuscitation attempts before paramedic arrival.</div><div>The trial is being conducted within a province-wide Canadian paramedic service and a municipal fire rescue service in the USA. Eligible 9-1-1 calls for suspected non-traumatic OHCA occurring in a public (non-residential) location are randomized in real time to activation or suppression of the PulsePoint system. The primary outcome is bystander CPR or AED use prior to paramedic or firefighter arrival. Patients are included in the primary analysis if they are determined to have paramedic-treated OHCA in a public location with at least one PulsePoint user within 400 m. The target sample size is 340 patients powered at 80 % to detect a 15 % absolute increase in the primary outcome.</div><div>This pragmatic trial addresses a critical evidence gap in resuscitation science. We anticipate findings will inform refinement of technology implementation, policy, guideline development, and system-level decisions regarding the implementation of mobile alert systems to improve early intervention and survival from OHCA.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"25 ","pages":"Article 101036"},"PeriodicalIF":2.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830136","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}