Compression-associated injuries using CLOVER3000 device in non-survivor patients of OHCA: A retrospective cohort study.

AIM: The incidence of compression-associated injuries from using the CLOVER3000, a new mechanical cardiopulmonary resuscitation (CPR) device, is not well studied in the context of out-of-hospital cardiac arrest (OHCA). Thus, we aimed to compare compression-associated injuries between CLOVER3000 and manual CPR. METHODS: This single-center, retrospective, cohort study used data from the medical records of a tertiary care center in Japan between April 2019 and August 2022. We included adult non-survivor patients with non-traumatic OHCA who were transported by emergency medical services and underwent post-mortem computed tomography. Compression-associated injuries were tested using logistic regression models adjusting for age, sex, bystander CPR performance, and CPR duration. RESULTS: A total of 189 patients (CLOVER3000, 42.3%; manual CPR, 57.7%) were included in the analysis. The overall incidence of compression-associated injuries was similar between the two groups (92.5% vs. 94.54%; adjusted odds ratio (AOR), 0.62 [95% confidence interval (CI), 0.06-1.44]). The most common injury was anterolateral rib fractures with a similar incidence between the two groups (88.7% vs. 88.9%; AOR, 1.03 [95% CI, 0.38 to 2.78]). The second most common injury was sternal fracture in both groups (53.1% vs. 56.7%; AOR, 0.68 [95% CI, 0.36-1.30]). The incidence rates of other injuries were not statistically different between the both groups. CONCLUSION: We observed a similar overall incidence of compression-associated injuries between the CLOVER3000 and manual CPR groups on small sample size.

Success rate of anterior shoulder dislocation reduction by emergency physicians: a retrospective cohort study.

Aim: Emergency physicians (EPs) often treat anterior shoulder dislocation, but epidemiology of anterior shoulder dislocation in the emergency department of Japan remains unclear. In this study, we clarified the success rate of anterior shoulder reduction performed by EPs. Methods: This single-center cohort study included patients with anterior shoulder dislocation for whom the EP performed initial reduction. The period was from January 2006 to March 2021 and we used the electronic medical record data of the tertiary care hospital. Our primary outcome was the success rate of the shoulder reduction performed by EP. The secondary outcome was to compare the success of reduction with the failure of the reduction. Results: In total, 293 eligible patients were identified. Of these patients, 244 were included in this study. The success rate of the shoulder reduction performed by EP was 92.2% (225/244). EPs failed in successfully performing reduction in 19 (7.8%) cases of anterior shoulder dislocations. The failure group was older (P = 0.017), had a higher frequency of fall down in the mechanism of dislocation (P = 0.019), used intravenous analgesics more frequently (P = 0.004), used peripheral nerve blocks more frequently (P = 0.006), and had fewer patients who did not use drugs (P = 0.002). We could not perform statical adjustment because the sample size was small. Conclusion: The success rate of the shoulder reduction performed by EPs was 92.2%. Older age might be associated with failure of shoulder reduction.