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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2614-2617, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018542

RESUMO

The main goal of this research is to evaluate the defibrillation efficacy with the high-frequency waveform on ventricular fibrillation in small animals. A biphasic defibrillator with adjustable frequency was designed for this study. This custom-designed defibrillator can be adjusted to generate four different frequencies of 125, 250, 500, and 1000 Hz. Six rat hearts were induced VT/VF by electrical induction using the waveform of these four frequencies. Success VT/VF-induction by applying those four frequencies were recorded and observed by optical mapping. The results showed that the VT/VF-induction success rate is increasing along with higher frequencies. The VT/VF-induction success rate is 16% in 125Hz and 250 Hz, 33% in 500 Hz, and 100% in 1000 Hz with S1-S2 protocol at 100 ms coupling interval. Also, using optical mapping technique, shock-induced optical potential showed that only high-frequency waveform exhibited the largest tissue responses in the middle position of the heart. In conclusion, high-frequency (1000Hz) defibrillation waveform has the highest defibrillation efficacy comparing to other lower frequencies used in this study.


Assuntos
Coração , Fibrilação Ventricular , Animais , Desfibriladores , Eletricidade , Masculino , Ratos , Registros , Fibrilação Ventricular/terapia
2.
PLoS One ; 15(10): e0241028, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33091034

RESUMO

INTRODUCTION: An increase in the incidence of OHCA during the COVID-19 pandemic has been recently demonstrated. However, there are no data about how the COVID-19 epidemic influenced the treatment of OHCA victims. METHODS: We performed an analysis of the Lombardia Cardiac Arrest Registry comparing all the OHCAs occurred in the Provinces of Lodi, Cremona, Pavia and Mantua (northern Italy) in the first 100 days of the epidemic with those occurred in the same period in 2019. RESULTS: The OHCAs occurred were 694 in 2020 and 520 in 2019. Bystander cardiopulmonary resuscitation (CPR) rate was lower in 2020 (20% vs 31%, p<0.001), whilst the rate of bystander automated external defibrillator (AED) use was similar (2% vs 4%, p = 0.11). Resuscitation was attempted by EMS in 64.5% of patients in 2020 and in 72% in 2019, whereof 45% in 2020 and 64% in 2019 received ALS. At univariable analysis, the presence of suspected/confirmed COVID-19 was not a predictor of resuscitation attempt. Age, unwitnessed status, non-shockable presenting rhythm, absence of bystander CPR and EMS arrival time were independent predictors of ALS attempt. No difference regarding resuscitation duration, epinephrine and amiodarone administration, and mechanical compression device use were highlighted. The return of spontaneous circulation (ROSC) rate at hospital admission was lower in the general population in 2020 [11% vs 20%, p = 0.001], but was similar in patients with ALS initiated [19% vs 26%, p = 0.15]. Suspected/confirmed COVID-19 was not a predictor of ROSC at hospital admission. CONCLUSION: Compared to 2019, during the 2020 COVID-19 outbreak we observed a lower attitude of laypeople to start CPR, while resuscitation attempts by BLS and ALS staff were not influenced by suspected/confirmed infection, even at univariable analysis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Serviços Médicos de Emergência , Parada Cardíaca Extra-Hospitalar/terapia , Pneumonia Viral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Amiodarona/administração & dosagem , Reanimação Cardiopulmonar , Infecções por Coronavirus/virologia , Desfibriladores , Epinefrina/administração & dosagem , Feminino , Humanos , Incidência , Itália , Estudos Longitudinais , Masculino , Pandemias , Pneumonia Viral/virologia , Estudos Prospectivos , Sistema de Registros , Fatores de Tempo , Vasoconstritores/administração & dosagem , Vasodilatadores/administração & dosagem
6.
Artigo em Inglês | MEDLINE | ID: mdl-32751367

RESUMO

Many prehospital factors that are known to influence survival rates after out-of-hospital cardiac arrest (OHCA) have been rarely studied as to how their influence varies depending on the age. In this study, we tried to find out what prehospital factors affect the survival rate after OHCA by age groups and how large the effect size of those factors is in each age group. We used the South Korean OHCA registry, which includes information on various prehospital factors relating OHCA and final survival status. The association between prehospital factors and survival was explored through logistic regression analyses for each age group. The effects of prehospital factors vary depending on the patient's age. Being witnessed was relatively more influential in younger patients and the presence of first responders became more important as patients became older. While bystander cardiopulmonary resuscitation (CPR) did not appear to significantly affect survival in younger people, use of an automated external defibrillator (AED) showed the largest effect size on the survival in all age groups. Since the pathophysiology and etiologies of OHCA vary according to age, more detailed information on life support by age is needed for the development and application of more specialized protocols for each age.


Assuntos
Reanimação Cardiopulmonar , Serviços Médicos de Emergência , Parada Cardíaca Extra-Hospitalar , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Desfibriladores , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/mortalidade , Parada Cardíaca Extra-Hospitalar/terapia , Sistema de Registros , Taxa de Sobrevida , Adulto Jovem
7.
PLoS One ; 15(6): e0233966, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32484818

RESUMO

BACKGROUND: Laypersons' efforts to initiate basic life support (BLS) in witnessed Out-of-Hospital Cardiac Arrest (OHCA) remain comparably low within western society. Therefore, in order to shorten no-flow times in cardiac arrest, several police-based first responder systems equipped with automated external defibrillators (Pol-AED) were established in urban areas, which subsequently allow early BLS and AED administration by police officers. However, data on the quality of BLS and AED use in such a system and its impact on patient outcome remain scarce and inconclusive. METHODS: A total of 85 Pol-AED cases were randomly assigned to a gender, age and first rhythm matched non-Pol-AED control group (n = 170) in a 1:2 ratio. Data on quality of BLS were extracted via trans-thoracic impedance tracings of used AED devices. RESULTS: Comparing Pol-AED cases and the control group, we observed a similar compression rate per minute (p = 0.677) and compression ratio (p = 0.651), mirroring an overall high quality of BLS administered by police officers. Time to the first shock was significantly shorter in Pol-AED cases (6 minutes [IQR: 2-10] vs. 12 minutes [IQR: 8-17]; p<0.001). While Pol-AED was not associated with increased sustained return of spontaneous circulation (p = 0.564), a strong and independent impact on survival until hospital discharge (adj. OR: 1.85 [95%CI: 1.06-3.23; p = 0.030]) and a borderline significance for the association with favorable neurological outcome (adj. OR: 1.58 [95%CI: 0.96-2.89; p = 0.052) were observed. CONCLUSION: We were able to demonstrate an early start and a high quality of BLS and AED use in Pol-AED assessed OHCA cases. Moreover, the presence of Pol-AED care was associated with better patient survival and borderline significance for favorable neurological outcome.


Assuntos
Socorristas , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/prevenção & controle , Polícia , Idoso , Reanimação Cardiopulmonar , Desfibriladores , Cardioversão Elétrica , Serviços Médicos de Emergência , Feminino , Humanos , Sistemas de Manutenção da Vida , Masculino , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/fisiopatologia
8.
Stud Health Technol Inform ; 271: 93-100, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32578547

RESUMO

Over the last few decades, implantable defibrillators have become an established method of treating malign cardiac arrhythmias. There are some situations, however, in which it would be premature to implant a permanent defibrillator. In such cases, a wearable cardioverter defibrillator (WCD) can provide temporary relief and protect patients from life-threatening cardiac arrhythmias. Treatment with WCD is now included in national and international guidelines. Nevertheless, there are still some deficits in connection with WCD, especially regarding rescue chain optimization. For example, there is currently no telemedical link in place to emergency call centers and healthcare practitioners in the case of an event. Likewise, there are still some problems with rhythm analysis, concerning both shock delivery and cardiopulmonary resuscitation (CPR). These deficits are now to be addressed within the framework of MiniDefi, a project funded by the German Federal Ministry of Education and Research (BMBF). The concepts are described here for the first time.


Assuntos
Desfibriladores Implantáveis , Insuficiência Cardíaca , Dispositivos Eletrônicos Vestíveis , Morte Súbita Cardíaca , Desfibriladores , Cardioversão Elétrica , Insuficiência Cardíaca/terapia , Humanos
10.
Resuscitation ; 151: 145-147, 2020 06.
Artigo em Inglês | MEDLINE | ID: covidwho-154701

RESUMO

Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.


Assuntos
Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/terapia , Parada Cardíaca/terapia , Pandemias/estatística & dados numéricos , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Comitês Consultivos , Reanimação Cardiopulmonar/tendências , Consenso , Infecções por Coronavirus/epidemiologia , Estado Terminal/terapia , Desfibriladores/estatística & dados numéricos , Feminino , Saúde Global , Humanos , Internacionalidade , Masculino , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Análise de Sobrevida
12.
Resuscitation ; 151: 145-147, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32371027

RESUMO

Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.


Assuntos
Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/terapia , Parada Cardíaca/terapia , Pandemias/estatística & dados numéricos , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Comitês Consultivos , Reanimação Cardiopulmonar/tendências , Consenso , Infecções por Coronavirus/epidemiologia , Estado Terminal/terapia , Desfibriladores/estatística & dados numéricos , Feminino , Saúde Global , Humanos , Internacionalidade , Masculino , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Análise de Sobrevida
16.
J Environ Public Health ; 2020: 7453027, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32351583

RESUMO

Security personnel are the first ones who attend the scene in the case of out-of-hospital cardiac arrest (OHCA) at malls. Cardiopulmonary resuscitation (CPR) is not enough for those patients; they need an automated external defibrillator (AED) to bring the heart to function normally. This study aimed to assess the current status of CPR and AED knowledge and availability in Saudi malls by security personnel. Using a descriptive design, a study was conducted at seven malls located in the Eastern Province of Saudi Arabia. Two hundred and fifty participants were surveyed using the American Heart Association (AHA) 2015 guidelines to assess CPR and AED knowledge and availability in Saudi malls. The sample mean age was 32.60 years (SD = 10.02), and 87% of participants were working as security personnel. The majority of the participants had not received training about CPR and AED (75.8% and 95.2%, respectively). Common misconceptions are fallen into all categories of CPR and AED knowledge. Correctly answered statements ranged from 7.2% in the compression rate to 24.2% in hand placement. The study results indicated a poor training knowledge of CPR and AED in public settings. Integrating high-quality CPR and AED knowledge within the school and college curricula is a vital need. However, in order to maximize the survival rate, it is important to set laws and legislation adopted by stakeholders and decision makers to advocate the people who try to help, mandate AED installation in crowded places, and mandate teaching hands-only CPR and AED together as a package.


Assuntos
Reanimação Cardiopulmonar/educação , Desfibriladores/provisão & distribução , Socorristas/educação , Parada Cardíaca Extra-Hospitalar/terapia , Adulto , Reanimação Cardiopulmonar/métodos , Reanimação Cardiopulmonar/normas , Desfibriladores/normas , Desfibriladores/estatística & dados numéricos , Socorristas/estatística & dados numéricos , Feminino , Humanos , Masculino , Parada Cardíaca Extra-Hospitalar/epidemiologia , Arábia Saudita/epidemiologia , Inquéritos e Questionários
17.
J Cardiovasc Transl Res ; 13(3): 331-338, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32300931

RESUMO

Sudden cardiac arrest (SCA) is the leading cause of exercise-related fatalities in athletes. A comprehensive emergency action plan (EAP) is critical to facilitate a rapid and effective response to a cardiac emergency. SCA should be suspected in any athlete that collapses suddenly and is unresponsive. All potential responders to a collapsed athlete should be trained in the recognition of SCA, cardiopulmonary resuscitation, and use of an automated external defibrillator (AED). AEDs should be accessible on-site at sporting venues with a target collapse to first shock interval of less than 3 min. Every school, club, and sporting organization that sponsors athletic activities should have a written EAP for SCA. An EAP coordinator should be designated to foster compliance with training, practice, and rehearsal of the EAP at least once annually. Some sports require special considerations for equipment removal or access to emergency services in geographically broad or water-based venues.


Assuntos
Atletas , Reanimação Cardiopulmonar , Morte Súbita Cardíaca/prevenção & controle , Desfibriladores , Cardioversão Elétrica/instrumentação , Serviços Médicos de Emergência/organização & administração , Parada Cardíaca Extra-Hospitalar/terapia , Emergências , Humanos , Parada Cardíaca Extra-Hospitalar/diagnóstico , Parada Cardíaca Extra-Hospitalar/mortalidade , Parada Cardíaca Extra-Hospitalar/fisiopatologia , Resistência Física , Técnicas de Planejamento
18.
Educ. med. (Ed. impr.) ; 21(2): 92-99, mar.-abr. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194475

RESUMO

INTRODUCCIÓN: El uso de videos parece ser un buen recurso para la difusión de las técnicas de reanimación cardiopulmonar (RCP) entre jóvenes y adolescentes. OBJETIVO: Nuestro objetivo ha sido evaluar el efecto de la creación y difusión de un video formativo en técnicas de RCP y uso del desfibrilador semiautomático en un equipo de fútbol-sala de adolescentes. MATERIAL Y MÉTODOS: Se realizó un estudio prospectivo, analítico y observacional con una muestra de 65 jugadores (entre 12 y 33 años). En primer lugar se evaluaron los conocimientos sobre soporte vital básico con un cuestionario. Posteriormente se divulgó un video hecho ad hoc por medio de redes sociales durante una semana. A continuación un total de 52 sujetos se dividieron en grupo experimental, que vieron el video, y grupo control. Ambos fueron evaluados con un test estandarizado. RESULTADOS: El 55% de la muestra inicial refiere no tener conocimientos y el 81% no sabe cómo usar un desfibilador semiautomático. Tras la difusión del video, encontramos diferencias estadísticamente significativas entre ambos grupos en cuanto a apertura de vía aérea, profundidad y número de compresiones correctas, mejorando por tanto la calidad de RCP. En cuanto al desfibrilador semiautomático, la descarga efectiva se realiza de media en 85seg desde la entrega del desfibrilador. CONCLUSIONES: Podemos concluir que la visualización de un video breve mejora la capacidad de respuesta ante una parada cardiorrespiratoria y la calidad de la RCP


INTRODUCTION: Using videos seems to be a good option to share cardiopulmonary resuscitation (CPR) techniques. AIM: Our aim was to evaluate the learning effect of viewing a video about why and how to do CPR in young footballers, as well as on how to use an automatic external defibrillator. MATERIAL AND METHODS: A prospective, analytical and observational study was conducted that included 65 young footballers (aged between 12 and 33 years old). First of all, basic life support knowledge was assessed using a questionnaire. After that, a video made ad hoc for this study was shared on the social media for a week. Then, 52 of the participants were split into the experimental group (who watched the video), and a control group. Both groups were evaluated using a standardised test scenario. RESULTS: Fifty five per cent of the sample did not have sufficient knowledge, and 81% said that they did not know how to use an automatic external defibrillator. After the video release, a statistical difference was found between both groups in terms of airway opening, depth and correct compressions, thus improving overall CPR quality. The mean time to deliver an effective shock with the automatic external defibrillator was 85 seconds. CONCLUSION: In conclusion, watching a brief video improves the responsiveness in a cardiac arrest and the CPR quality


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Rede Social , Suporte Vital Cardíaco Avançado/educação , Reanimação Cardiopulmonar/educação , Recursos Audiovisuais , Desfibriladores/tendências , Avaliação Educacional , Estudos Prospectivos , Manequins
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