32 research outputs found
Incidence of in-hospital cardiac arrest at general wards before and after implementation of an early warning score
No full textAbstract Background In order to reduce the incidence of in-hospital cardiac arrest (IHCA) at general wards, medical emergency teams (MET) were implemented in the Capital Region of Denmark in 2012 as the efferent part of a track and trigger system. The National Early Warning Score (NEWS) system became the afferent part. This study aims at investigating the incidence of IHCA at general wards before and after the implementation of the NEWS system. Material and methods We included patients at least 18 years old with IHCA at general wards in our hospital in the periods of 2006 to 2011 (pre-EWS group) and 2013 to 2018 (post-EWS group). Data was obtained from a local database and the National In-Hospital Cardiac Arrest Registry (DANARREST). We calculated incidence rate ratios (IRR) for IHCA at general wards with 95% confidence interval (95% CI). Odds ratios (OR) for return of spontaneous circulation (ROSC) and 30-day survival were also calculated with 95% CI. Results A total of 444 IHCA occurred before the implementation of NEWS at general wards while 494 IHCA happened afterwards. The incidence rate of IHCA at general wards was 1.13 IHCA per 1000 admissions in the pre-EWS group (2006–2011) and 1.11 IHCA per 1000 admissions in the post-EWS group (2013–2018). The IRR between the two groups was 0.98 (95% CI [0.86;1.11], p = 0.71). The implementation did not affect the chance of ROSC with a crude OR of 1.14 (95% CI [0.88;1.47], p = 0.32) nor did it change the 30-day survival with a crude OR 1.30 (95% CI [0.96;1.75], p = 0.09). Conclusion Implementation of the EWS system at our hospital did not decrease the incidence rate of in-hospital cardiac arrest at general wards
Basic life support and automated external defibrillator skills among ambulance personnel: a manikin study performed in a rural low-volume ambulance setting
No full textAmbulance personnel play an essential role in the 'Chain of Survival'. The prognosis after out-of-hospital cardiac arrest was dismal on a rural Danish island and in this study we assessed the cardiopulmonary resuscitation performance of ambulance personnel on that island
Advanced life support for cardiac arrest beyond the algorithm
No full textIn an advanced emergency medical service all parts of the advanced life support (ALS) algorithm can be provided. This evidence-based algorithm outlines resuscitative efforts for the first 10-15 minutes after cardiac arrest, whereafter the algorithm repeats itself. Restoration of spontaneous circulation fails in most cases, but in some circumstances the patient may benefit from additional interventional approaches, in which case transport to hospital with ongoing cardiopulmonary resuscitation is indicated. This paper has summarized treatments outside the ALS algorithm, which may be beneficial, but are not supported by firm scientific evidence.</p
Availability of social authorities in a simulated paediatric emergency
No full textINTRODUCTION. In cases of parental opposition to emergency medical care for minors, defined as children below 15 years of age, involving the social authorities may be necessary. When medical personnel assess that an intervention is in the minor’s best interests, approval for such intervention is warranted from the local authorities in the municipality of residence. It wasthe primary aim of this study to assess the urgent availability of these authorities. METHODS. The urgent phone availability of social authorities at the 98 Danish local municipal offices was assessed during bothregular hours and off-hours. The primary objective was to assess availability during regular hours. Urgent availability was predefined as obtained contact to a self-proclaimed accountable authority within 30 minutes. Secondary objectives wereassessment of off-hour availability, time until obtained contact and number of contact links. RESULTS. Contact was obtained within 30 minutes in 59 inquiries (~ 58%) made during regular hours, with a median of threecontact links and a median time until contact of eight minutes (interquartile range (IQR): 5.5-11 minutes). During off-hours, contact was obtained within 30 minutes in 91 inquiries (~ 93%), with a median of two contact links and a median time until contact of seven minutes (IQR: 5-12 minutes). CONCLUSION. During regular hours, we found that an accountable authority was urgently available for attendance to a case ofparental opposition to emergency medical care of a minor within 30 minutes at the local municipal office in 58% of Danish municipalities.FUNDING. None.TRIAL REGISTRATION. Not relevant.INTRODUCTION: In cases of parental opposition to emergency medical care for minors, defined as children below 15 years of age, involving the social authorities may be necessary. When medical personnel assess that an intervention is in the minor's best interests, approval for such intervention is warranted from the local authorities in the municipality of residence. It was the primary aim of this study to assess the urgent availability of these authorities.METHODS: The urgent phone availability of social authorities at the 98 Danish local municipal offices was assessed during both regular hours and off-hours. The primary objective was to assess availability during regular hours. Urgent availability was predefined as obtained contact to a self-proclaimed accountable authority within 30 minutes. Secondary objectives were assessment of off-hour availability, time until obtained contact and number of contact links.RESULTS: Contact was obtained within 30 minutes in 59 inquiries (~ 58%) made during regular hours, with a median of three contact links and a median time until contact of eight minutes (interquartile range (IQR): 5.5-11 minutes). During off-hours, contact was obtained within 30 minutes in 91 inquiries (~ 93%), with a median of two contact links and a median time until contact of seven minutes (IQR: 5-12 minutes).CONCLUSION: During regular hours, we found that an accountable authority was urgently available for attendance to a case of parental opposition to emergency medical care of a minor within 30 minutes at the local municipal office in 58% of Danish municipalities.FUNDING: None.TRIAL REGISTRATION: Not relevant.</p
Can mass education and a television campaign change the attitudes towards cardiopulmonary resuscitation in a rural community?
No full textSurvival after out-of-hospital cardiac arrest (OHCA) is improved when bystanders provide Basic Life Support (BLS). However, bystander BLS does not occur frequently. The aim of this study was to assess the effects on attitudes regarding different aspects of resuscitation of a one-year targeted media campaign and widespread education in a rural Danish community. Specifically, we investigated if the proportion willing to provide BLS and deploy an automated external defibrillator (AED) increased
Persisting effect of community approaches to resuscitation
No full textAbstractBackgroundOn the Danish island of Bornholm an intervention was carried out during 2008–2010 aiming at increasing out-of-hospital cardiac arrest (OHCA) survival. The intervention included mass media focus on resuscitation and widespread educational activities. The aim of this study was to compare the bystander BLS rate and survival after OHCA on Bornholm in a 3-year follow-up period after the intervention took place.MethodsData on OHCA on Bornholm were collected from September 28th, 2010 to September 27th, 2013 and compared to data from the intervention period, September 28th, 2008 to September 27th, 2010.ResultsThe bystander BLS rate for non-EMS witnessed OHCAs with presumed cardiac aetiology was significantly higher in the follow-up period (70% [95% CI 61–77] vs. 47% [95% CI 37–57], p=0.001). AEDs were deployed in 22 (18%) cases in the follow-up period and a shock was provided in 13 cases. There was no significant change in all-rhythm 30-day survival for non-EMS witnessed OHCAs with presumed cardiac aetiology (6.7% [95% CI 3–13] in the follow-up period; vs. 4.6% [95% CI 1–12], p=0.76).ConclusionIn a 3-year follow-up period after an intervention engaging laypersons in resuscitation through mass education in BLS combined with a media focus on resuscitation, we observed a persistent significant increase in the bystander BLS rate for all OHCAs with presumed cardiac aetiology. There was no significant difference in 30-day survival
Temporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement
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