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Cardiac arrest teams and medical emergency teams in Finland: a nationwide cross-sectional postal survey.

https://arctichealth.org/en/permalink/ahliterature257973
Source
Acta Anaesthesiol Scand. 2014 Apr;58(4):420-7
Publication Type
Article
Date
Apr-2014
Author
J. Tirkkonen
J. Nurmi
K T Olkkola
J. Tenhunen
S. Hoppu
Author Affiliation
Department of Intensive Care Medicine and Critical Care Medicine Research Group, Tampere University Hospital, Tampere, Finland; Medical School, University of Tampere, Tampere, Finland.
Source
Acta Anaesthesiol Scand. 2014 Apr;58(4):420-7
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Cardiopulmonary Resuscitation
Crisis Intervention
Cross-Sectional Studies
Emergency Medical Services - manpower
Emergency Service, Hospital
Finland - epidemiology
Guideline Adherence
Guidelines as Topic
Health Care Surveys
Heart Arrest - prevention & control - therapy
Humans
Intensive Care Units - statistics & numerical data
Intensive Care Units, Pediatric
Operating Rooms
Patient care team
Questionnaires
Vital Signs
Abstract
The implementation, characteristics and utilisation of cardiac arrest teams (CATs) and medical emergency teams (METs) in Finland are unknown. We aimed to evaluate how guidelines on advanced in-hospital resuscitation have been translated to practice.
A cross-sectional postal survey including all public hospitals providing anaesthetic services.
Of the 55 hospitals, 51 (93%) participated in the study. All hospitals with intensive care units (university and central hospitals, n = 24) took part. In total, 88% of these hospitals (21/24) and 30% (8/27) of the small hospitals had CATs. Most hospitals with CATs (24/29) recorded team activations. A structured debriefing after a resuscitation attempt was organised in only one hospital. The median incidence of in-hospital cardiac arrest in Finland was 1.48 (Q1 = 0.93, Q3 = 1.93) per 1000 hospital admissions. METs had been implemented in 31% (16/51) of the hospitals. A physician participated in MET activation automatically in half (8/16) of the teams. Operating theatres (13/16), emergency departments (10/16) and paediatric wards (7/16) were the most common sites excluded from the METs' operational areas. The activation thresholds for vital signs varied between hospitals. The lower upper activation threshold for respiratory rate was associated with a higher MET activation rate. The national median MET activation rate was 2.3 (1.5, 4.8) per 1000 hospital admissions and 1.5 (0.96, 4.0) per every cardiac arrest.
Current guidelines emphasise the preventative actions on in-hospital cardiac arrest. Practices are changing accordingly but are still suboptimal especially in central and district hospitals. Unified guidelines on rapid response systems are required.
PubMed ID
24571412 View in PubMed
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Early intralipid therapy may have prevented bupivacaine-associated cardiac arrest.

https://arctichealth.org/en/permalink/ahliterature86760
Source
Reg Anesth Pain Med. 2008 Mar-Apr;33(2):178-80
Publication Type
Article
Author
McCutchen Thomas
Gerancher J C
Author Affiliation
Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. mccutcq@netscape.net
Source
Reg Anesth Pain Med. 2008 Mar-Apr;33(2):178-80
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Anesthetics, Local - adverse effects
Bupivacaine - adverse effects
Fat Emulsions, Intravenous - therapeutic use
Female
Heart Arrest - prevention & control
Humans
Resuscitation - methods
Tachycardia, Ventricular - chemically induced - therapy
Time Factors
Abstract
OBJECTIVE: Local anesthetic-induced cardiotoxicity remains a complication of regional anesthesia, with the potential to result in cardiac arrest refractory to resuscitation. Successful resuscitation using Intralipid (Baxter Pharmaceuticals by Fresenius Kabi, Uppsala, Sweden), has been reported in 2 patients with bupivacaine-induced cardiac arrest. CASE REPORT: We report another case for which Intralipid was used as part of a successful resuscitation in a patient with local anesthetic-induced cardiotoxicity. CONCLUSIONS: Early treatment with Intralipid may help prevent cardiac arrest and speed successful resuscitation efforts.
PubMed ID
18299100 View in PubMed
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[Hospital mortality rate of acute myocardial infarction. II. Complicating factors, complications and temporal relations]

https://arctichealth.org/en/permalink/ahliterature56137
Source
Ugeskr Laeger. 1976 Jan 12;138(3):138-42
Publication Type
Article
Date
Jan-12-1976

Regression methods for cost-effectiveness analysis with censored data.

https://arctichealth.org/en/permalink/ahliterature177648
Source
Stat Med. 2005 Jan 15;24(1):131-45
Publication Type
Article
Date
Jan-15-2005
Author
Andrew R Willan
D Y Lin
Andrea Manca
Author Affiliation
Program in Population Health Sciences, Research Institute, Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8. willana@mcmaster.ca
Source
Stat Med. 2005 Jan 15;24(1):131-45
Date
Jan-15-2005
Language
English
Publication Type
Article
Keywords
Amiodarone - economics
Anti-Arrhythmia Agents - economics
Canada
Cost-Benefit Analysis - methods
Defibrillators, Implantable - economics
Female
Heart Arrest - prevention & control
Humans
Hysterectomy, Vaginal - economics
Laparoscopy - economics
Male
Models, Statistical
Quality-Adjusted Life Years
Randomized Controlled Trials as Topic - economics
Survival Analysis
Abstract
A system of seemingly unrelated regression equations is proposed for prognostic factor adjustment and subgroup analysis when comparing two groups in a cost-effectiveness analysis with censored data. Because of the induced dependent censoring on costs and quality-adjusted survival, inverse probability weighting is employed for parameter estimation. The method is illustrated with data from two recent examples using both survival time and quality-adjusted survival time as the measures of effectiveness.
PubMed ID
15515137 View in PubMed
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Very high survival among patients defibrillated at an early stage after in-hospital ventricular fibrillation on wards with and without monitoring facilities.

https://arctichealth.org/en/permalink/ahliterature53144
Source
Resuscitation. 2005 Aug;66(2):159-66
Publication Type
Article
Date
Aug-2005
Author
Johan Herlitz
Soveig Aune
Angela Bång
Martin Fredriksson
Ann-Britt Thorén
Lars Ekström
Stig Holmberg
Author Affiliation
Division of Cardiology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. johan.herlitz@hjl.gu.se
Source
Resuscitation. 2005 Aug;66(2):159-66
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Comparative Study
Defibrillators
Early Diagnosis
Electric Countershock - methods
Evaluation Studies
Female
Follow-Up Studies
Heart Arrest - prevention & control
Hospital Mortality - trends
Humans
Inpatients
Male
Middle Aged
Monitoring, Physiologic - instrumentation
Patient Discharge
Probability
Prospective Studies
Research Support, Non-U.S. Gov't
Risk assessment
Survival Rate
Sweden
Treatment Outcome
Ventricular Fibrillation - diagnosis - mortality - therapy
Abstract
BACKGROUND: The association between the interval between collapse and defibrillation and outcome is well described in out of hospital cardiac arrest but not as well in in-hospital cardiac arrest. We report the outcome among patients who suffered an in-hospital cardiac arrest and were found in ventricular fibrillation (VF) with the emphasis on the delay to defibrillation. METHODS AND RESULTS: In patients who suffered an in-hospital cardiac arrest at Sahlgrenska University Hospital in G?teborg between 1994 and 2002 there were 1.570 calls for the rescue team of which 71% had suffered a cardiac arrest. Among cardiac arrests 47% took place on monitored wards. The proportion of patients found in VF was 59% on wards with monitoring facilities and 45% on wards without (p12 min. On monitored wards, the survival was 63% if defibrillated 3 min after collapse (NS). The corresponding values for non-monitored wards were 72% and 35%, respectively (p=0.0003). Cerebral function among survivors at discharge appeared to be good among the majority of patients both in monitored and non monitored wards. CONCLUSION: If patients with in hospital VF were defibrillated early in both monitored and non monitored wards survival to hospital discharge was high. This highlights the importance of being prepared for the rapid defibrillation on wards without monitoring facilities.
PubMed ID
15955610 View in PubMed
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When the unreal becomes real: family members' experiences of cardiac arrest.

https://arctichealth.org/en/permalink/ahliterature53193
Source
Nurs Crit Care. 2005 Jan-Feb;10(1):15-22
Publication Type
Article
Author
Marita Weslien
Tore Nilstun
Anita Lundqvist
Bengt Fridlund
Author Affiliation
Department of Nursing, Lund University, Lund, Sweden. marita.weslien@omv.lu.se
Source
Nurs Crit Care. 2005 Jan-Feb;10(1):15-22
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Aged
Attitude to Health
Caregivers - psychology
Emergency Medical Technicians - psychology
Empathy
Family - psychology
Female
First Aid - psychology
Heart Arrest - prevention & control
Holistic Health
Humans
Male
Middle Aged
Narration
Needs Assessment
Nursing Methodology Research
Professional-Family Relations
Qualitative Research
Questionnaires
Research Support, Non-U.S. Gov't
Social Distance
Sweden
Visitors to Patients - psychology
Abstract
The aim of this study was to provide insight into family members' experiences related to cardiac arrest. Data were collected through semi-structured interviews with 17 family members approximately 5-34 months after the cardiac arrest of a relative. As the focus was on the family members' experiences seen from a holistic perspective, content analysis was chosen for the study. When the event occurred to the patient, family members realized the need for assistance and managed to initiate first actions. When the emergency medical service arrived, family members responded to stress and forgot their own needs. When the staff took over at the hospital, family members not only received sympathy but also encountered professional distancing. Because their experiences vary widely, the encounter has to be developed through a comforting, sympathetic and respectful dialogue in consideration for individuals' preferences.
PubMed ID
15739635 View in PubMed
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7 records – page 1 of 1.