Improving cardiac arrest survival rates (Canada)

Researchers at St. Michael's Hospital and Sunnybrook along with paramedics in the Greater Toronto Area are taking part in two of the largest clinical trials in the world aimed at finding ways to improve survival rates of people who suffer a cardiac arrest outside of a hospital. One trial examines whether cooling a patient's body temperature in the ambulance en route to a hospital improves the rate of cooling in the hospital, which has been proven to improve survival and reduce brain damage. The other seeks to determine the best drug to give people to treat the heart rhythm that signals they are about to go into cardiac arrest. "The survival rate from cardiac arrest has increased five-fold in regions where paramedics are participating in these resuscitation trials, which highlights incredible improvements in quality of care," said Dr. Laurie Morrison, an emergency medicine physician at St. Michael's. Dr. Morrison heads Rescu, the largest research team of its kind in Canada, dedicated to improving out-of-hospital resuscitation. Rescu is conducting the trials along with Toronto-area base hospitals (Sunnybrook Centre for Prehospital Medicine and Lakeridge Health Central East Prehospital Care Program), and associated paramedic and fire services. About 15,000 to 20,000 Canadians suffer cardiac arrest outside of a hospital every year. During a cardiac arrest, the heart stops beating, and unless it is restarted within minutes, the person usually dies. Although immediate resuscitation can be lifesaving, more than 90 percent of people who experience a cardiac arrest outside of a hospital will die before reaching a hospital or soon after

Double-blind study tests heart-rhythm drugs (USA)

In the next three years, about 400 people on the brink of death will be part of a study for which they did not volunteer. In Clackamas and Washington counties in Oregon, and Clark County in Washington state, paramedics responding to unconscious people in cardiac arrest will administer CPR, then shock with a defibrillator. That's standard procedure, but if that doesn't work, a paramedic will pull open a mystery packet of unlabeled syringes for injection. Inside will be either one of two heart-rhythm medications, or a simple saline solution - saltwater. Neither paramedics nor doctors will be told what the syringes contained. Researchers later will use bar codes on the syringe to see if survival rates differ between them

Cardiac arrest survival improving in U.S. hospitals: study

More people hospitalized for cardiac arrest are surviving compared with a decade ago, according to a U.S. study, possibly because of changes in hospital treatment and the way bystanders respond when somebody collapses. The study, which appeared in the journal Circulation, found that in 2008, the death rate among U.S. residents hospitalized after cardiac arrest was just under 58 percent - down from almost 70 percent in 2001. Researchers, led by Alejandro Rabinstein of the Mayo Clinic in Rochester, Minnesota, based their findings on a national hospital discharge database that included nearly 1.2 million people hospitalized for cardiac arrest. They stressed that the numbers accounted only for cardiac arrest victims who survive long enough to be admitted to the hospital. Many people die before then

Canada's emergency doctors push to improve rate of "bystander" CPR assistance

Canadians who suffer cardiac arrest outside of a hospital are three to four times more likely to survive if they receive cardiopulmonary resuscitation (CPR). According to the Canadian Association of Emergency Physicians, such assistance is provided in only about one-quarter of cases. In a position statement on "bystander" CPR to be published in the Canadian Journal of Emergency Medicine, CAEP says it is not acceptable that vast numbers of witnessed cardiac arrest victims do not receive bystander CPR. More than 20,000 people suffer out-of-hospital cardiac arrests in Canada each year, with 85 per cent of cases occurring in residential dwellings. Currently, less than 10 per cent of these people survive. Every Canadian should be trained in CPR and all Canadians should respond and provide chest compressions, with or without mouth-to-mouth ventilation, whether they are trained or not, CAEP says

New light on near-death flashes

"Near-death experiences during cardiac arrest - from flashing lights to life flashing before one's eyes - may be down to carbon dioxide, a study finds. Examination of 52 patients found levels of the body's waste gas were higher in the 11 who reported such experiences, the journal Critical Care reports. The Slovenian researchers hope to move on the debate over why so many cardiac arrest patients report the experiences. Reasons previously suggested for the phenomenon include religion and drugs. Those who have had near-death experiences report various encounters, including seeing a tunnel or bright light, a mystical entity, or looking down from the ceiling at the scene below in an "out of body" experience. Others describe a simple but overwhelming feeling of peace and tranquillity. It is thought between one in ten and nearly a quarter of cardiac arrest patients have experienced one of these sensations" - BBC

Cardiac arrest? Nellie the Elephant could save your life

"To resuscitate someone who has suffered a cardiac arrest, you need to make between 90 and 100 chest compressions per minute, and, according to a new study in the BMJ, running through the song Nellie the Elephant in your head while you do it significantly helps. Unfortunately, the team of researchers, led by Malcolm Woollard, professor in pre- hospital and emergency care at Coventry University, also found the song distracted people from maintaining an adequate depth of compression (equally important as speed) and so doesn't recommend that first aid trainers use the song to teach CPR"

Texas Health Dallas researchers publish major study examining connection between nausea and heart attacks

Researchers at Texas Health Presbyterian Hospital Dallas are investigating what symptoms could help doctors better spot heart attacks and if certain symptoms might indicate different types of heart attacks. Their most recent work, "Relation of Nausea and Vomiting in Acute Myocardial Infarction to Location of the Infarct," appears in the December edition of the American Journal of Cardiology. According to the findings, almost two-thirds of heart attack patients suffer nausea when arriving in the ER - but whether they have an upset stomach does not indicate where cardiac blood flow is blocked, said senior author Dr. Mark Feldman, chair of internal medicine at Texas Health Dallas and director of the hospital's internal medicine residency program - Texas Health Resources

Vigorous CPR is best for cardiac arrest

Vigorous cardiopulmonary resuscitation (CPR) with more chest compressions on people with sudden cardiac arrest can improve the survival rate, a new study shows. "Chest compressions move blood with oxygen to the heart and the brain to save the brain and prepare the heart to start up its own rhythm when a shock is delivered with a defibrillator," says study researcher Jim Christenson, MD, of the University of British Columbia. "We found that even short pauses in chest compressions were quite detrimental." In the new study, published in Circulation: Journal of the American Heart Association, researchers analyzed data from 78 emergency medical services agencies to determine the effect of chest compressions on patient outcome. They specifically looked at something called the "chest compression fraction" (CCF), which refers to the percentage of time spent performing chest compressions relative to the entire time that CPR is performed - WebMD

Black patients are less likely to survive cardiac arrest

"Black hospital patients are far less likely to survive cardiac arrest than white patients, new research shows. And the reason in many cases is that black patients usually go to the hospitals that do the poorest job resuscitating patients. Just 25.2 percent of black patients who suffered cardiac arrest while they were hospitalized left the hospital alive, according to a study published this week in The Journal of the American Medical Association. That compares with 37.4 percent of white patients who survived - a difference of 48 percent" - AZ Star

Survivor contestant dies in Philippines

A Bulgarian competing in the reality TV show Survivor Bulgaria died of a heart attack during filming at a beach resort in the central Philippines, local television reports. Moncho Vodnicharov, 53, died on the way to hospital after he collapsed at Gotta Beach resort while filming the show, ABS-CBN television said, quoting local police chief Ayn Natuel. "After performing an activity as part of the contest, he suffered cardiac arrest that resulted in his instant death," said Natuel - TVNZ

Seasonal Naples resident meets 911 dispatcher who helped save his life (USA)

Collapsed on the floor, Lee Lustig's tongue began to swell as his face turned black. Only moments earlier Lustig, 62, had been sharing a coffee with his wife, Diane, 62, inside their fourth floor North Naples condominium in the early morning hours of March 25. Out of the blue he said 'oww' and fell forward. In a panic, Diane Lustig called 911. 'Listen carefully. I'll tell you how to do chest compressions," Collier County Sheriff's Office 911 supervisor Julie Becker told her. Becker, 51, instructed Diane Lustig on how to position her husband's body, and where to place her hands. "I want you to pump the chest hard and fast," Becker said..." - Naples News

Brumbies mourn Mackay death (Australia)

Super 14 (rugby) side Brumbies are mourning the loss of forward Shawn Mackay, 26, who died in a Durban hospital on Monday morning (AEST) from complications arising from a bloodstream infection. Mackay had been involved in a collision with a vehicle following the Brumbies' Super 14 loss to the Sharks in Durban last weekend, suffering spinal damage, a fractured skull and a broken leg. He underwent surgery to fuse vertebrae and spent time in a medically induced coma before his death from cardiac arrest.

Coronary angiography improves outcomes for cardiac arrest patients

"People who suffer cardiac arrests and then receive coronary angiography are twice as likely to survive without significant brain damage compared with those who don't have the procedure, according to a study by University of Pittsburgh School of Medicine researchers. The study, published in the May/June issue of the Journal of Intensive Care Medicine and now available online, showed that patient outcomes improved with coronary angiography, an imaging procedure that shows how blood flows through the heart, regardless of certain clinical and demographic factors that influenced who received the procedure" - News-Medical.net

EMS improvements boost cardiac arrest survival

Early advanced life support measures and improved procedures have boosted survival following "out-of-hospital" cardiac arrest, according to a study conducted in Japan and reported Tuesday in the medical journal Circulation. "This study is important," lead investigator Dr. Taku Iwami told Reuters Health "because it demonstrates that improvements of the 'chain of survival' really increase survival after out-of-hospital cardiac arrest." - Reuters

"Chain Of Survival" saves lives, lessens damage in out-of-hospital cardiac arrest patients in Japan

Improvements to the "chain of survival" increased survival and decreased residual neurological damage in out-of-hospital cardiac arrest patients in Japan, researchers report in Circulation: Journal of the American Heart Association. Researchers considered 8,782 bystander-witnessed cardiac arrests from May 1998 to December 2006 in Osaka, Japan. During this time period, Japanese citizens received training in cardiopulmonary resuscitation (CPR), dispatcher instruction in CPR was introduced and procedures were changed to allow emergency service personnel to deliver shocks with a defibrillator without online physician oversight and to intubate patients in the field. Intubation is the placement of a flexible plastic tube into the trachea to protect the patient's airway and provide a means of mechanical ventilation. - Medical News Today

Arrhythmia patients can run, swim again after treatment with new technology at Bangkok Hospital

"Bangkok Hospital recently acquired the Cartosound Imaging System for treating cardiac arrhythmia, the first of its kind in Thailand. It has the potential to save thousands of lives lost due to stroke and cardiac arrest. The CartoSound Image Integration Module is a new system for intracardiac echocardiography, an imaging system used in the electrical treatment of heart arrhythmia. Arrhythmia is estimated to affect up to 1 in 85 people in many Western countries, with 4 million people in the US suffering recurrent arrhythmias, and 700,000 in the UK" - PR-inside.com

Go Between dies of cardiac arrest

Go Between, the winner of last year's Pacific Classic Stakes (G1) and Sunshine Millions Classic Stakes, died of cardiac arrest following a workout on Monday at Payson Park Training Center in Florida. The six-year-old Point Given horse had breezed six furlongs in 1:17.80 in preparation for a repeat bid in the Sunshine Millions. - Thoroughbred Times

New emergency technique saves a life

Early the morning of January 3, Agnes Phillips was sleeping next to her husband Bernie, when she noticed his breathing sounded strange. "I heard an irregular breathing sound, and I thought he was in the middle of a bad dream," recalled Agnes Phillips, 47, a chemistry teacher at Schenectady High School. She tried to awaken her husband. When she got no response, she called 911 and started cardio-pulmonary resuscitation. Minutes later, emergency medical responders from Colonie and Latham arrived at the couple's Latham home and determined that Phillips had gone into cardiac arrest - the abrupt loss of heart function. Death usually begins within four to six minutes. They established an airway, got his heart beating again and rushed him to Albany Medical Center Hospital. Phillips then made history, becoming the first cardiac arrest patient in the Capital Region to be revived using therapeutic cooling - a process by which the temperature of the body is lowered to a near hypothermic state in order to prevent or reduce brain damage. - Daily Gazette Co

Newer antipsychotics pose cardiac risk: study

"A new study warns that the second generation of antipsychotic drugs, used to treat conditions ranging from schizophrenia to anxiety, put patients at higher risk of sudden death due to cardiac arrest. The odds of a heart problem are low, and specialists said that the drugs are appropriate for certain patients. Still, doctors, families and patients should be cautious, said study lead author Wayne Ray, director of the Vanderbilt University School of Medicine's Division of Pharmacoepidemiology." - HealthDay

London-bound plane makes emergency landing

"A London-bound Pakistan International Airlines (PIA) flight made an emergency landing on Monday at Benazir Bhutto Airport when its captain suffered a cardiac arrest around an hour after the take-off, Civil Aviation Authority (CAA) sources told Daily Times. Flight PK-785 - carrying 435 passengers - took off at 11:35 pm for London and was headed to its destination when captain Shaukat suffered the attack, prompting the co-pilot to make an emergency landing at 1:35 pm. Shaukat was given first aid soon after the plane touched down, and later shifted to Pakistan Institute of Medical Sciences (PIMS) where he is in stable condition. The flight took off for London at 2:55 pm." - Daily Times