Steroids and Post-resuscitation Infectious (Septic) Complications
InfectionsCardiac ArrestPostresuscitation disease is characterized by post-insult systemic inflammation, adrenal insufficiency, and circulatory failure. Such severe pathology may be associated with increased susceptibility to infectious complications and increased risk of death due to postresuscitation septic shock. The latter may be attenuated by stress-dose steroids. In this re-analysis of synthesized randomized clinical trial (RCT) data, the investigators will use individual patient data from two prior RCTs of in-hospital cardiac arrest (NCT00411879 & NCT00729794), in order to determine the effect of stress-dose steroids on the severity of postresuscitation infectious complications, and more specifically, on the risk of septic shock-associated death.
Effect of the Cardio First Angle Device on CPR Outcomes
Cardiopulmonary ArrestThe investigators conducted a randomized, controlled, single-blinded study of patients undergoing CPR for cardiac arrest in the mixed medical-surgical ICUs of four academic teaching hospitals in Tehran, Iran from June 1 to October 31, 2014. Patients were randomized to receive CPR with either standard manual compression, or compression with real-time audiovisual feedback using the Cardio First Angel™ device.
Automated Respiration Rate to Improve Accuracy of the Electronic Cardiac Arrest Risk Triage Score...
Heart ArrestCurrently, breathing rate and heart rate are checked by nursing staff manually every few hours and entered into a patient's medical record. The investigators are doing this study to see if a device that will automatically record breathing rate and heart rate every 15 minutes is as accurate as the manual measurement. The investigators will also see if these measurements, taken every 15 minutes, will help us predict adverse events more quickly and accurately than the measurements taken every few hours.
Risk Modelling for Quality Improvement in the Critically Ill: Making Best Use of Routinely Available...
Critical IllnessHeart ArrestThe aim of the proposed study is to better understand the epidemiology of, risk factors for and consequences of critical illness leading to improvements in the risk models used to underpin national clinical audits for adult general critical care, cardiothoracic critical care and in-hospital cardiac arrest using data linkage with other routinely collected data sources.
Simulation Training to Improve 911 Dispatcher Identification of Cardiac Arrest
Cardiac ArrestThis study is to test the use of simulation training to improve 9-1-1 telecommunicators' call processing and response. Training sessions will expose 9-1-1 telecommunicators to several realistic emergency situations through mock 9-1-1 calls with a trained actor playing the part of a reporting party, followed immediately by feedback on call handling provided by a trained call observer. Investigators hypothesize that simulation followed by trained observer-directed feedback will increase correct triage of medical emergency and delivery of pre-arrival instructions during simulated calls and in actual 9-1-1 calls.
S-ICD® System Post Approval Study
Primary Prevention of Sudden Cardiac ArrestSecondary Prevention of Sudden Cardiac ArrestThe purpose of the S-ICD Post Approval Study is to document long term safety and effectiveness outcomes associated with the implantation of the SQ-RX pulse generator and Q-TRAK electrode in a commercial clinical setting.
COOL-ARREST Pilot Study to Assess Intravascular Temperature Management (IVTM) in the Treatment of...
Out of Hospital Cardiac ArrestA multicenter prospective single arm interventional trial in hospitals where therapeutic hypothermia is standard practice. This trial will enroll 50 subjects to evaluate the ability of the ZOLL Intravascular Temperature Management (IVTM) System to induce, maintain, and reverse mild therapeutic hypothermia and maintain normothermia post cardiac arrest.
Clinical Audit of Cardio Pulmonary Resuscitation Management in Adults Patient Units of Care by in...
in Hospital Cardiac Arrestin Situ Simulation2 moreClinical audit of in-hospital cardiac arrest management by in situ simulation Objectives: correct latent safety threats, knowledge gap, and crisis resource management (CRM) Design: clinical audit, observational sudy. Primary outcome: In Hospital resuscitation scale. Exploratory outcomes: non technical skills, validated stress inventory, and questionnaire on perceptions of the simulation and organisational changes needed.
Mastery Learning Versus Time-based Education: Skill Acquisition and Retention of Basic Life Support...
Basic Life SupportCardiac ArrestBackground: In cardiac arrest survival rates dramatically increase when bystanders are present and initiate Basic Life Support (BLS). However, even though serious efforts have been made, skill retention after a traditional time-based BLS course for laypeople remains suboptimal. In contrast, a mastery learning-based educational approach was shown to be efficacious and might be promising even for laypersons. Therefore the investigators aim to evaluate the impact of a mastery learning-based BLS course on skills retention of BLS in laypeople. Methods: Forty laypeople without previous BLS experiences will be randomized into the traditional time-based BLS course group (Control - TB group) or mastery learning-based group (Intervention - ML group). Both groups will receive BLS training consisting of 6 successive stations including diagnosis of cardiac arrest, chest compression, ventilation, one-rescuer BLS, two-rescuer BLS and AED use. In the ML group, subjects will deliberately practice and receive feedback at each station until a pre-set target level is reached. Subjects will be allowed to proceed to the next station only when they achieve the required target level of performance. In contrast, participants of the TB group will be taught the same 6 stations in two hours, according to standard American Heart Association BLS criteria. All subjects will have an assessment of knowledge and skills immediately after teaching (immediate post-test) and at four months (retention post-test). Implications: Previous research has shown that mastery learning-based education improves learners' procedural skill performance. The investigators study will determine the impact of a mastery learning-based BLS course on skill retention in laypeople.
Hypothermia's Impact on Pharmacology
Cardiac ArrestHypothermiaThe purpose of the study will help us understand the complex interaction between hypothermia (cooling) and pharmacogenetics (how specific genes effect how drugs are handled), and their impact on how routinely given sedation drug are broken down and used by the body when given to children after cardiac arrest (when heart stops pumping blood) and are critically ill.