Early recognition of out-of-hospital cardiac arrest (OHCA) by the medical dispatcher is a prerequisite for an effective chain of survival, leading to rapid dispatch of emergency medical services.
 
  To analyse and compare the accuracy of the Emergency Medical Dispatch Centre in identifying OHCA before and after an educational intervention.
 
  A quality-assessment study collecting data from prehospital medical voice logs in Southern Denmark during two periods. Baseline data and post-interventional data were obtained during December, January, and February 2017/2018 and 2019/2020, respectively. We imposed an intervention consisting of a specifically targeted education in quick assessment of OHCA and instructions regarding telephone-assisted-CPR.The primary outcome measure was the dispatcher's ability to recognise OHCA. Secondary outcome measures were time from contact with the caller to the dispatcher formulated essential questions related to the NO-NO-GO algorithm. These questions included an assessment of the se the first compression did not differ significantly. This indicates that continuing education and quality assessment may be beneficial and necessary.
  Ventricular fibrillation (VF) cardiac arrest may consist of three time-sensitive phases electrical, circulatory, and metabolic. However, the time boundaries of these phases are unclear. We aimed to determine the time boundaries of the three-phase model for VF cardiac arrest.
 
  We reviewed 20,741 out-of-hospital cardiac arrest cases with initial VF and presumed cardiac origin from the All-Japan Utstein-style registry between 2013 and 2017. The study endpoint was 1-month neurologically intact survival. The collapse-to-shock interval was defined as the time from collapse to the first shock delivery by emergency medical service personnel. The patients were divided into the bystander cardiopulmonary resuscitation (CPR, 
  =11,606) and non-bystander CPR (
  =9135) groups.
 
  In the bystander CPR group, the collapse-to-shock times that were associated with increased adjusted 1-month neurologically intact survival, compared with those in the non-bystander CPR group, ranged from 7min (42.9% [244/4999] vs. 26.0% [119/458], adjusted odds ratio [aOR], 1.95; 95% confidence interval [CI], 1.44-2.63; 
  <0.0001) to 17min (17.1% [70/410] vs. 7.3% [21/288], aOR, 2.82; 95% CI, 1.62-4.91; 
  =0.0002). However, the neurologically intact survival rate of the bystander CPR group was statistically insignificant compared with that of the non-bystander CPR group when the collapse-to-shock time was outside this range.
 
  The time boundaries of the three-phase time-sensitive model for VF cardiac arrest may be defined as follows electrical phase, from collapse to <7min; circulatory phase, from 7 to 17min; and metabolic phase, from >17min onward.
 17 min onward.
  Pre-pause imaging during cardiopulmonary resuscitation (CPR) involves the acquisition of poor-quality, brief images immediately prior to stopping CPR to allow shorter, better-quality images during the pause. We hypothesize that pre-pause imaging is associated with a decrease in CPR pause length and shorter image acquisition time.
 
  Prospective, interventional cohort study enrolling out-of-hospital (OOH) cardiac arrest patients. Pre-pause imaging involves pre-localizing of the approximate sonographic window during CPR to support subsequent fine tuning when CPR pauses. Physicians were educated on pre-pause imaging and data was recorded prior- and post- introduction of pre-pause imaging into American cardiac life support (ACLS). Timing of CPR pauses and identification of interventions and events during pause were recorded (e.g., intubation, defibrillation, multiple cardiac ultrasounds). Ultrasound (US) images were reviewed for image quality using a 5-point scale. Primary outcome was length of CPR pause with anuse imaging should be encouraged for any clinicians who use ultrasound during ACLS.
  Regional cerebral oxygen saturation (rSO
  ) is a non-invasive method of measuring cerebral perfusion; However, serial changes in cerebral rSO
  values among out-of-hospital cardiac arrest (OHCA) patients in pre-hospital settings have not been sufficiently investigated.  https://www.selleckchem.com/products/disodium-r-2-hydroxyglutarate.html  We aimed to investigate the association between the serial change in rSO
  pattern and patient outcome.
 
  We evaluated rSO
  in OHCA patients using portable monitoring by emergency life-saving technicians (ELTs) from June 2013 to December 2019 in Osaka City, Japan. We divided the patterns of serial of rSO
  change into type 1 (increasing pattern) and type 2 (non-increasing pattern). Patients in whom measurement started after return of spontaneous circulation (ROSC) were excluded. The outcome measures were 'Prehospital ROSC', 'Alive at admission', '1-month survival' and 'Cerebral Performance Category (CPC) 1 or 2'.
 
  Eighty-seven patients were eligible for this analysis (type 1 
  =40, median age 80.5 [IQR 72-85.5] years, male 
  =20 [50.0%]; type 2 
  =47, 81 [72-85.5] years, male 
  =28 [59.6%]). In a multivariable logistic regression adjusted for confounding factors, outcomes of 'Prehospital ROSC' and 'Alive at admission' were significantly higher in type 1 than type 2 pattern (11/40 [27.5%] vs. 2/47 [4.26%], AOR 5.67, 95% CI 1.04-30.96, 
  <0.045 and 17/40 [42.5%] vs. 6/41 [12.8%], AOR 3.56, 95% CI 1.11-11.43, 
  <0.033). There was no significant difference in '1-month survival' and 'CPC 1 or 2' between patterns.
 
  Type 1 (increasing pattern) was associated with 'Prehospital ROSC' and 'Alive at admission'. Pre-hospital monitoring of cerebral rSO
  might lead to a new resuscitation strategy.
 Type 1 (increasing pattern) was associated with 'Prehospital ROSC' and 'Alive at admission'. Pre-hospital monitoring of cerebral rSO2 might lead to a new resuscitation strategy.
  Out-of-hospital cardiac arrests with negligible chance of survival are routinely transported to hospital and many are pronounced dead thereafter. This leads to some potentially avoidable costs. The 'Termination of Resuscitation' protocol allows paramedics to terminate resuscitation efforts onsite for medically futile cases. This study estimates the changes in frequency of costly events that might occur when the protocol is applied to out-of-hospital cardiac arrests, as compared to existing practice.
 
  We used Singapore data from the Pan-Asian Resuscitation Outcomes Study, from 1 Jan 2014 to 31 Dec 2017. A Markov model was developed to summarise the events that would occur in two scenarios, existing practice and the implementation of a Termination of Resuscitation protocol. The model was evaluated for 10,000 hypothetical patients with a cycle duration of 30 days after having a cardiac arrest. Probabilistic sensitivity analysis accounted for uncertainties in the outcomes number of urgent transports and emergency treatments, inpatient bed days, and total number of deaths.