Seizure-like presentation in OHCA creates barriers to dispatch recognition of cardiac arrest

Abstract Purpose Early recognition of out-of-hospital cardiac arrest (OHCA) by 9-1-1 dispatchers is a critical first step along the resuscitation pathway. Barriers to recognition may lead to adverse outcomes among patients. This study aims to determine the impact of seizure-like activity among OHCA patients during 9-1-1 calls. Methods We evaluated a retrospective cohort study of all adult, non-traumatic OHCAs that occurred prior to emergency medical … Continue reading Seizure-like presentation in OHCA creates barriers to dispatch recognition of cardiac arrest

Clinical Characteristics of Patients With COVID-19 Receiving EMS

Question  What is the clinical presentation to emergency medical services among persons with coronavirus disease 2019 (COVID-19)? Findings  This cohort study of 124 patients with COVID-19 revealed that most patients with COVID-19 presenting to emergency medical services were older and had multiple chronic health conditions. Initial concern, symptoms, and examination findings were heterogeneous and not consistently characterized as febrile respiratory illness. Meaning  The findings of this study suggest … Continue reading Clinical Characteristics of Patients With COVID-19 Receiving EMS

Prevalence of COVID-19 in OHCA: Implications for Bystander CPR

We undertook a cohort investigation of OHCA attended by emergency medical services (EMS) in Seattle and King County, WA from January 1 to April 15, 2020. Patients where EMS attempted resuscitation (EMS treated) and where EMS responded but did not provide resuscitation because of signs of irreversible death (dead on EMS arrival) were included. Our population-based OHCA registry systematically abstracts information about OHCA presentation, treatment, and outcome from dispatch audio recordings, defibrillator electronic data, prehospital … Continue reading Prevalence of COVID-19 in OHCA: Implications for Bystander CPR

Research Analysis: Preventing downstream consequences of EMS assaults

The National Association of EMTs (NAEMT) recently published a survey on member experiences with violence in the prehospital setting. They received nearly 2,200 responses from mostly paramedics and EMTs detailing not only their exposure to violence, but also the role violence plays on their perceptions of safety, provider knowledge of reporting systems, agency policies and procedures, as well as the types of education and training … Continue reading Research Analysis: Preventing downstream consequences of EMS assaults

Occupational Exposures and Programmatic Response to COVID-19 Pandemic: An EMS Experience

Abstract Background: Rigorous assessment of occupational COVID-19 risk and personal protective equipment (PPE) use are not well-described. We evaluated 9-1-1 emergency medical services (EMS) encounters for patients with COVID-19 to assess occupational exposure, programmatic strategies to reduce exposure, and PPE use. Methods: We conducted a retrospective cohort investigation of lab-confirmed COVID-19 patients in King County, WA who received 9-1-1 EMS responses from February 14, 2020 … Continue reading Occupational Exposures and Programmatic Response to COVID-19 Pandemic: An EMS Experience

Research Analysis: Status epilepticus: Pick your antidote

Results from the Established Status Epilepticus Treatment Trial (ESETT) were recently published in New England Journal of Medicine (NEJM), providing medical directors with a research-centric resource to turn to when epileptic patients don’t respond to traditional benzodiazepines. Specifically, ESETT was an NIH and FDA funded joint effort by the Neurological Emergencies Treatment Trials (NETT) Network and the Pediatric Emergency Care Applied Research Network (PECARN) in … Continue reading Research Analysis: Status epilepticus: Pick your antidote

8 types of data: Telling the story of COVID-19

As the United States enters its second month of COVID-19, the availability of data on the pandemic that will define a generation has become almost overwhelming. Websites abound with tables, graphics and projections on how different aspects of the crisis are unfolding. Some use data to make their case for a far-flung theory, others display it in a way that tells an easy-to-interpret story of … Continue reading 8 types of data: Telling the story of COVID-19

7 data visualizations that explain COVID-19

Throughout the last two months, Seattle and King County have been on the front lines of the COVID-19 pandemic in the United States. The first COVID-19 case within our borders was confirmed in Snohomish County, Washington on Jan. 21, 2020. The first reported death happened nearly six weeks later at a hospital 15 miles from downtown Seattle. For a month and a half, the virus … Continue reading 7 data visualizations that explain COVID-19

Causes of Chest Compression Interruptions During OHCA

Abstract Background Interruptions in chest compressions contribute to poor outcomes in out‐of‐hospital cardiac arrest. The objective of this retrospective observational cohort study was to characterize the frequency, reasons, and duration of interruptions in chest compressions and to determine if interruptions changed over time. Methods and Results All out‐of‐hospital cardiac arrests treated by the Seattle Fire Department (Seattle, WA, United States) from 2007 to 2016 with … Continue reading Causes of Chest Compression Interruptions During OHCA

Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study

Abstract Objectives: To determine the association between targeted temperature managementgoal temperature of 33°C versus 36°C and neurologic outcome after out-of-hospital cardiac arrest. Design: This was a retrospective, before-and-after, cohort study. Setting: Urban, academic, level 1 trauma center from 2010 to 2017. Patients: Adults with nontraumatic out-of-hospital cardiac arrest who received targeted temperature management. Interventions: Our primary exposure was targeted temperature management goal temperature, which was changed from 33°C to 36°C in April of 2014 at the study hospital. Primary … Continue reading Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study