Out-of-Hospital Cardiac Arrest in US Airports.

Importance: Airports are uniquely situated to facilitate several aspects of the out-of-hospital cardiac arrest (OHCA) chain of survival, including a high likelihood of cardiac arrest events being witnessed and the ready availability of automated external defibrillators (AEDs). Focused analyses suggest airports are associated with a higher prevalence of witnessed cardiac arrest and AED use; however, there is a lack of national US data on the topic to facilitate comparison of response characteristics with other OHCA events occurring in nonairport locations.

Objective: To compare OHCAs occurring at airports with OHCAs occurring in nonairport, nonresidential settings.

Delays to chest compressions and defibrillation after prehospital rearrest.

Introduction: Prehospital rearrest following return of spontaneous circulation (ROSC) is associated with low rates of survival, and delays to chest compressions and defibrillation in rearrest are poorly understood. We aimed to characterize delays in initiation of chest compressions and defibrillation delivery following rearrest.

Methods: We included out-of-hospital cardiac arrest patients with on-scene ROSC in an urban emergency medical services (EMS) network between 2021 and 2023.

Prehospital notification in acute stroke: a retrospective cohort study.

Background: Emergency medical services (EMS) play a key role in identifying stroke patients and transporting them to specialty care centers. We aimed to quantify the time saved in stroke care by EMS prehospital notification.

Methods: We performed a retrospective cohort study at a large comprehensive stroke center in a major metropolitan system including patients treated between 2021 and 2022.

Neutrophil extracellular traps mediate pathophysiology of hepatic cells during liver injury.

Neutrophil extracellular traps (NETs) are web-like, bactericidal structures produced by neutrophils and are composed principally of extracellular DNA, histones, elastase, and myeloperoxidase, among other components. NET formation is an innate immune response that is beneficial for pathogen killing and clearance. However, excessive NET formation and clearance defects can lead to inflammation and induce damage to host organs.

Highly potent quinoxalinediones inhibit α-hemolysin and ameliorate Staphylococcus aureus lung infections.

Hospital-acquired pneumonia caused by Staphylococcus aureus is associated with patient morbidity and mortality, despite adequate antibiotic therapy. This illustrates the need for treatments beyond antibiotics. The pore-forming heptameric toxin α-hemolysin (Hla) is a major pathogenicity factor of S.

Flexible Tip Bougie for Emergency Tracheal Intubation by Paramedics and Emergency Physicians.

Objective: Given the consequences of failed intubation, there is great interest in optimizing airway management success rates. Growing evidence suggests that use of a bougie device is associated with improved airway success. Bougies with a flexible tip may increase intubation success by offering operators greater control.

Association of Racial Residential Segregation and Survival After Out-of-Hospital Cardiac Arrest in the United States.

Background: Social determinants of health such as residential segregation have been identified as drivers of disparities in health outcomes; however, this has been understudied for out-of-hospital cardiac arrest (OHCA). We sought to examine whether there were differences in survival to discharge and survival with good neurological outcome, as well as likelihood of bystander cardiopulmonary resuscitation, using validated measures of racial, ethnic, and economic segregation.

Methods: We conducted a retrospective observational study using data from the Cardiac Arrest Registry to Enhance Survival data set.

Measuring intra-arrest transport in out-of-hospital cardiac arrest: A methodological study of registry-compatible definitions.

Introduction: For out-of-hospital cardiac arrest (OHCA) with refractory arrest, transport to hospital with ongoing cardiopulmonary resuscitation (CPR)-"intra-arrest transport (IAT)"-is a treatment option, however it may reduce resuscitation quality. Unfortunately, international registries do not measure IAT directly, but other variables may be used to estimate IAT. We compared three indirect definitions to a direct measurement of IAT.

Use of a large language model (LLM) for ambulance dispatch and triage.

Introduction: Large language models (LLMs) have grown in popularity in recent months and have demonstrated advanced clinical reasoning ability. Given the need to prioritize the sickest patients requesting emergency medical services (EMS), we attempted to identify if an LLM could accurately triage ambulance requests using real-world data from a major metropolitan area.

Methods: An LLM (ChatGPT 4o Mini, Open AI, San Francisco, CA, USA) with no prior task-specific training was given real ambulance requests from a major metropolitan city in the United States.

Ambulance Transports from NCAA Division 1 Football Games.

Introduction: There is significant public health interest towards providing medical care at mass-gathering events. Furthermore, mass gatherings have the potential to have a detrimental impact on the availability of already-limited municipal Emergency Medical Services (EMS) resources. This study presents a cross-sectional descriptive analysis to report broad trends regarding patients who were transported from National Collegiate Athletic Association (NCAA) Division 1 collegiate football games at a major public university in order to better inform emergency preparedness and resource planning for mass gatherings.

Total Synthesis of Tosyl-Samroiyotmycin A and Its Biological Profiling.

A total synthesis of the enantiopure syn,syn-tosyl-samroiyotmycin A, a C-symmetric 20-membered antimalarial macrodiolide with syn,syn-configuration of the 8,24-dihydroxy-9,25-dimethyl units and it's enantiopure anti,anti-derivative is described. The synthesis was accomplished utilizing a linear approach in 7 steps and 3 % overall yield via a sequence of diastereoselective methylation of SuperQuat oxazolidinone auxiliary, cross metathesis and Yamaguchi macrolactonization of fully functionalized seco-acids. By a similar approach we gained access to several samroiyotmycin analogues and precursors.

Geospatial Analysis for Prehospital Extracorporeal Cardiopulmonary Resuscitation in Houston, Texas.

Objectives: Extracorporeal cardiopulmonary resuscitation (eCPR) is a promising treatment that could improve survival for refractory out-of-hospital (OHCA) patients. Healthcare systems may choose to start eCPR in the prehospital setting to optimize time to eCPR initiation and decrease low-flow time. We used geospatial modeling to evaluate different eCPR catchment strategies for a forthcoming prehospital eCPR program in Houston, Texas.

Infant out-of-hospital cardiac arrest during nights and weekends.

Background: A growing body of evidence suggests outcomes for cardiac arrest in adults are worse during nights and weekends when compared with daytime and weekdays. Similar research has not yet been carried out in the infant setting.

Methods: We examined the National Emergency Medical Services Information System (NEMSIS), a database containing millions of emergency medical services (EMS) runs in the United States.

Helicopter emergency medical services (HEMS) response to out-of-hospital cardiac arrest (OHCA) in the United States.

Introduction: Helicopter emergency medical services (HEMS) are used in the United States and globally to respond to patients with critical illness and victims of traumatic injury. Relatively limited research has examined their role in responding to out-of-hospital cardiac arrests (OHCA) in the United States. In this study, we compared OHCA treated by HEMS units with cardiac arrests treated by ground ambulances.

The Association of Racial Residential Segregation and Survival After Out-of-Hospital Cardiac Arrest in the United States.

Background: Residential segregation has been identified as drivers of disparities in health outcomes, but further work is needed to understand this association with clinical outcomes for out-of-hospital cardiac arrest (OHCA). We utilized Cardiac Arrest Registry to Enhance Survival (CARES) dataset to examine if there are differences in survival to discharge and survival with good neurological outcome, as well as likelihood of bystander CPR, using validated measures of racial, ethnic, and economic segregation.

Methods: We conducted a retrospective observational study using data from the Cardiac Arrest Registry to Enhance Survival (CARES) dataset to examine associations among adult OHCA patients.

The Public Health and Economic Impact of Drug Overdose Out-of-Hospital Cardiac Arrest in the United States.

Objective: To calculate disability-adjusted life years (DALY) and labor productivity loss due to drug overdose out-of-hospital cardiac arrest (DO-OHCA) and compare its contribution to the burden of disease and economic impact of all-cause nontraumatic out-of-hospital cardiac arrest (OHCA) in the US.

Methods: We performed a retrospective observational cohort analysis of all adult (age 18 years) nontraumatic emergency medical services-treated OHCA events, including those due to DO-OHCA, from the national Cardiac Arrest Registry to Enhance Survival (CARES) database from January 1, 2017 and December 31, 2020. The main outcome measures of interest were disability-adjusted life years, annual, and lifetime labor productivity loss over the 4-year study period.

Shenfu injection as treatment for critical illness: a narrative review of clinical trials.

Background And Objective: Shenfu injection (SFI) is a traditional herbal medicine derived from components of ginseng and aconite and is commonly used in China to treat a variety of conditions. Shenfu has been suggested to have beneficial effects in various critical illnesses, including heart failure, cardiac arrest, and septic shock. In recent years, there have been a number of studies reporting that SFI improves patient outcomes when used concurrently with other treatments, but its use has not been adopted outside of China.

False Electrical Capture in Prehospital Transcutaneous Pacing by Paramedics: A Case Series.

Introduction: The use of transcutaneous pacing (TCP) for unstable bradycardia has a class 2B recommendation from the American Heart Association. Prior studies have not adequately described the frequency or possible causes of treatment failure. EMS clinicians and leaders have reported false electrical capture as a potential cause.

Cardiac Arrest Following Drug Overdose in the United States: An Analysis of the Cardiac Arrest Registry to Enhance Survival.

Background: Given increases in drug overdose-associated mortality, there is interest in better understanding of drug overdose out-of-hospital cardiac arrest (OHCA). A comparison between overdose-attributable OHCA and nonoverdose-attributable OHCA will inform public health measures.

Methods And Results: We analyzed data from 2017 to 2021 in the Cardiac Arrest Registry to Enhance Survival (CARES), comparing overdose-attributable OHCA (OD-OHCA) with OHCA from other nontraumatic causes (non-OD-OHCA).

Soybean polyenylphosphatidylcholine (PPC) is beneficial in liver and extrahepatic tissue injury: An update in experimental research.

Polyenylphosphatidylcholine (PPC) is a purified polyunsaturated phosphatidylcholine extract of soybeans. This article updates PPC's beneficial effects on various forms of liver cell injury and other tissues in experimental research. PPC downregulates hepatocyte CYP2E1 expression and associated hepatotoxicity, as well as attenuates oxidative stress, apoptosis, lipoprotein oxidation and steatosis in alcoholic and nonalcoholic liver injury.