Day: November 8, 2021

Categories : Cardiovascular DiseaseTags :

Better Outcomes with Earlier Adrenaline Treatment in Cardiac Arrest

On By ModernMedia
Source: Mat Napo on Unsplash

Earlier adrenaline treatment during a cardiac arrest is linked to better recovery compared to later treatment, according to preliminary research to be presented at the American Heart Association’s Resuscitation Science Symposium (ReSS) 2021.

“Our study’s findings should guide emergency medical services professionals towards earlier administration of epinephrine [adrenaline] during out-of-hospital cardiac arrest management,” said lead study author Shengyuan Luo, MD, MHS, an internal medicine resident physician at Rush University Medical Center in Chicago.

Previous research found that only about 1 in 5 people survive a cardiac arrest outside of the hospital and those who do survive often have long-term impairment in the ability to perform daily living tasks.

During a cardiac arrest, immediate CPR (cardiopulmonary resuscitation) is critical. For some types of cardiac arrest, an AED (automated external defibrillator) also is used to deliver an electric shock through the chest to the heart to restore a heartbeat. For these ‘shockable’ cardiac arrests, adrenalineis injected to help restore blood flow. Previous research indicated that adrenaline should be given after three unsuccessful electric shocks with an AED, however, it was unclear whether it should be given even earlier – such as after the first electric shock.

To compare the effects of earlier versus later administration of adrenaline, the researchers examined medical records to compare epinephrine timing to patient recovery. Study subjects included 6416 multi-ethnic adults across North America who had an out of hospital cardiac arrest with shockable initial rhythm from 2011-2015. They were an average age of 64 years, and most were men.

Overall, adrenaline administration within four minutes after the first shock from an AED was associated with greater chances of recovery, while administration after four minutes was associated with reduced chances. Specifically, people who received adrenaline after four minutes were nearly half as likely to have heartbeat and blood flow restored before hospital admittance and half as likely to survive to hospital discharge or be able to perform daily tasks, as measured by a standard test, at discharge. Additionally, the risks of later adrenaline treatment rose with each minute of delayed treatment.

“It is crucial that whenever a cardiac arrest event is suspected, the emergency medical system be notified and activated immediately, so that people with cardiac arrest receive timely, life-saving medical care,” Dr Luo said.

These findings support the latest American Heart Association CPR and Emergency Cardiovascular Care Guidelines, which were released in October 2020. The guidelines indicate adrenaline should be administered as early as possible to maximise good resuscitation outcome chances. The guideline recommendation was based on previous observational data that suggest better outcomes when adrenaline is given sooner.

Source: EurekAlert!

Categories : Cardiovascular DiseaseTags :

Firefighters’ Blood Pressure Soars in an Emergency

On By ModernMedia
Source: Pixabay CC0

When the emergency alarm sounds, blood pressure (BP) among firefighters often soars, according to preliminary research presented at the American Heart Association’s Scientific Sessions 2021.

“All emergency and first responders should be aware of their health. They should know what their typical blood pressure level is and be aware of how it fluctuates. Most important, if they have high blood pressure, they should make sure it is well-controlled,” said senio author Deborah Feairheller, PhD.

The study recruited 37 male and 4 female volunteer and municipal firefighters who wore ambulatory BP monitors during an on-call work shift lasting at least 12 consecutive hours. In addition to the automatic BP readings from the monitor, study participants were instructed to prompt the monitor to take a BP reading whenever a pager or emergency call sounded and whenever they felt they entered a stressful situation. Participants also logged activities and call types for each measurement. The firefighters’ average age was 41.2 years. Average body mass index (BMI) of all participants was 30.3, with BMI ≥ 25 defined as overweight, while BMI ≥ 30 is defined as obesity. The firefighters all had high blood pressure, defined as systolic BP as 130 mm Hg or higher, or a diastolic BP of 80 mm Hg or higher, as defined by the American Heart Association’s most recent guideline.

The findings were that:

  • Average BP and heart rate (HR) were 131/79.3 mmHg and 75.7 beats per minute (bpm) respectively.
  • Compared with the reading immediately preceding the call, systolic BPsurged an average of 19.2 mm Hg with fire calls and 18.7 mm Hg with medical calls.
  • Meanwhile, diastolic BP surged 10.5 mm Hg with fire calls and 16.5 mm Hg with medical calls.
  • Compared with the average BP during the entire 12-hour shift, systolic BP was 9% higher during fire calls, and diastolic BP was 9% higher during medical calls.
  • Average HR also increased during both types of calls: 10bpm with fire calls, and 15bpm for medical calls.
  • There were no significant differences in BP, HR or BP surge levels when comparing responses among fire calls, medical calls, riding an emergency vehicle or false alarms.

Surprising findings
“The public knows the value that emergency responders provide to communities. We hope to increase awareness that many firefighters have hypertension and that their blood pressure can increase to very dangerous levels when responding to emergency calls,” said Dr Feairheller.

“The current data show that almost 75% of firefighters have hypertension, and less than 25% have their blood pressure under control. I hope that our research can help identify occupational factors that affect blood pressure and increase awareness among this population,” Dr Feairheller added.

They were also surprised at the findings on diastolic BP increases. “We anticipated systolic blood pressure surges because that reading is usually more responsive to stimuli; however, the extent of the diastolic blood pressure surge was unexpected,” said Dr Feairheller.

The investigators are currently exploring whether diet and exercise regimens could help to lower the BP surge that firefighters experience during emergency calls.

Source: EurekAlert!