MyMedR

Transit Time Flowmeter Graft Flow Measurement in an Arrested Heart

Hashim SA

Heart Lung Circ, 2019 02;28(2):e3.

PMID: 30654949 DOI: 10.1016/j.hlc.2018.04.288

Matched MeSH terms: Heart Arrest*

Fulltext Rising from the dead!

Low DW, Looi I, Manocha AB, Ang HA, Nagalingam M, Ayop NA, et al.

Med J Malaysia, 2012 Oct;67(5):538-9.

PMID: 23770879 MyJurnal

A report of a patient with Lazarus phenomenon (the return of spontaneous circulation after cardiopulmonary resuscitation) following cardiac arrest (myocardium ischemia) is presented. A 65 year patient was found unconscious at home. He taken to the emergency department On arrival he was unconscious, his pupils fixed and dilated bilaterally. Resuscitation proceeded for 55 minutes. He was then pronounced dead. Forty minutes later spontaneous breathing was noted and his blood pressure was 110/48 and heart rate 90bpm. He survived a further 13 days in the coronary care unit. The implications for management of cardiac arrest in the emergency and medical department are discussed.

Matched MeSH terms: Heart Arrest*

A novel approach to life support training using "action-linked phrases"

Hunt EA, Cruz-Eng H, Bradshaw JH, Hodge M, Bortner T, Mulvey CL, et al.

Resuscitation, 2015 Jan;86:1-5.

PMID: 25457379 DOI: 10.1016/j.resuscitation.2014.10.007

Observations of cardiopulmonary arrests (CPAs) reveal concerning patterns when clinicians identify a problem, (e.g. loss of pulse) but do not immediately initiate appropriate therapy (e.g. compressions) resulting in delays in life saving therapy.

Matched MeSH terms: Heart Arrest/therapy*

Fulltext Outcomes of cardiopulmonary resuscitation performed in Emergency Department, Hospital Universiti Sains Malaysia

Chew KS, Idzwan ZM, Hisamuddin NA, Kamaruddin J, Wan Aasim WA

Med J Malaysia, 2008 Mar;63(1):4-8.

PMID: 18935723 MyJurnal

Despite the progresses made in the science of cardiopulmonary resuscitation, there is lack of published works on this area in the Malaysian context. This survey was done to look at the outcomes of all cardiopulmonary resuscitation performed in Emergency Department (ED), Hospital Universiti Sains Malaysia (HUSM). This is a one year cross-sectional study from March 2005-March 2006. All adult cardiac arrest cases with CPR performed in ED, HUSM were included in the survey. The end points are return of spontaneous circulation (ROSC) and survival to ward admission. Out of the total 63 cases of cardiac arrest with CPR performed, only 19 cases (30.2%) had ROSC after CPR performed on them. Eventually only six patients (9.5%) had survival to ward admission. Patients with shockable intial arrest rhythm has a significantly higher chance to achieve ROSC (60.0%) compared to non-shockable rhythms (24.5%) (p = 0.025). However, there was no different in survival to ward admission between shockable and non shockable rhythms groups. The survival after cardiac arrest is still dismally poor. Perhaps we should be more selective in initiating CPR especially for out of hospital cardiac arrest.

Matched MeSH terms: Heart Arrest/mortality

Cardiac arrest following an intravenous urogram--a case report

Chan CP

Med J Malaysia, 1977 Dec;32(2):147-8.

PMID: 614481

Matched MeSH terms: Heart Arrest/etiology*

Fulltext Factors predicting outcome of cardiopulmonary resuscitation among elderly Malaysians: a retrospective study

Nik Muhamad NA, Nidzwani S

Med J Malaysia, 2012 Jun;67(3):278-83.

PMID: 23082417 MyJurnal

Cardiopulmonary resuscitation (CPR) has been standard treatment for all cardiac arrest patients that arrive at the Emergency Department. However it is unclear whether prolonging resuscitation among the elderly victims will provide any benefit or improve outcome. This study is to evaluate factors that can influence outcome of CPR among the elderly, such as time of arrest, duration of CPR, lactate levels and age (among elderly age groups). 89 patients fit the inclusion criteria from January 2007 to January 2009, and all underwent CPR. Lactate levels (p=0.047) and duration of CPR performed (p=0.019) had significant relation to outcome. Time of arrest to CPR and age had no significance. Of 89 patients studied, 4 (4.5%) survived to hospital discharge. The remaining 85 (95.5%) died either in the emergency department, the wards or the Intensive Care Unit. Among the survivors, only 2 (2.3%) functional (independent on activities of daily life) patients were identified. Among the survivors, the mean lactate level was 4.0 mmol/L. The mean lactate levels among the dead were 9.84 mmol/L. The mean length of CPR among the survivors was 5.42 minutes and for the non-survivors, 19.28 minutes. This study reports certain factors such as duration of resuscitation and initial lactate levels that can be valuable tools in decision making when resuscitating an elderly.

Matched MeSH terms: Heart Arrest/blood; Heart Arrest/therapy*

The use of bispectral index during a cardiopulmonary arrest: a potential predictor of cerebral perfusion

Azim N, Wang CY

Anaesthesia, 2004 Jun;59(6):610-2.

PMID: 15144304

A 62-year-old male underwent off-pump coronary artery grafting surgery while cerebral function was monitored with bispectral index (BIS). The BIS monitoring was continued into the immediate postoperative period, during which time the patient experienced a cardiopulmonary arrest. The changes in the BIS values helped the resuscitating team in assessing the cerebral response to the cardiopulmonary resuscitation.

Matched MeSH terms: Heart Arrest/physiopathology; Heart Arrest/therapy*

Designing a prehospital system for a developing country: estimated cost and benefits

Hauswald M, Yeoh E

Am J Emerg Med, 1997 Oct;15(6):600-3.

PMID: 9337371

Many of the costs associated with prehospital care in developed countries are covered in budgets for fire suppression, police services, and the like. Determining these costs is therefore difficult. The costs and benefits of developing a prehospital care system for Kuala Lumpur, Malaysia, which now has essentially no emergency medical services (EMS) system, were estimated. Prehospital therapies that have been suggested to decrease mortality were identified. A minimal prehospital system was designed to deliver these treatments in Kuala Lumpur. The potential benefit of these therapies was calculated by using statistics from the United States corrected for demographic differences between the United States and Malaysia. Costs were extrapolated from the current operating budget of the Malaysian Red Crescent Society. Primary dysrhythmias are responsible for almost all potentially survivable cardiac arrests. A system designed to deliver a defibrillator to 85% of arrests within 6 minutes would require an estimated 48 ambulances. Kuala Lumpur has approximately 120 prehospital arrhythmic deaths per year. A 6% resuscitation rate was chosen for the denominator, resulting in seven survivors. Half of these would be expected to have significant neurological damage. Ambulances cost $53,000 (US dollars) to operate per year in Kuala Lumpur; 48 ambulances would cost a total of $2.5 million. Demographic factors and traffic problems would significantly increase the cost per patient. Other therapies, including medications, airway management, and trauma care, were discounted because both their additional cost and their benefit are small. Transport of patients (including trauma) is now performed by police or private vehicle and would probably take longer by ambulance. A prehospital system for Kuala Lumpur would cost approximately $2.5 million per year. It might save seven lives, three of which would be marred by significant neurological injury. Developing countries would do well to consider alternatives to a North American EMS model.

Matched MeSH terms: Heart Arrest/etiology; Heart Arrest/therapy*

A puzzling case of cardiac arrest

Hannah HB

Br J Anaesth, 1971 Oct;43(10):991-3.

PMID: 5115036

Matched MeSH terms: Heart Arrest/chemically induced; Heart Arrest/etiology*

Fulltext How frequent is bystander cardiopulmonary resuscitation performed in the community of Kota Bharu, Malaysia?

Chew KS, Mohd Idzwan Z, Nik Hishamuddun NA, Wan Aasim WA, Kamaruddin J

Singapore Med J, 2008 Aug;49(8):636-9.

PMID: 18756348

INTRODUCTION: Bystander cardiopulmonary resuscitation (CPR) serves as a vital link to improve the chance of survival among the out-of-hospital cardiac arrest (OHA) patients. The frequency of bystander CPR in Malaysia is largely unknown. The aim of this study was to find out how frequently bystander CPR was performed among OHA patients with CPR performed at the Emergency Department (ED), Hospital Universiti Sains Malaysia (HUSM), prior to their arrival to the department.
METHODS: In this one-year observational study, data was collected from cases of CPR performed in ED, HUSM. In the OHA category, a subanalysis was further performed to look into the frequency and effects of bystander CPR on achieving return of spontaneous circulation and survival to hospital admission. The categorical data collected was analysed using chi-square test or Fisher-exact test.
RESULTS: Out of a total of 23 OHA patients that had CPR performed on arrival at the ED, HUSM, from March 2005 to March 2006, only two cases (8.7 percent) had bystander CPR performed. None of these two cases achieved return of spontaneous circulation.
CONCLUSION: Although this study has many limitations, it does indicate that the frequency of bystander CPR is dismally low in our community and the mere fact that bystander CPR was reported to be done does not seem to translate into a higher chance of survival to admission. The quality and effectiveness of the technique is equally important.
KEYWORDS: bystander cardiopulmonary resuscitation, cardiopulmonary resuscitation, out-of-hospital cardiac arrest , return of spontaneous circulation

Matched MeSH terms: Heart Arrest/mortality; Heart Arrest/therapy*

Fulltext A Survey on The Knowledge, Attitude and Confidence Level of Adult Cardiopulmonary Resuscitation Among Junior Doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia

Chew F Z A W M N KS, Mohd Hashairi F, Ida Zarina Z, Shaik Farid AW, Abu Yazid MN, Nik Hisamuddin NA

Med J Malaysia, 2011 Mar;66(1):56-9.

PMID: 23765145 MyJurnal

Junior doctors are often the "first line" doctors called to attend to patients in cardiac arrest. We performed an anonymous questionnaire study from October 2008 to December 2008 to assess the knowledge, attitude and skill of cardiopulmonary resuscitation among junior doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II. Out of the 100 questionnaire forms sent out, 70 were returned completed. The majority (85.8%) stated that they were not confident of managing a resuscitation case. There was a statistically significant (p<0.001) association between duration of clinical practice and confidence level. Up to 77.1% said that BLS should be re-certified every two years.

Matched MeSH terms: Heart Arrest

Fulltext Diagnosing Perioperative Cardiovascular Risks in Noncardiac Surgery Patients

Li P, Lei Y, Li Q, Lakshmipriya T, Gopinath SCB, Gong X

J Anal Methods Chem, 2019;2019:6097375.

PMID: 31534814 DOI: 10.1155/2019/6097375

Every year, over 200 million adults are undergoing noncardiac surgery. These noncardiac surgery patients may face the risk of cardiac mortality and morbidity during the perioperative and recovery periods. Around ten million patients who underwent noncardiac surgery experience cardiac complications within the first 30 days of the postoperative period; the complications are myocardial infarction, cardiac death, and cardiac arrest. This cardiovascular risk is mostly faced by the patients having cerebrovascular or cardiac disease and the patients with the age greater than 50 years. Monitoring and treating cardiac diseases with a suitable biomarker during the perioperative period is necessary for the early recovery of noncardiac surgery patients. This review discussed the risk factors and the key guidelines to avoid the cardiovascular risks during the perioperative period of noncardiac surgery patients. In addition, the biomarkers and identification strategies for cardiac diseases are discussed.

Matched MeSH terms: Heart Arrest

Fulltext A case of cardiac arrest due to air embolism during scoliosis surgery

Haji Mohd Amin MZ, Beng JTB, Young BTY, Faruk Seman NA, Ching TS, Chek WC

J Orthop Surg (Hong Kong), 2019 4 9;27(2):2309499019840083.

PMID: 30955449 DOI: 10.1177/2309499019840083

Cardiac arrest during scoliosis surgery is rare in idiopathic scoliosis. We present a case of cardiorespiratory collapse during corrective surgery in a young patient with idiopathic scoliosis. A diagnosis of venous air embolism was made by exclusion. A cardiorespiratory resuscitation was performed in supine position. Patient recovered without any sequelae and had operation completed 6 weeks later.

Matched MeSH terms: Heart Arrest/diagnosis; Heart Arrest/etiology*; Heart Arrest/therapy

Fulltext A Study of House Officers in a Teaching Hospital on Knowledge, Perception of Skills and Confidence Level in

Ismail Mohd Saiboon, Noraliza Mohd Ariffin, Teodoro Javier Herbosa, Ahmad Khaldun Ismail, Nariman Singmamae, Shamsuriani Md Jamal, et al.

Medicine & Health, 2007;2(2):110-116.

MyJurnal

Cardio-pulmonary Resuscitation (CPR) is important and should be mastered by House Officers (HO). House officers who have just completed their studies are assigned to acute medical and surgical wards. If a patient in the ward has a cardiac arrest (CA), these doctors are usually the first to attend. Therefore an HO must be confident with CPR skills. They must be competent in performing CPR. The authors assessed 26 new HOs from Universiti Kebangsaan Malaysia Hospital (HUKM) with respect to their self-perception about CPR skills, confidence level in performing CPR and knowledge in performing CPR. Knowledge was assessed by a questionnaire. We found that 16 of 26 (61.5%) assessed themselves to have inadequate knowledge and 46.2% had no confidence in performing CPR. The mean score of the written test was 5.7 ± 1.8. Seven out of 26 (27.0%) HOs had incorrect hand placement position for CPR. Only 4 and 9 out of 26 HOs had their sternal paddle and cardiac apex paddle positions correctly placed respectively. In conclusion, knowledge, perception of skills and confidence levels of HOs on CPR are inadequate and need further assessment and improvement. Medical schools need to review their CPR curriculum in order to prepare HOs adequately to work in emergency situations.

Matched MeSH terms: Heart Arrest

Fulltext Improving perception and confidence towards bystander cardiopulmonary resuscitation and public access automated external defibrillator program: how does training program help?

Liaw SY, Chew KS, Zulkarnain A, Wong SSL, Singmamae N, Kaushal DN, et al.

Int J Emerg Med, 2020 Mar 17;13(1):13.

PMID: 32183687 DOI: 10.1186/s12245-020-00271-3

BACKGROUND: In conjunction with an automated external defibrillator (AED) placement program at various locations within a public university in Malaysia, a series of structured training programs were conducted. The objectives of this study is to (1) evaluate the effectiveness of a structured training program in improving the perception of the importance of AED and cardiopulmonary resuscitation (CPR), (2) evaluate the confidence of the employees in using an AED and performing bystander CPR, (3) identify the fears and concerns of these employees in using AED and performing CPR, and (4) determine the perception of these employees towards the strategy of the AEDs placed at various locations within the university.

METHODS: In this single-center observational study, a validated questionnaire aimed to assess the university employees' attitude and confidence in handling AED and performing CPR before (pre-test) and immediately after (post-test) the training program was conducted.

RESULTS: A total of 184 participants participated in this study. Using the Wilcoxon signed-rank test, the training programs appeared to have improved the perception that "using AED is important for unresponsive victims" (z = 4.32, p arrest is yet to be seen.

Matched MeSH terms: Heart Arrest

Pediatric resident resuscitation skills improve after "rapid cycle deliberate practice" training

Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, et al.

Resuscitation, 2014 Jul;85(7):945-51.

PMID: 24607871 DOI: 10.1016/j.resuscitation.2014.02.025

Previous studies reveal pediatric resident resuscitation skills are inadequate, with little improvement during residency. The Accreditation Council for Graduate Medical Education highlights the need for documenting incremental acquisition of skills, i.e., "Milestones". We developed a simulation-based teaching approach "Rapid Cycle Deliberate Practice" (RCDP) focused on rapid acquisition of procedural and teamwork skills (i.e., "first-five minutes" (FFM) resuscitation skills). This novel method utilizes direct feedback and prioritizes opportunities for learners to "try again" over lengthy debriefing.

Matched MeSH terms: Heart Arrest/therapy*

Fulltext Translating knowledge to attitude: a survey on the perception of bystander cardiopulmonary resuscitation among dental students in Universiti Sains Malaysia and school teachers in Kota Bharu, Kelantan

Chew KS, Yazid MN, Kamarul BA, Rashidi A

Med J Malaysia, 2009 Sep;64(3):205-9.

PMID: 20527268

This voluntary, anonymous questionnaire survey was performed to assess the willingness of Basic Life Support (BLS) participants to perform bystander cardiopulmonary resuscitation (CPR). A total of 55 dental students and 73 school teachers were assessed on their willingness to perform bystander CPR after completion of their BLS training. In general, only 29.0% of the total 128 participants said that they would offer to perform CPR under any cardiac arrest condition and 69.0% said that they would just offer to call the ambulance but they would not offer to perform CPR. When analyzed separately, only 16.4% of school teachers said that they would perform CPR as compared to 45.5% of dental students (p < 0.001). Knowing how to perform CPR does not necessarily translate into willingness to perform CPR.

Matched MeSH terms: Heart Arrest/therapy*

A case of cardiac arrest following oral 250 mg. mefenamic acid

Leong LL

Med J Malaysia, 1976 Mar;30(3):229-37.

PMID: 1085401

Matched MeSH terms: Heart Arrest/chemically induced*

A Flowmeter Technique to Exclude Internal Mammary Artery Anastomosis Error in an Arrested Heart

Hashim SA, Amin MA, Nair A, Raja Mokhtar RA, Krishnasamy S, Cheng K

Heart Lung Circ, 2018 May;27(5):e59-e63.

PMID: 29246681 DOI: 10.1016/j.hlc.2017.11.011

The revision of an internal mammary artery graft anastomosis because of a technical error can be time-consuming and complicated and may lead to complications. Here, we describe the technical details and our early experience of using a standard transit-time flowmeter to exclude technical errors and facilitate rapid decision making for anastomosis revision in an arrested heart during aortic cross-clamping in the absence of ultrasound guidance.

Matched MeSH terms: Heart Arrest*

Fulltext Suxamethonium and cardiac arrest

Lee YM, Fountain SW

Singapore Med J, 1997 Jul;38(7):300-1.

PMID: 9339098

We report a case of cardiac arrest due to hyperkalaemia following administration of suxamethonium during a procedure to facilitate a change of endotracheal tube in a septic patient. The cause of this rare but fatal complication is briefly described and discussed. In view of this, suxamethonium should be used with great caution in patients with burns and other forms of physical injury, in a number of nervous system disorders, and in critically ill patients requiring prolonged ITU care.

Matched MeSH terms: Heart Arrest/chemically induced*

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