ORCID Profile
0000-0002-3003-4792
Current Organisations
National University of Ireland Galway
,
HSE National Ambulance Service
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Publisher: Wiley
Date: 19-07-2019
Publisher: BMJ
Date: 25-10-2018
DOI: 10.1136/OPENHRT-2018-000912
Abstract: Resuscitation from out-of-hospital cardiac arrest (OHCA) is largely determined by the availability of cardiopulmonary resuscitation (CPR) and defibrillation within 5–10 min of collapse. The potential contribution of organised groups of volunteers to delivery of CPR and defibrillation in their communities has been little studied. Ireland has extensive networks of such volunteers this study develops and tests a model to examine the potential impact at national level of these networks on early delivery of care. A geographical information systems study considering all statutory ambulance resource locations and all centre point locations for community first responder (CFR) schemes that operate in Ireland were undertaken. ESRI ArcGIS Desktop 10.4 was used to map CFR and ambulance base locations. ArcGIS Online proximity analysis function was used to model 5–10 min drive time response areas under s le peak and off-peak conditions. Response areas were linked to Irish population census data so as to establish the proportion of the population that have the potential to receive a timely cardiac arrest emergency response. This study found that CFRs are present in many communities throughout Ireland and have the potential to reach a million additional citizens before the ambulance service and within a timeframe where CPR and defibrillation are likely to be effective treatments. CFRs have significant potential to contribute to survival following OHCA in Ireland. Further research that examines the processes, experiences and outcomes of CFR involvement in OHCA resuscitation should be a scientific priority.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.RESUSCITATION.2018.03.024
Abstract: The highest achievable survival rate following out-of-hospital cardiac arrest is unknown. Data from airports serving international destinations (international airports) provide the opportunity to evaluate the success of pre-hospital resuscitation in a relatively controlled but real-life environment. This retrospective cohort study included all cases of out-of-hospital cardiac arrest at international airports with resuscitation attempted between January 1st, 2013 and December 31st, 2015. Crude incidence, patient, event characteristics and survival to hospital discharge/survival to 30 days (survival) were calculated. Mixed effect logistic regression analyses were performed to identify predictors of survival. Variability in survival between airports/countries was quantified using the median odds ratio. There were 800 cases identified, with an average of 40 per airport. Incidence was 0.024/100,000 passengers per year. Percentage survival for all patients was 32%, and 58% for patients with an initial shockable heart rhythm. In adjusted analyses, initial shockable heart rhythm was the strongest predictor of survival (odds ratio, 36.7 95% confidence interval [CI], 15.5-87.0). In the bystander-witnessed subgroup, delivery of a defibrillation shock by a bystander was a strong predictor of survival (odds ratio 4.8 95% CI, 3.0-7.8). Grouping of cases was significant at country level and survival varied between countries. In international airports, 32% of patients survived an out-of-hospital cardiac arrest, substantially more than in the general population. Our analysis suggested similarity between airports within countries, but differences between countries. Systematic data collection and reporting are essential to ensure international airports continually maximise activities to increase survival.
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.RESUSCITATION.2019.03.018
Abstract: Out-of-hospital cardiac arrest (OHCA) survival varies greatly between communities. The Utstein template was developed and promulgated to improve the comparability of OHCA outcome reports, but it has undergone limited empiric validation. We sought to assess how much of the variation in OHCA survival between emergency medical services (EMS) across the globe is explained by differences in the Utstein factors. We also assessed how accurately the Utstein factors predict OHCA survival. We performed a retrospective analysis of patient-level prospectively collected data from 12 OHCA registries from 12 countries for the period 1 Jan 2006 through 31 Dec 2011. We used generalized linear mixed models to examine the variation in survival between EMS agencies (n=232). Twelve registries contributed 86,759 cases. Patient arrest characteristics, EMS treatment and patient outcomes varied across registries. Overall survival to hospital discharge was 10% (range, 6% to 22%). Overall survival with Cerebral Performance Category of 1 or 2 (available for 8/12 registries) was 8% (range, 2% to 20%). The area-under-the-curve for the Utstein model was 0.85 (Wald CI: 0.85-0.85). The Utstein factors explained 51% of the EMS agency variation in OHCA survival. The Utstein factors explained 51% of the variation in survival to hospital discharge among multiple large geographically separate EMS agencies. This suggests that quality improvement and public health efforts should continue to target modifiable Utstein factors to improve OHCA survival. Further study is required to identify the reasons for the variation that is incompletely understood.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 20-12-2022
DOI: 10.1161/CIR.0000000000001095
Abstract: This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. Topics covered by systematic reviews include cardiopulmonary resuscitation during transport approach to resuscitation after drowning passive ventilation minimizing pauses during cardiopulmonary resuscitation temperature management after cardiac arrest use of diagnostic point-of-care ultrasound during cardiac arrest use of vasopressin and corticosteroids during cardiac arrest coronary angiography after cardiac arrest public-access defibrillation devices for children pediatric early warning systems maintaining normal temperature immediately after birth suctioning of amniotic fluid at birth tactile stimulation for resuscitation immediately after birth use of continuous positive airway pressure for respiratory distress at term birth respiratory and heart rate monitoring in the delivery room supraglottic airway use in neonates prearrest prediction of in-hospital cardiac arrest mortality basic life support training for likely rescuers of high-risk populations effect of resuscitation team training blended learning for life support training training and recertification for resuscitation instructors and recovery position for maintenance of breathing and prevention of cardiac arrest. Members from 6 task forces have assessed, discussed, and debated the quality of the evidence using Grading of Recommendations Assessment, Development, and Evaluation criteria and generated consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections, and priority knowledge gaps for future research are listed.
Publisher: Elsevier BV
Date: 11-2014
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Siobhan Masterson.