Resuscitation plus最新文献

{"title":"Wolf Creek XVIII Part 1: advancing resuscitation science","authors":"Robert W. Neumar","doi":"10.1016/j.resplu.2025.101173","DOIUrl":"10.1016/j.resplu.2025.101173","url":null,"abstract":"<div><div>The Wolf Creek Conference, initiated in 1975, provides a unique forum for robust intellectual exchange between thought leaders and scientists from academia and industry focused on advancing the science and practice of cardiac arrest resuscitation. The 50th year anniversary Wolf Creek XVIII Conference was hosted by the Max Harry Weil Institute for Critical Care Research and Innovation in Ann Arbor, Michigan, USA, on June 19–21, 2025. A major focus of the conference proceedings was to identify and prioritize knowledge gaps, barriers to translation, and research priorities for six major domains in the field of resuscitation: (1) optimizing time intervals in cardiac arrest care, (2) innovations in defibrillation science, (3) innovations in extracorporeal cardiopulmonary resuscitation (ECPR) technology, (4) cardiac arrest survivorship science, (5) transforming clinical trial design in cardiac arrest research, and (6) strategies to optimize international collaboration in cardiac arrest research. In addition, industry scientists and academic investigators were given the opportunity to present and discuss cutting edge innovations. Finally, the “Wolf Creek Innovator Award” competition recognized early career investigators who were challenging current paradigms in resuscitation science. The overall goal was to fuel active discussion and debate among emerging and established experts and steer the future direction of research efforts in the field. This manuscript provides an overview of the conference, which is expanded upon in the individual manuscripts within this special edition of Resuscitation Plus. The intent of these publications is to provide a roadmap for impactful academic and commercial advances in the field of cardiac arrest resuscitation.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101173"},"PeriodicalIF":2.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in cardiopulmonary resuscitation training – A scoping review","authors":"Timo de Raad ,&nbsp;Olfa Chakroun-Walha ,&nbsp;Brenna Leslie ,&nbsp;Robert Greif ,&nbsp;Sabine Nabecker","doi":"10.1016/j.resplu.2025.101175","DOIUrl":"10.1016/j.resplu.2025.101175","url":null,"abstract":"<div><h3>Objectives</h3><div>This scoping review aimed to identify Artificial Intelligence methods used in cardiopulmonary resuscitation (CPR) training.</div></div><div><h3>Methods</h3><div>Members of the writing group ‘Education for Resuscitation’ of the European Resuscitation Council 2025 guidelines used the PICOST format for this scoping review, which included only published randomized and non-randomized studies. Medline, Embase, Cochrane, Education Resources Information Center, Web of Science, and PubMed were searched from inception to July 2025. Title and abstract screening, full-text review, and data extraction were performed by two researchers in pairs. PRISMA reporting standards were followed. The review was registered at PROSPERO. Because the evidence was insufficient for a systematic review, we changed our initial plan and performed a scoping review.</div></div><div><h3>Results</h3><div>The search identified 6977 citations. After removing 2521 duplicates, reviewing titles and abstracts yielded 43 articles for full-text review. Of these, 15 studies were included in the final analysis. Our findings reveal that Artificial Intelligence is being explored across key areas of CPR training, including its accuracy in detecting CPR quality parameters, providing real-time feedback, creating personalized training experiences, detecting and analyzing dialog segments during and after simulation, generating medical teaching illustrations, its capacity for interactive simulations, and answering laypersons’ medical questions.</div></div><div><h3>Conclusion</h3><div>Artificial Intelligence shows potential for transforming CPR training via enhancing real-time feedback, enabling personalized learning, improving dialog analysis, facilitating content creation, and serving as an information source. The current evidence is dominated by proof-of-concept studies. Future research needs to establish the efficacy of Artificial Intelligence-supported CPR training compared to traditional methods.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101175"},"PeriodicalIF":2.4,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in perioperative code status management: a national survey among Swiss anaesthetists","authors":"Samuel K. Zumbrunn ,&nbsp;Flavio Gössi ,&nbsp;Benjamin Bissmann ,&nbsp;Armon Arpagaus ,&nbsp;Sebastian Gross ,&nbsp;Christoph Becker ,&nbsp;Simon A. Amacher ,&nbsp;Roaul Sutter ,&nbsp;Kai Tisljar ,&nbsp;Ariane Rossi ,&nbsp;Marc Lüthy ,&nbsp;Luzius A. Steiner ,&nbsp;Thierry Girard ,&nbsp;Sabina Hunziker","doi":"10.1016/j.resplu.2025.101174","DOIUrl":"10.1016/j.resplu.2025.101174","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate current practices and beliefs among anaesthetists regarding perioperative code status discussions and management in surgical patients.</div></div><div><h3>Methods</h3><div>A nationwide web-based survey was conducted in Switzerland among anaesthetists providers. Primary endpoint: proportion of participants routinely discussing code status with medium-risk patients based on the American Society of Anesthesiologists (ASA) physical status classification system (ASA 3–4). Secondary endpoints: proportion of code status discussions in low-risk (ASA 1–2) and high-risk (ASA 5) patients; perioperative intensive care unit (ICU) admissions, severe complications, therapy limitations and management of patients with Do Not Resuscitate (DNR) orders.</div></div><div><h3>Results</h3><div>Of 496 respondents, 474 were included. 56.8 % (<em>n</em> = 269) of anaesthetists reported routinely discussing code status with medium-risk patients (ASA 3–4). Factors associated with routine code status discussion included greater experience (mean [±SD] 20.7 [±10.6] vs. 17.4 [10.8] years, adjusted OR 1.03 [95 % CI 1.02–1.05], <em>p</em> &lt; 0.001), more exposure to cardiopulmonary resuscitation (CPR) (≥50 CPRs: 169/269 [62.8 %] vs. 93/205 [45.4 %]; adjusted OR 2.99 [95 % CI 1.39–6.42], <em>p</em> = 0.005), and awareness of institutional teaching (48/243 [19.8 %] vs. 13/180 [7.2 %], adjusted OR 2.93 [95 % CI 1.51–5.68], <em>p</em> = 0.001), though only 14.4 % reported such training. 76.3 % (<em>n</em> = 318) of anaesthetists reported discussing code status preoperatively with patients who have DNR orders. While 70.4 % (<em>n</em> = 285) supported respecting DNR orders perioperatively, 21.3 % (<em>n</em> = 86) felt they should not apply.</div></div><div><h3>Conclusion</h3><div>Code status discussions are commonly reported for medium-risk patients, but formal education is limited. Experience and clinical exposure increase the likelihood of such discussions. Enhanced training and clearer guidelines are needed to support consistent ethical management of code status in the perioperative setting.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101174"},"PeriodicalIF":2.4,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and attitudes toward cardiopulmonary resuscitation on women in Arab countries: An international cross-sectional survey study","authors":"Zainab Alqudah ,&nbsp;Sebastian Schnaubelt ,&nbsp;Zehra’ Al-Hilali ,&nbsp;Alaa Oteir ,&nbsp;Mahmoud Alwidyan ,&nbsp;Ayman Nasr ,&nbsp;Safa Alqudah ,&nbsp;Andrew Lockey","doi":"10.1016/j.resplu.2025.101172","DOIUrl":"10.1016/j.resplu.2025.101172","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the knowledge and attitudes of individuals in Arab countries toward performing cardiopulmonary resuscitation (CPR) on women and to explore sex-based differences. Also, to identify potential factors that may hinder or improve CPR rates.</div></div><div><h3>Methods</h3><div>This cross-sectional study used a questionnaire specifically designed to address the study objectives. The participants were adults aged ≥18 years and residing in an Arab country. Descriptive statistics were used and sex-based differences were examined.</div></div><div><h3>Results</h3><div>In total, 558 participants were included. The mean age was 31.7 years (Standard deviation (SD): 12.3), 63.4 % were female, and 75.8 % were healthcare workers. The mean total knowledge score for the participants was 3.9/5.0 (SD: 1.1) and there were generally positive attitudes (mean score: 4.6/5, SD: 0.52) toward providing CPR on women. Female sex of participants was independently associated with significantly higher knowledge scores (β = −0.29, <em>p</em> = 0.001). Attitudes did not significantly differ by sex. Three major barriers were identified to perform CPR on women: fear of legal accountability, not practising on clearly female manikins during CPR training, and fear of being blamed by the injured person’s relatives. Participants suggested that having specific CPR training and using female manikins, community awareness, and legal protection may serve as potential motivators to increase the provision of CPR on women.</div></div><div><h3>Conclusion</h3><div>Although attitudes toward CPR on women were favourable across sex among Arab survey participants, significant knowledge disparities remain. Sex-sensitive, culturally adapted CPR training programs and legal policy efforts would be essential to address identified barriers and improve equitable response for women in cardiac arrest to improve survival rates.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101172"},"PeriodicalIF":2.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of peri-arrest hypertonic/hyperoncotic fluid treatment on clinical outcomes in non-trauma-related resuscitation – A scoping review","authors":"Samira Akbas ,&nbsp;Clara Castellucci ,&nbsp;Christopher Haresleb ,&nbsp;Alexander Kaserer ,&nbsp;Donat R. Spahn ,&nbsp;Jan Breckwoldt","doi":"10.1016/j.resplu.2025.101171","DOIUrl":"10.1016/j.resplu.2025.101171","url":null,"abstract":"<div><h3>Aim</h3><div>This scoping review aimed to summarize existing evidence on the administration of hypertonic and hyperoncotic (HTF/HOF) fluids during cardiopulmonary resuscitation (CPR) in both human and animal studies. Further, we sought to provide guidance for future research and potential clinical implementation strategies.</div></div><div><h3>Methods</h3><div>We searched <em>Medline, EMBASE, Cochrane, Web of Science, Scopus and</em> <span><span><em>Clinicaltrials.gov</em></span><svg><path></path></svg></span> from inception to June 11th, 2025, for comparative studies using HTF/HOF in non-trauma-related <em>peri</em>-arrest settings in animal models and humans. Studies were selected using a PICOST format. Studies were assessed on their risk of bias. Results were synthesized narratively and presented using descriptive statistics. No meta-analysis was performed.</div></div><div><h3>Results</h3><div>We included 21 animal and four human studies. Animal studies showed high heterogeneity in species, cardiac arrest models, timing and composition of HTF/HOF. Most of them found improved neurological outcomes compared to normal saline. In the human studies (overall sample size 932), patients were either treated with a combination of hypertonic saline and hydroxyethyl starch (HHS) or with hypertonic saline alone (HS). Time points of fluid administration and assessed outcome parameters differed substantially. Overall, human studies indicated neutral to favorable effects, supporting the potential value of HTF/HOF treatment.</div></div><div><h3>Conclusions</h3><div>Studies analyzing the effects of HTF/HOF in <em>peri</em>-arrest settings in animals and in humans suggest potential benefit on survival and neurological outcomes. Findings are limited by substantial heterogeneity in study designs, timing and outcome measures. It therefore appears necessary to conduct more rigorous clinical trials with standardized endpoints to further explore the potential of <em>peri</em>-arrest HTF/HOF treatment.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101171"},"PeriodicalIF":2.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial differences in cardiac arrest survival: insights from Minnesota metro data and the University of Minnesota extracorporeal cardiopulmonary resuscitation cohort","authors":"Despoina Koukousaki ,&nbsp;Rebecca Freese ,&nbsp;Lucinda Hodgson ,&nbsp;Marinos Kosmopoulos ,&nbsp;Rajat Kalra ,&nbsp;Tamas Alexy ,&nbsp;Alejandra Gutierrez ,&nbsp;Demetris Yannopoulos","doi":"10.1016/j.resplu.2025.101166","DOIUrl":"10.1016/j.resplu.2025.101166","url":null,"abstract":"<div><h3>Aims</h3><div>The study explores the association between race, survival and neurological outcomes among out-of-hospital cardiac arrest (OHCA) patients listed in Minnesota metro and the University of Minnesota Extracorporeal Cardiopulmonary Resuscitation (UMN-ECPR) program.</div></div><div><h3>Methods</h3><div>This retrospective study included OHCA patients with initial shockable rhythm from two distinct cohorts: the Minnesota metro CARES cohort, treated with conventional CPR and the UMN-ECPR database (2016–2023). Race was categorized as white or non-white. Good neurological outcome was defined as a Cerebral-Performance-Category score of 1–2. Logistic regression analyses examined survival by race, with primary models adjusted for age and gender and exploratory models further adjusted for witnessed status, location, bystander CPR, return-of-spontaneous-circulation, CPR duration.</div></div><div><h3>Results</h3><div>Of 2,700 OHCA patients in the CARES cohort, primarily treated with conventional CPR, 16.5 % were non-white. Compared to white patients, non-whites were younger (mean age 54.0 vs. 64.4 years), more often female (32.8 % vs. 23.6 %), and less likely to receive bystander CPR (52.2 % vs. 60 %). Non-white patients had lower age- and gender-adjusted odds of survival to discharge (OR: 0.64; 95 % CI, 0.5–0.82; <em>p</em> &lt; 0.001) and favorable neurological outcome (OR: 0.48; 95 % CI, 0.35–0.64; <em>p</em> &lt; 0.001). Among 414 ECPR patients (22.7 % non-white), non-white patients were younger (mean age 51 vs. 58.8 years) with lower bystander CPR rates (65.2 % vs. 74.8 %). There were no significant differences in age- and gender-adjusted survival (OR: 1.17; 95 % CI, 0.69–2; <em>p</em> = 0.554) or neurological outcome (OR: 1.07; 95 % CI, 0.61–1.88; <em>p</em> = 0.818).</div></div><div><h3>Conclusion</h3><div>Non-white race was linked to worse outcomes in the conventional CPR cohort but not in the ECPR cohort.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101166"},"PeriodicalIF":2.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and implications of patients included vs excluded for extracorporeal cardiopulmonary resuscitation after initial activation","authors":"Kevin George ,&nbsp;Joshua B. Wiener ,&nbsp;Michael Zacharias ,&nbsp;Frank Forde ,&nbsp;Yasir Abu-Omar ,&nbsp;Colin McCloskey","doi":"10.1016/j.resplu.2025.101165","DOIUrl":"10.1016/j.resplu.2025.101165","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study is to describe the implementation of a new Extracorporeal Cardiopulmonary Resuscitation (ECPR) program in Cleveland, Ohio, USA. We also provide a novel comparison of outcomes between patients cannulated vs excluded from cannulation for ECPR after initial field activation.</div></div><div><h3>Methods</h3><div>A prospective observational study of ECPR activations between September 2021 and February 2025. Patients meeting initial eligibility criteria for out-of-hospital cardiac arrest (OHCA)—namely based on age, bystander-CPR, and initial shockable rhythm—were transported to the emergency department where the ECPR team completed cannulation based on further biochemical criteria. Medical records were used to collect data after every ECPR activation.</div></div><div><h3>Results</h3><div>45 ECPR activations were identified. Among these, 13 patients were cannulated for ECMO, while 32 patients did not meet cannulation criteria. Among those cannulated, 10 of 13 (76.9 %) survived to hospital discharge vs 5 of 32 (15.6 %) who did not receive ECMO (p &lt; 0.001). Among patients who underwent ECPR, there was no incidence of brain death or significant access site bleeding complications<em>.</em> The most common reason for aborted cannulation was due to the biochemical exclusion criteria of pH &lt;7 or lactate &gt;15 mmol/L.</div></div><div><h3>Conclusion</h3><div>The implementation of ECPR with strict eligibility criteria resulted in a small number of cannulations but a high survival rate. Strict criteria may lead to missed opportunities for successful ECPR and occasionally trigger activation of the ECPR team without ultimately performing cannulation. As institutions develop their ECPR programs, they should carefully consider eligibility criteria in order to balance survival rate and case volume.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101165"},"PeriodicalIF":2.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing theoretical BLS knowledge with virtual reality: a randomized controlled trial in medical students","authors":"Nico Tannemann ,&nbsp;Olga Tsarenko ,&nbsp;Frank Herbstreit ,&nbsp;Margarita Gestmann ,&nbsp;Thorsten Brenner ,&nbsp;Cynthia Szalai","doi":"10.1016/j.resplu.2025.101169","DOIUrl":"10.1016/j.resplu.2025.101169","url":null,"abstract":"<div><h3>Background</h3><div>High-quality cardiopulmonary resuscitation (CPR) training, including both technical and non-technical skills, is essential for medical students. Virtual reality (VR) offers immersive learning environments that may enhance traditional teaching methods. This study investigates the impact of a single VR session prior to an Advanced Life Support (ALS) course on knowledge and performance of basic life support skills among medical students.</div></div><div><h3>Methods</h3><div>In this single blind randomized controlled trial, 126 fourth-year medical students with prior Basic Life Support (BLS) training were assigned to either an intervention group (<em>n</em> = 66) with an additional 3-part immersive VR session covering BLS theory and practice or a control group (<em>n</em> = 60) receiving standard preparation. All participants underwent a seminar based on advanced life support principles as dictated by the European Resuscitation Council (ERC) and International Liaison Committee on Resuscitation (ILCOR) guidelines. Theoretical knowledge was assessed via multiple-choice questionnaires at three time points (baseline, post-course, 12 weeks later). Practical skills were evaluated through an Objective Structured Clinical Examination (OSCE). Data were analyzed using Wilcoxon tests, repeated-measures ANOVA, and linear mixed models. Student evaluations were used to gauge subjective satisfaction with the scenario during teaching,</div></div><div><h3>Results</h3><div>No significant differences were observed between groups at baseline. The intervention group demonstrated significantly greater gains in knowledge at both post-course (<em>p</em> &lt; 0.01) and follow-up (<em>p</em> = 0.04). However, no significant differences were found in OSCE performance. The VR group’s improvement over time was significantly higher, suggesting a positive effect of VR on knowledge retention. Students were satisfied with the addition of a VR scenario in the teaching format.</div></div><div><h3>Conclusion</h3><div>A single VR session prior to ALS training enhanced theoretical knowledge but did not significantly affect practical performance. Students were open to integration of the technology into training, so that VR may serve as a valuable adjunct in CPR education. Further research is needed to evaluate its long-term impact and the optimal integration method into curricula.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101169"},"PeriodicalIF":2.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced community first responder support system: protocol of a randomized trial to improve bystander cardiopulmonary resuscitation quality for out-of-hospital cardiac arrest patients","authors":"Alexander E. White ,&nbsp;Sungwon Yoon ,&nbsp;Stephanie Fook-Chong ,&nbsp;Tonje S. Birkenes ,&nbsp;Wei Ming Ng ,&nbsp;Phyo Thet Naing Win ,&nbsp;Benjamin S.H. Leong ,&nbsp;Nurul Asyikin Jalil ,&nbsp;Helge Myklebust ,&nbsp;Marcus E.H. Ong ,&nbsp;Fahad Javaid Siddiqui","doi":"10.1016/j.resplu.2025.101167","DOIUrl":"10.1016/j.resplu.2025.101167","url":null,"abstract":"<div><h3>Introduction</h3><div>The earliest and impactful intervention for out-of-hospital cardiac arrest (OHCA) patients is cardiopulmonary resuscitation (CPR) delivered by a community first responder (CFR). However, the CFRs often fail to meet the established performance targets for compression rate and depth throughout the event, thereby defeating the purpose of instituting the CFR system. While telephone CPR has been shown to help, certain aspects cannot be improved with a voice-only guidance. Therefore, a trial has been designed to evaluate an enhanced CFR support system (eCSS) intervention that comprises (a) audio/video communication between a CFR and dispatcher, in addition to (b) relaying compression depth and rate data to the dispatcher in real time through a battery-operated Bluetooth-enabled motion sensor-mounted CPR card connected to a smart phone through an application over 5G mobile phone network. Both these features of eCSS will allow the dispatchers to better guide the CFR, ensuring high-quality CPR. The control group will have voice-only dispatcher assistance as per the current standard of care.</div></div><div><h3>Objective</h3><div>This protocol paper describes the rationale, methodology, and run-in period recruitment experience of the trial, where all non-pregnant adult suspected OHCA patients will be eligible for the study, on whom CFR provides CPR engaging the eCSS. CFRs will be recruited from a volunteers’ registry maintained by the Singapore Civic Defence Force, the largest publicly funded EMS agency. This trial protocol has been registered in the <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> registry [ID NCT06530433].</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101167"},"PeriodicalIF":2.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and outcomes of out-of-hospital cardiac arrests at sport and recreational events in England, 2015–2022","authors":"Helen Winterburn ,&nbsp;Gavin D. Perkins ,&nbsp;Chen Ji ,&nbsp;Scott Booth ,&nbsp;Adam de Paeztron ,&nbsp;Rachael Fothergill ,&nbsp;Terry P. Brown","doi":"10.1016/j.resplu.2025.101168","DOIUrl":"10.1016/j.resplu.2025.101168","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies suggest favourable outcomes for patients experiencing exercise-related out-of-hospital cardiac arrest (OHCA). This study aimed to examine the characteristics and outcomes of OHCAs occurring at sports and recreational events in England.</div></div><div><h3>Methods</h3><div>Data were obtained from the OHCA Outcomes registry for cases between 2015 and 2022 where resuscitation was attempted. Descriptive statistics were used to compare OHCA characteristics with outcomes: return of spontaneous circulation (ROSC) sustained to hospital handover and survival (discharge or 30-day). Logistic regression identified factors influencing outcomes.</div></div><div><h3>Results</h3><div>Of EMS-resuscitated OHCAs, 0.5 % (N = 1316) occurred at sports and recreational events. ROSC sustained to hospital handover occurred in 43 % of cases, and 25 % survived. Most patients were male and over 65-years. These OHCAs were more likely to be witnessed (73.5 %), receive bystander cardiopulmonary resuscitation (CPR) (91.8 %), have an automated external defibrillator (AED) attached (34.3 %) and receive an ambulance response within 7-min (43.5 %). Survival was 36 % in cases that were bystander witnessed with an initial shockable rhythm. ROSC to hospital handover improved survival further (93.6 %). Regression analysis indicated initial shockable rhythm had the greatest impact on outcomes (ROSC: odds ratio (OR) = 2.97, 95 %CI = 2.25–3.92; survival: OR = 4.25, 95 %CI = 2.96–6.10).</div></div><div><h3>Conclusion</h3><div>OHCA at sports/recreational events are rare but show better outcomes than the general population, driven by higher rates of witnessed arrests, bystander interventions and initial shockable rhythms. Findings underscore the importance of strengthening the chain of survival through early recognition, CPR training, and AED.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"27 ","pages":"Article 101168"},"PeriodicalIF":2.4,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}