The Experts below are selected from a list of 60 Experts worldwide ranked by ideXlab platform
Xi Lu - One of the best experts on this subject based on the ideXlab platform.
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A Hierarchical Scheme for Utilizing Plug-In Electric Vehicle Power to Hedge Against Wind-Induced Unit Ramp Cycling Operations
IEEE Transactions on Power Systems, 2018Co-Authors: Ka Wing Chan, Xi LuAbstract:Increasing wind power (WP) integration is forcing conventional units to go through more frequent and significant cycling operations, which would accelerate wear and tear to unit components and eventually affect the unit's lifespan. In this context, this paper proposes a hierarchical scheme to control the power of plug-in electric vehicles (PEVs) to mitigate unit ramp cycling (URC) operations. A general-form representation of the URC operation is proposed for the first time. At the top level of the hierarchical scheme, a system net load variation range (NLVR) is constructed first to capture the uncertainty in WP forecasts, and then the PEV power is scheduled to reshape the NLVR so as to minimize the URC operations that can be caused by the possible net load realizations in the NLVR. Based on updated WP forecasts, the middle-level Dispatch model exempts overscheduled anti-URC regulation onus on PEVs to promote PEV charging. At the bottom level, a decentralized PEV charging control strategy is used to implement the PEV power Dispatch Instruction. Simulation results verify that the proposed scheme can avert the URC operations effectively, while preserve most of the desired PEV charging energy. Simulation results also show that the proposed scheme is more capable of withstanding WP forecast errors compared with its deterministic version and a benchmark scheme.
Hidetada Fukushima - One of the best experts on this subject based on the ideXlab platform.
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Performance review of regional emergency medical service pre‐arrival cardiopulmonary resuscitation with or without Dispatcher Instruction: a population‐based observational study
Acute medicine and surgery, 2017Co-Authors: Hidetada Fukushima, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hideki Asai, Kazuo OkuchiAbstract:Background To investigate variations in emergency medical service (EMS) pre-arrival cardiopulmonary resuscitation (CPR), including both bystander CPR without Dispatch assistance and Dispatch-assisted CPR (DACPR). Methods We carried out an observational study by implementing EMS pre-arrival CPR reports in three fire agencies. We included adult, non-traumatic, and non-EMS witnessed out-of-hospital cardiac arrests. This reporting system comprised the Dispatch Instruction process and bystander CPR quality based on evaluations by EMS crews who arrived on the scene. Bystander CPR was categorized as "ongoing CPR" if the bystander was performing CPR when the EMS reached the patient's side and "good-quality CPR" if the CPR was performed proficiently. We compared the frequencies of ongoing and good-quality CPR in the bystander CPR already started without Dispatch assistance (CPR in progress) group and DACPR group. Results Of 688 out-of-hospital cardiac arrests, CPR was already started in 150 cases (CPR in progress group). Dispatcher CPR Instruction was provided in 368 cases. Among these, callers started chest compressions in 162 cases (DACPR group). Ongoing CPR was performed in 220 cases and was more frequent in the DACPR group (128/162 [79.0%] versus 92/150 [61.3%], P < 0.001). Good-quality CPR was more frequent in the CPR in progress group, but the difference was not statistically significant (36/92 [39.1%] versus 42/128 [29.0%], P = 0.888). Conclusions Ongoing CPR and good-quality CPR were not frequent in EMS pre-arrival CPR. Detailed analysis of Dispatch Instructions and bystander CPR can contribute to improvement in EMS pre-arrival CPR.
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Implementation of a Dispatch-Instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study.
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2015Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Kenji NishioAbstract:Background We modified the Dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of Dispatch Instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among ‘Not in cardiac arrest (CA)’ unresponsive cases.
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Implementation of a Dispatch-Instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2015Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Kenji NishioAbstract:Background We modified the Dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of Dispatch Instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among ‘Not in cardiac arrest (CA)’ unresponsive cases. Methods This study was conducted prospectively using the population-based registry of out-of-hospital cardiac arrests (OHCAs). For 8 months we implemented this modified protocol in cooperation with 4 fire departments that cover regions with a total population of 840,000. Results There were 478 and 427 OHCAs before and after implementation, respectively. Among them, 69 and 71 layperson-witnessed OHCAs for pre- and post-implementation, respectively, were analyzed. Dispatchers provided CPR Instructions more frequently after protocol implementation than before (55/71 [77.5 %] vs. 41/69 [59.4 %], p
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Abstract 58: The Quality of Prearrival Cardiopulmonary Resuscitation: A Performance Review of Regional Dispatchers and Bystanders
Circulation, 2014Co-Authors: Hidetada Fukushima, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Asami Iwamura, K. Nishio, Masami ImanishiAbstract:Background: Emergency Medical Service (EMS) Dispatchers and bystanders play key roles in EMS pre-arrival cardiopulmonary resuscitation (CPR). There is, however, no standardized review process for evaluating the performance of Dispatchers and bystanders. Method: We conducted a performance review of pre-arrival CPR in Nara city (276.8km2, 364,000 residents). Dispatch Instruction for CPR was defined as ‘Complete Instruction’ (Dispatchers recognized first compression) or ‘Incomplete Instruction’ (Dispatchers failed to recognize first compression). Based on evaluation by EMS at the scene, bystander CPR continuing until EMS arrival was classified as ‘Continuous Compression’. Bystander CPR with hard and fast chest compressions was classified as ‘Good Compression’. Results: We reviewed 197 cardiac arrest calls between Nov. 2013 and Mar. 2014. CPR was already in progress in 51 cases. In the remaining 146 cases, CPR need was recognized in 129. Due to barriers preventing CPR Instruction, Dispatchers provided Instruction in 106 cases and bystanders performed CPR in 51 cases. Among these, Dispatchers provided ‘Complete Instruction’ in 33 cases and ‘Incomplete Instruction’ in 18 cases. ‘Continuous Compression’ was performed in 37 cases and significantly more often in the ‘Complete Instruction’ than the ‘Incomplete Instruction’ group (28/33[84.8%] vs 9/18[50.0%], Chi-square test p=0.008*). The median elapsed time before first compression was 145 seconds in the ‘Continuous Compression’ with ‘Complete Instruction’ group (N=28). ‘Good Compression’ was performed in only 15 cases. Conclusion: Our performance review found that ‘Complete Instruction’ was strongly associated with immediate and continuous bystander CPR until EMS arrival. Unfortunately, ‘Good Compression’ was not frequently provided. Performance reviews of both Dispatchers and bystanders can yield useful information for improving the quality of pre-arrival CPR.
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Abnormal breathing of sudden cardiac arrest victims described by laypersons and its association with emergency medical service Dispatcher-assisted cardiopulmonary resuscitation Instruction.
Emergency Medicine Journal, 2014Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Michiaki Hata, Kenji Nishio, Keigo SaekiAbstract:Background Current guidelines for cardiopulmonary resuscitation (CPR) emphasise that emergency medical service (EMS) Dispatchers should identify sudden cardiac arrest (CA) with abnormal breathing and assist lay rescuers performing CPR. However, lay rescuers description of abnormal breathing may be inconsistent, and it is unclear how EMS Dispatchers provide Instruction for CPR based on the breathing status of the CA victims described by laypersons. Methods and results To investigate the incidence of abnormal breathing and the association between the EMS Dispatcher-assisted CPR Instruction and layperson CPR, we retrospectively analysed 283 witnessed CA cases whose information regarding breathing status of CA victims was available from population-based prospective cohort data. In 169 cases (59.7%), laypersons described that the CA victims were breathing in various ways, and that the victims were ‘not breathing’ in 114 cases (40.3%). Victims described as breathing in various ways were provided EMS Dispatch-Instruction for CPR less frequently than victims described as ‘not breathing’ (27.8% (47/169) vs 84.2% (96/114); p Conclusions This population-based study indicates that 60% of CA victims showed agonal respiration, which was described as breathing in various ways at the time of EMS call. Although EMS Dispatch-Instruction was associated significantly with an increase in layperson CPR, abnormal breathing was associated with a much lower rate of CPR Instruction and, in turn, was related to a much lower rate of bystander CPR.
Kenji Nishio - One of the best experts on this subject based on the ideXlab platform.
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Implementation of a Dispatch-Instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study.
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2015Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Kenji NishioAbstract:Background We modified the Dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of Dispatch Instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among ‘Not in cardiac arrest (CA)’ unresponsive cases.
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Implementation of a Dispatch-Instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2015Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Kenji NishioAbstract:Background We modified the Dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of Dispatch Instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among ‘Not in cardiac arrest (CA)’ unresponsive cases. Methods This study was conducted prospectively using the population-based registry of out-of-hospital cardiac arrests (OHCAs). For 8 months we implemented this modified protocol in cooperation with 4 fire departments that cover regions with a total population of 840,000. Results There were 478 and 427 OHCAs before and after implementation, respectively. Among them, 69 and 71 layperson-witnessed OHCAs for pre- and post-implementation, respectively, were analyzed. Dispatchers provided CPR Instructions more frequently after protocol implementation than before (55/71 [77.5 %] vs. 41/69 [59.4 %], p
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Abnormal breathing of sudden cardiac arrest victims described by laypersons and its association with emergency medical service Dispatcher-assisted cardiopulmonary resuscitation Instruction.
Emergency Medicine Journal, 2014Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Michiaki Hata, Kenji Nishio, Keigo SaekiAbstract:Background Current guidelines for cardiopulmonary resuscitation (CPR) emphasise that emergency medical service (EMS) Dispatchers should identify sudden cardiac arrest (CA) with abnormal breathing and assist lay rescuers performing CPR. However, lay rescuers description of abnormal breathing may be inconsistent, and it is unclear how EMS Dispatchers provide Instruction for CPR based on the breathing status of the CA victims described by laypersons. Methods and results To investigate the incidence of abnormal breathing and the association between the EMS Dispatcher-assisted CPR Instruction and layperson CPR, we retrospectively analysed 283 witnessed CA cases whose information regarding breathing status of CA victims was available from population-based prospective cohort data. In 169 cases (59.7%), laypersons described that the CA victims were breathing in various ways, and that the victims were ‘not breathing’ in 114 cases (40.3%). Victims described as breathing in various ways were provided EMS Dispatch-Instruction for CPR less frequently than victims described as ‘not breathing’ (27.8% (47/169) vs 84.2% (96/114); p Conclusions This population-based study indicates that 60% of CA victims showed agonal respiration, which was described as breathing in various ways at the time of EMS call. Although EMS Dispatch-Instruction was associated significantly with an increase in layperson CPR, abnormal breathing was associated with a much lower rate of CPR Instruction and, in turn, was related to a much lower rate of bystander CPR.
Kazunobu Norimoto - One of the best experts on this subject based on the ideXlab platform.
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Performance review of regional emergency medical service pre‐arrival cardiopulmonary resuscitation with or without Dispatcher Instruction: a population‐based observational study
Acute medicine and surgery, 2017Co-Authors: Hidetada Fukushima, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hideki Asai, Kazuo OkuchiAbstract:Background To investigate variations in emergency medical service (EMS) pre-arrival cardiopulmonary resuscitation (CPR), including both bystander CPR without Dispatch assistance and Dispatch-assisted CPR (DACPR). Methods We carried out an observational study by implementing EMS pre-arrival CPR reports in three fire agencies. We included adult, non-traumatic, and non-EMS witnessed out-of-hospital cardiac arrests. This reporting system comprised the Dispatch Instruction process and bystander CPR quality based on evaluations by EMS crews who arrived on the scene. Bystander CPR was categorized as "ongoing CPR" if the bystander was performing CPR when the EMS reached the patient's side and "good-quality CPR" if the CPR was performed proficiently. We compared the frequencies of ongoing and good-quality CPR in the bystander CPR already started without Dispatch assistance (CPR in progress) group and DACPR group. Results Of 688 out-of-hospital cardiac arrests, CPR was already started in 150 cases (CPR in progress group). Dispatcher CPR Instruction was provided in 368 cases. Among these, callers started chest compressions in 162 cases (DACPR group). Ongoing CPR was performed in 220 cases and was more frequent in the DACPR group (128/162 [79.0%] versus 92/150 [61.3%], P < 0.001). Good-quality CPR was more frequent in the CPR in progress group, but the difference was not statistically significant (36/92 [39.1%] versus 42/128 [29.0%], P = 0.888). Conclusions Ongoing CPR and good-quality CPR were not frequent in EMS pre-arrival CPR. Detailed analysis of Dispatch Instructions and bystander CPR can contribute to improvement in EMS pre-arrival CPR.
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Implementation of a Dispatch-Instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study.
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2015Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Kenji NishioAbstract:Background We modified the Dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of Dispatch Instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among ‘Not in cardiac arrest (CA)’ unresponsive cases.
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Implementation of a Dispatch-Instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2015Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Kenji NishioAbstract:Background We modified the Dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of Dispatch Instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among ‘Not in cardiac arrest (CA)’ unresponsive cases. Methods This study was conducted prospectively using the population-based registry of out-of-hospital cardiac arrests (OHCAs). For 8 months we implemented this modified protocol in cooperation with 4 fire departments that cover regions with a total population of 840,000. Results There were 478 and 427 OHCAs before and after implementation, respectively. Among them, 69 and 71 layperson-witnessed OHCAs for pre- and post-implementation, respectively, were analyzed. Dispatchers provided CPR Instructions more frequently after protocol implementation than before (55/71 [77.5 %] vs. 41/69 [59.4 %], p
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Abstract 58: The Quality of Prearrival Cardiopulmonary Resuscitation: A Performance Review of Regional Dispatchers and Bystanders
Circulation, 2014Co-Authors: Hidetada Fukushima, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Asami Iwamura, K. Nishio, Masami ImanishiAbstract:Background: Emergency Medical Service (EMS) Dispatchers and bystanders play key roles in EMS pre-arrival cardiopulmonary resuscitation (CPR). There is, however, no standardized review process for evaluating the performance of Dispatchers and bystanders. Method: We conducted a performance review of pre-arrival CPR in Nara city (276.8km2, 364,000 residents). Dispatch Instruction for CPR was defined as ‘Complete Instruction’ (Dispatchers recognized first compression) or ‘Incomplete Instruction’ (Dispatchers failed to recognize first compression). Based on evaluation by EMS at the scene, bystander CPR continuing until EMS arrival was classified as ‘Continuous Compression’. Bystander CPR with hard and fast chest compressions was classified as ‘Good Compression’. Results: We reviewed 197 cardiac arrest calls between Nov. 2013 and Mar. 2014. CPR was already in progress in 51 cases. In the remaining 146 cases, CPR need was recognized in 129. Due to barriers preventing CPR Instruction, Dispatchers provided Instruction in 106 cases and bystanders performed CPR in 51 cases. Among these, Dispatchers provided ‘Complete Instruction’ in 33 cases and ‘Incomplete Instruction’ in 18 cases. ‘Continuous Compression’ was performed in 37 cases and significantly more often in the ‘Complete Instruction’ than the ‘Incomplete Instruction’ group (28/33[84.8%] vs 9/18[50.0%], Chi-square test p=0.008*). The median elapsed time before first compression was 145 seconds in the ‘Continuous Compression’ with ‘Complete Instruction’ group (N=28). ‘Good Compression’ was performed in only 15 cases. Conclusion: Our performance review found that ‘Complete Instruction’ was strongly associated with immediate and continuous bystander CPR until EMS arrival. Unfortunately, ‘Good Compression’ was not frequently provided. Performance reviews of both Dispatchers and bystanders can yield useful information for improving the quality of pre-arrival CPR.
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Abnormal breathing of sudden cardiac arrest victims described by laypersons and its association with emergency medical service Dispatcher-assisted cardiopulmonary resuscitation Instruction.
Emergency Medicine Journal, 2014Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Michiaki Hata, Kenji Nishio, Keigo SaekiAbstract:Background Current guidelines for cardiopulmonary resuscitation (CPR) emphasise that emergency medical service (EMS) Dispatchers should identify sudden cardiac arrest (CA) with abnormal breathing and assist lay rescuers performing CPR. However, lay rescuers description of abnormal breathing may be inconsistent, and it is unclear how EMS Dispatchers provide Instruction for CPR based on the breathing status of the CA victims described by laypersons. Methods and results To investigate the incidence of abnormal breathing and the association between the EMS Dispatcher-assisted CPR Instruction and layperson CPR, we retrospectively analysed 283 witnessed CA cases whose information regarding breathing status of CA victims was available from population-based prospective cohort data. In 169 cases (59.7%), laypersons described that the CA victims were breathing in various ways, and that the victims were ‘not breathing’ in 114 cases (40.3%). Victims described as breathing in various ways were provided EMS Dispatch-Instruction for CPR less frequently than victims described as ‘not breathing’ (27.8% (47/169) vs 84.2% (96/114); p Conclusions This population-based study indicates that 60% of CA victims showed agonal respiration, which was described as breathing in various ways at the time of EMS call. Although EMS Dispatch-Instruction was associated significantly with an increase in layperson CPR, abnormal breathing was associated with a much lower rate of CPR Instruction and, in turn, was related to a much lower rate of bystander CPR.
Yasuyuki Urisono - One of the best experts on this subject based on the ideXlab platform.
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Performance review of regional emergency medical service pre‐arrival cardiopulmonary resuscitation with or without Dispatcher Instruction: a population‐based observational study
Acute medicine and surgery, 2017Co-Authors: Hidetada Fukushima, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hideki Asai, Kazuo OkuchiAbstract:Background To investigate variations in emergency medical service (EMS) pre-arrival cardiopulmonary resuscitation (CPR), including both bystander CPR without Dispatch assistance and Dispatch-assisted CPR (DACPR). Methods We carried out an observational study by implementing EMS pre-arrival CPR reports in three fire agencies. We included adult, non-traumatic, and non-EMS witnessed out-of-hospital cardiac arrests. This reporting system comprised the Dispatch Instruction process and bystander CPR quality based on evaluations by EMS crews who arrived on the scene. Bystander CPR was categorized as "ongoing CPR" if the bystander was performing CPR when the EMS reached the patient's side and "good-quality CPR" if the CPR was performed proficiently. We compared the frequencies of ongoing and good-quality CPR in the bystander CPR already started without Dispatch assistance (CPR in progress) group and DACPR group. Results Of 688 out-of-hospital cardiac arrests, CPR was already started in 150 cases (CPR in progress group). Dispatcher CPR Instruction was provided in 368 cases. Among these, callers started chest compressions in 162 cases (DACPR group). Ongoing CPR was performed in 220 cases and was more frequent in the DACPR group (128/162 [79.0%] versus 92/150 [61.3%], P < 0.001). Good-quality CPR was more frequent in the CPR in progress group, but the difference was not statistically significant (36/92 [39.1%] versus 42/128 [29.0%], P = 0.888). Conclusions Ongoing CPR and good-quality CPR were not frequent in EMS pre-arrival CPR. Detailed analysis of Dispatch Instructions and bystander CPR can contribute to improvement in EMS pre-arrival CPR.
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Implementation of a Dispatch-Instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study.
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2015Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Kenji NishioAbstract:Background We modified the Dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of Dispatch Instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among ‘Not in cardiac arrest (CA)’ unresponsive cases.
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Implementation of a Dispatch-Instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study
Scandinavian Journal of Trauma Resuscitation and Emergency Medicine, 2015Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Kenji NishioAbstract:Background We modified the Dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of Dispatch Instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among ‘Not in cardiac arrest (CA)’ unresponsive cases. Methods This study was conducted prospectively using the population-based registry of out-of-hospital cardiac arrests (OHCAs). For 8 months we implemented this modified protocol in cooperation with 4 fire departments that cover regions with a total population of 840,000. Results There were 478 and 427 OHCAs before and after implementation, respectively. Among them, 69 and 71 layperson-witnessed OHCAs for pre- and post-implementation, respectively, were analyzed. Dispatchers provided CPR Instructions more frequently after protocol implementation than before (55/71 [77.5 %] vs. 41/69 [59.4 %], p
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Abstract 58: The Quality of Prearrival Cardiopulmonary Resuscitation: A Performance Review of Regional Dispatchers and Bystanders
Circulation, 2014Co-Authors: Hidetada Fukushima, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Hironori Kitaoka, Hideki Asai, Asami Iwamura, K. Nishio, Masami ImanishiAbstract:Background: Emergency Medical Service (EMS) Dispatchers and bystanders play key roles in EMS pre-arrival cardiopulmonary resuscitation (CPR). There is, however, no standardized review process for evaluating the performance of Dispatchers and bystanders. Method: We conducted a performance review of pre-arrival CPR in Nara city (276.8km2, 364,000 residents). Dispatch Instruction for CPR was defined as ‘Complete Instruction’ (Dispatchers recognized first compression) or ‘Incomplete Instruction’ (Dispatchers failed to recognize first compression). Based on evaluation by EMS at the scene, bystander CPR continuing until EMS arrival was classified as ‘Continuous Compression’. Bystander CPR with hard and fast chest compressions was classified as ‘Good Compression’. Results: We reviewed 197 cardiac arrest calls between Nov. 2013 and Mar. 2014. CPR was already in progress in 51 cases. In the remaining 146 cases, CPR need was recognized in 129. Due to barriers preventing CPR Instruction, Dispatchers provided Instruction in 106 cases and bystanders performed CPR in 51 cases. Among these, Dispatchers provided ‘Complete Instruction’ in 33 cases and ‘Incomplete Instruction’ in 18 cases. ‘Continuous Compression’ was performed in 37 cases and significantly more often in the ‘Complete Instruction’ than the ‘Incomplete Instruction’ group (28/33[84.8%] vs 9/18[50.0%], Chi-square test p=0.008*). The median elapsed time before first compression was 145 seconds in the ‘Continuous Compression’ with ‘Complete Instruction’ group (N=28). ‘Good Compression’ was performed in only 15 cases. Conclusion: Our performance review found that ‘Complete Instruction’ was strongly associated with immediate and continuous bystander CPR until EMS arrival. Unfortunately, ‘Good Compression’ was not frequently provided. Performance reviews of both Dispatchers and bystanders can yield useful information for improving the quality of pre-arrival CPR.
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Abnormal breathing of sudden cardiac arrest victims described by laypersons and its association with emergency medical service Dispatcher-assisted cardiopulmonary resuscitation Instruction.
Emergency Medicine Journal, 2014Co-Authors: Hidetada Fukushima, Masami Imanishi, Taku Iwami, Tadahiko Seki, Yasuyuki Kawai, Kazunobu Norimoto, Yasuyuki Urisono, Michiaki Hata, Kenji Nishio, Keigo SaekiAbstract:Background Current guidelines for cardiopulmonary resuscitation (CPR) emphasise that emergency medical service (EMS) Dispatchers should identify sudden cardiac arrest (CA) with abnormal breathing and assist lay rescuers performing CPR. However, lay rescuers description of abnormal breathing may be inconsistent, and it is unclear how EMS Dispatchers provide Instruction for CPR based on the breathing status of the CA victims described by laypersons. Methods and results To investigate the incidence of abnormal breathing and the association between the EMS Dispatcher-assisted CPR Instruction and layperson CPR, we retrospectively analysed 283 witnessed CA cases whose information regarding breathing status of CA victims was available from population-based prospective cohort data. In 169 cases (59.7%), laypersons described that the CA victims were breathing in various ways, and that the victims were ‘not breathing’ in 114 cases (40.3%). Victims described as breathing in various ways were provided EMS Dispatch-Instruction for CPR less frequently than victims described as ‘not breathing’ (27.8% (47/169) vs 84.2% (96/114); p Conclusions This population-based study indicates that 60% of CA victims showed agonal respiration, which was described as breathing in various ways at the time of EMS call. Although EMS Dispatch-Instruction was associated significantly with an increase in layperson CPR, abnormal breathing was associated with a much lower rate of CPR Instruction and, in turn, was related to a much lower rate of bystander CPR.