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Systematic Review

Resuscitation | Education & Simulation

The current evidence of 'peer-led' cardiopulmonary resuscitation training: a scoping review
Jeremy Pallas, Phillip Newton, Ginger Chu
In Press, Received February 26, 2026  Accepted May 6, 2026  Available online July 27, 2026  
DOI: https://doi.org/10.15441/ceem.26.098    [Accepted]

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The current evidence of 'peer-led' cardiopulmonary resuscitation training: a scoping review
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The current evidence of 'peer-led' cardiopulmonary resuscitation training: a scoping review
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Objective
To explore and map existing evidence relating to peer-led cardiopulmonary resuscitation (CPR) training across any population or setting.
Methods
A scoping review was conducted using Joanna Briggs Institute methodology with reporting aligned to PRISMA-ScR. MEDLINE, EMBASE, CINAHL, Scopus, and the Cochrane Library were searched for studies published to August 2025, supplemented by citation searching. Two reviewers independently screened titles, abstracts, and full texts, with disagreements resolved by a third reviewer. Data were extracted using a standardised form and summarised narratively.
Results
Out of 511 unique search results, 37 studies were included. Most were conducted in schools or health professional education settings, with few focusing on the wider adult community population. Four peer-training models (horizontal, near-peer, cascade, and self-regulated) were identified. Across diverse study designs and outcome measures, peer-led training frequently achieved similar educational outcomes to professional instructor-led training. Evidence on community-level implementation and patient-centred outcomes was limited.
Conclusion
Peer-led CPR training was supported by a largely heterogeneous evidence base demonstrating similar educational outcomes to traditional instruction. Research was concentrated in educational settings, with limited evaluation of community-wide implementation. Further rigorous, standardised studies are needed to clarify effectiveness, sustainability, and the role of peer-led training in expanding CPR training capacity in the broader community.
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Guidelines

2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 6. Post–cardiac arrest care
Hyo Jin Bang, Chun Song Youn, Min Chul Kim, Yongwhan Lim, Young-Jae Cho, Bitna Chu, June-Sung Kim, Youn-Jung Kim, Byoung-Gil Yoon, Jin Park, Min-Ju Kang, Kyung Woon Jeung, Soo Hyun Kim, Je Hyeok Oh, Taegyun Kim, Sang Hoon Oh, Yong Soo Kim, Changshin Kang, Dong Hun Lee, Jin Hong Min, Hyo Joon Kim, Do Kyun Kim, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Mi Jin Lee, Jisook Lee, Chang Hee Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang, Sung Phil Chung
Clin Exp Emerg Med 2026;13(Suppl 1):S75-S100.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.075

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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 6. Post–cardiac arrest care
Clin Exp Emerg Med. 2026;13(Suppl 1):S75-S100.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.075
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 6. Post–cardiac arrest care
Clin Exp Emerg Med. 2026;13(Suppl 1):S75-S100.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.075
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This guideline summarizes evidence-based post–cardiac arrest care following the return of spontaneous circulation (ROSC) in adults, incorporating updates from the 2025 Korean Guidelines for Cardiopulmonary Resuscitation and contemporary international evidence. Recommendations were informed by recent randomized controlled trials and systematic reviews, with an emphasis on patient-centered outcomes and practical clinical applications. After ROSC, early evaluation should focus on identifying reversible causes. A 12-lead electrocardiogram should be obtained promptly, with echocardiography and whole-body computed tomography performed when clinically indicated to assess cardiac function and detect noncardiac or occult etiologies. Respiratory management aims to minimize secondary brain injury by preventing hypoxemia and hyperoxemia. High inspired oxygen concentrations may be used initially, followed by titration to an appropriate oxygen saturation level once reliable measurements are available, and ventilation should target normocapnia. Hemodynamic management prioritizes adequate organ perfusion and prompt treatment of shock, including active correction of hypotension. Routine immediate coronary angiography is not recommended in patients without ST-segment elevation. However, urgent angiography is indicated in those with ST-segment elevation, cardiogenic shock, or a high likelihood of ongoing myocardial ischemia. In comatose survivors, temperature control is essential. The selected target temperature should be maintained for at least 24 hours, with active fever prevention for 36 to 72 hours. Additional intensive care unit management includes glucose control and seizure monitoring. Routine prophylactic antibiotics or anticonvulsants are not recommended. Neuroprognostication should use a multimodal approach after confounders, such as sedation and temperature management, are addressed, integrating clinical examination, electrophysiology, biomarkers, and neuroimaging to support individualized decision-making.
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 5. Cardiac arrest in special circumstances
Tae-Youn Kim, Gyo Jin Ahn, Kyoung-Chul Cha, Dong-Hyeok Kim, Youdong Sohn, Young Song, Gyuhong Shim, Do Kyun Kim, Yunhee Oh, Jin Wi, Chun Song Youn, Myung-Lyeol Lee, Mi Jin Lee, Byung Kook Lee, Byung Heon Lee, Jisook Lee, Chang Hee Lee, Hannah Lee, Youngbin Jang, Yong Soo Jang, Young Hwa Jung, Woo Jin Jung, Sung Phil Chung, Gyu Chong Cho, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S61-S74.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.074

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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 5. Cardiac arrest in special circumstances
Clin Exp Emerg Med. 2026;13(Suppl 1):S61-S74.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.074
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 5. Cardiac arrest in special circumstances
Clin Exp Emerg Med. 2026;13(Suppl 1):S61-S74.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.074
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The 2025 update of the Korean guidelines for cardiac arrest under special circumstances incorporates new evidence and expert consensus to clarify when clinicians should modify standard resuscitation algorithms. For cardiac arrest caused by acute hyperkalemia, the guidelines suggest administering intravenous insulin with glucose; however, current evidence remains insufficient to recommend for or against routine use of sodium bicarbonate or calcium. In suspected pulmonary embolism–related cardiac arrest, thrombolytic therapy may be considered. In confirmed cases, thrombolysis, surgical embolectomy, or percutaneous mechanical thrombectomy may be appropriate, despite very low certainty of evidence. For opioid-related cardiac arrest, current evidence does not support the routine administration of naloxone in addition to standard advanced life support; however, naloxone may be administered when it is unclear whether the patient is in true cardiac arrest. The guidelines also emphasize managing cardiac arrest in the prone position. If the patient is intubated and immediate repositioning is unsafe or impractical, prone cardiopulmonary resuscitation and defibrillation may be attempted using invasive arterial pressure or end-tidal carbon dioxide monitoring to guide the timing of repositioning. Immediate supination is strongly recommended for non-intubated patients. Additional updates address drowning, severe hypothermia, pregnancy, anaphylaxis, and cardiac arrest during interventional procedures, underscoring the importance of early correction of reversible causes, appropriate airway strategies, and timely consideration of extracorporeal life support in selected cases. Overall, the 2025 recommendations highlight cautious, etiology-directed interventions and explicitly grade recommendation strength and certainty to support context-sensitive clinical decision-making in high-risk and resource-variable settings.
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 4. Adult advanced life support
Tae-Youn Kim, Gyo Jin Ahn, Kyoung-Chul Cha, Dong-Hyeok Kim, Youdong Sohn, Young Song, Gyuhong Shim, Do Kyun Kim, Yunhee Oh, Jin Wi, Chun Song Youn, Myung-Lyeol Lee, Mi Jin Lee, Byung Kook Lee, Byung Heon Lee, Jisook Lee, Chang Hee Lee, Hannah Lee, Youngbin Jang, Yong Soo Jang, Young Hwa Jung, Woo Jin Jung, Sung Phil Chung, Gyu Chong Cho, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S32-S60.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.073

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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 4. Adult advanced life support
Clin Exp Emerg Med. 2026;13(Suppl 1):S32-S60.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.073
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 4. Adult advanced life support
Clin Exp Emerg Med. 2026;13(Suppl 1):S32-S60.   Published online May 31, 2026
DOI: https://doi.org/10.15441/ceem.26.073
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The 2025 Korean advanced life support guidelines were updated using a structured evidence evaluation process informed by recent randomized controlled trials and systematic reviews. The guideline development group prioritized patient-important outcomes and assessed the certainty of the evidence to formulate graded recommendations. For drug administration during adult cardiac arrest, intravenous access is the preferred initial route, with intraosseous access recommended when intravenous access cannot be rapidly established. Epinephrine remains the recommended vasopressor. Routine administration of vasopressin, either alone or in combination with corticosteroids, is not recommended for in-hospital or out-of-hospital cardiac arrest. In the absence of specific indications, the routine use of buffering agents and calcium is discouraged owing to insufficient evidence of their benefits and potential harm. Defibrillation recommendations were refined based on emerging evidence. In adults with refractory ventricular fibrillation or pulseless ventricular tachycardia after multiple unsuccessful defibrillation attempts, vector change or double sequential defibrillation may be considered in selected settings when performed by experienced teams with appropriate equipment. Airway management guidelines recommend cricothyroidotomy as a rescue technique when conventional airway management strategies fail. For patients receiving cardiopulmonary resuscitation while on mechanical ventilation, specific ventilator settings during chest compressions are recommended to optimize ventilation and minimize interference with high-quality cardiopulmonary resuscitation. The guidelines also address cardiopulmonary resuscitation–induced consciousness, allowing the cautious use of sedatives and/or analgesic agents when awareness interferes with resuscitation quality or safety. Overall, the guidelines emphasize evidence-based practice and individualized clinical decision-making.

Citations

Citations to this article as recorded by  Crossref logo
  • Serial Ultrasound-Guided Carotid Artery Compression During Chest Compressions for Assessing Circulatory Status: A Prospective Pilot Diagnostic Study
    Seung Jin Maeng, Hee Yoon, Ik Joon Jo, Sejin Heo, Hansol Chang, Gun Tak Lee, Jong Eun Park, Taerim Kim, Se Uk Lee, Sung Yeon Hwang, Jihyeon Kim, Min Ji Kim
    Diagnostics.2026; 16(18): 2956.     CrossRef
  • 1,601 View
  • 84 Download
  • 1 Crossref
2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 2. Current status of cardiac arrest and the chain of survival
Sung Oh Hwang, Kyoung-Chul Cha, Woo Jin Jung, Young-Il Roh, Gyo Jin Ahn, Do Kyun Kim, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Chun Song Youn, Mi Jin Lee, Jisook Lee, Chang Hee Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Ju Sun Heo, Sung Phil Chung
Clin Exp Emerg Med 2026;13(Suppl 1):S10-S17.   Published online May 29, 2026
DOI: https://doi.org/10.15441/ceem.26.072

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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 2. Current status of cardiac arrest and the chain of survival
Clin Exp Emerg Med. 2026;13(Suppl 1):S10-S17.   Published online May 29, 2026
DOI: https://doi.org/10.15441/ceem.26.072
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 2. Current status of cardiac arrest and the chain of survival
Clin Exp Emerg Med. 2026;13(Suppl 1):S10-S17.   Published online May 29, 2026
DOI: https://doi.org/10.15441/ceem.26.072
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In Korea, more than 30,000 out-of-hospital cardiac arrests (OHCAs) occur each year, and the survival rate remains below 10%. Because OHCA is difficult to predict and typically occurs outside medical facilities, effective management requires not only healthcare professionals but also laypersons, including bystanders and first responders. Survival depends on an uninterrupted and efficient sequence of time-critical actions: early recognition of cardiac arrest and activation of emergency services; prompt bystander cardiopulmonary resuscitation (CPR); use of an automated external defibrillator (AED) for shockable rhythms; on-scene and in-hospital advanced life support with comprehensive post–cardiac arrest care; and systematic assessment of neurologic and functional outcomes followed by rehabilitation and recovery. The chain of survival describes these essential steps required to maximize survival after cardiac arrest and comprises five links: (1) early recognition and call for help; (2) immediate bystander CPR; (3) early defibrillation with an AED; (4) advanced life support and post–cardiac arrest care; and (5) rehabilitation and recovery for survivors. The cardiac arrest survival environment represents a societal infrastructure that sustains and optimizes both medical and nonmedical factors across prevention, treatment, and rehabilitation to reduce mortality. Establishing such an environment requires each community to develop integrated medical systems for prevention, treatment, rehabilitation, and recovery, alongside nonmedical strategies, including public awareness initiatives, widespread CPR education and bystander participation, AED dissemination, and coordinated community responsiveness of the emergency medical system.
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 1. The update process and highlights
Sung Phil Chung, Do Kyun Kim, Tae-Youn Kim, Youdong Sohn, Gyuhong Shim, Young Hwa Jung, Yunhee Oh, Chun Song Youn, Mi Jin Lee, Jisook Lee, Chang Hee Lee, Youngbin Jang, Yong Soo Jang, Gyu Chong Cho, Kyoung-Chul Cha, Ju Sun Heo, Sung Oh Hwang
Clin Exp Emerg Med 2026;13(Suppl 1):S1-S9.   Published online May 21, 2026
DOI: https://doi.org/10.15441/ceem.26.071

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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 1. The update process and highlights
Clin Exp Emerg Med. 2026;13(Suppl 1):S1-S9.   Published online May 21, 2026
DOI: https://doi.org/10.15441/ceem.26.071
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2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 1. The update process and highlights
Clin Exp Emerg Med. 2026;13(Suppl 1):S1-S9.   Published online May 21, 2026
DOI: https://doi.org/10.15441/ceem.26.071
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In response to the expanding body of research on cardiopulmonary resuscitation (CPR) and updates from the International Liaison Committee on Resuscitation, the 2020 Korean CPR guidelines have been revised. This article presents the development process and summarizes the major updates in the 2025 Korean CPR guidelines. Seven task forces were established, with members nominated by professional societies involved in CPR. Each task force formulated key clinical questions and conducted systematic evidence reviews using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology. The 2025 CPR guidelines were finalized on the basis of the reviewed evidence and consensus discussions. The major updates are as follows: (1) addition of rehabilitation and recovery to the chain of survival; (2) inclusion of guidance for dispatchers on the use of automated external defibrillators; (3) recommendation that trained rescuers provide rescue breaths in cases of drowning-related cardiac arrest; (4) suggestion of double sequential defibrillation or vector-change defibrillation for refractory ventricular fibrillation; (5) revision of the target temperature range for post-resuscitation temperature management from 32–36 to 33–37.5 °C; (6) recommendation of public access defibrillation for children aged ≥1 year; (7) suggestion to use supraglottic airway devices and video laryngoscopy in neonatal resuscitation; (8) recommendation for the use of feedback devices in CPR training; and (9) addition of a first aid section addressing cardiac arrest–related emergencies. These guidelines reflect the most current evidence, and their implementation and dissemination are expected to improve survival after cardiac arrest.
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Original Article

Comparison of manual palpation, 2D carotid ultrasound, and end-tidal carbon dioxide for detecting return of spontaneous circulation
Akin Gullu, Sukru Kockan, Emre Sanci, Erdem Aydin, Ahmet Emir Sari, Asim Enes Ozbek, Huseyin Cahit Halhalli
In Press, Received May 28, 2025  Accepted December 26, 2025  Available online January 28, 2026  
DOI: https://doi.org/10.15441/ceem.25.113    [Accepted]

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Comparison of manual palpation, 2D carotid ultrasound, and end-tidal carbon dioxide for detecting return of spontaneous circulation
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Comparison of manual palpation, 2D carotid ultrasound, and end-tidal carbon dioxide for detecting return of spontaneous circulation
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Objective
Healthcare providers frequently spend excessive time attempting to identify a pulse and may have difficulty accurately confirming its presence. Point-of-care carotid artery ultrasonography has been suggested as a potential alternative to manual palpation. This study aimed to evaluate the effectiveness of manual palpation, 2D carotid ultrasonography, and rapid increases in end-tidal carbon dioxide (EtCO2) levels for determining the return of spontaneous circulation (ROSC) in patients with cardiac arrest presenting to an emergency department.
Methods
This was a single-center, prospective, observational study. Nontraumatic adult patients in cardiopulmonary arrest who were brought to the emergency department were included. After cardiac arrest was identified, the following data were recorded: initial arrest rhythm, ultrasonographic and manual pulse assessments, EtCO2 levels, resuscitation duration, and post-ROSC vital signs. The team leader’s judgment was used for ROSC adjudication and served as the reference standard.
Results
The investigation included 88 patients who underwent a total of 642 cycles of cardiopulmonary resuscitation. The area under the curve (AUC) values for 2D carotid ultrasonography, EtCO2, and manual palpation were 0.974, 0.802, and 0.862, respectively (all P<0.001). In pairwise AUC comparisons, ultrasonography differed significantly from manual palpation (P=0.001) and EtCO2 (P<0.001), whereas manual palpation and EtCO2 did not differ significantly (P=0.167). Bedside ultrasonography for detecting a carotid pulse had a sensitivity of 93.8% and a specificity of 100%.
Conclusion
These findings suggest that 2D carotid ultrasonography can be effectively used to detect a pulse in patients with cardiopulmonary arrest.
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Systematic Review

Impact of the rescuer’s posture and position, or manikin position on the efficacy and efficiency of chest compressions during cardiopulmonary resuscitation in adults: a systematic review
Maria Bhudarally, Tiago Atalaia, Hugo Pereira, Cláudia Febra, António Palmeira, José Pedro Morgado, Pedro Aleixo
In Press, Received July 1, 2025  Accepted October 2, 2025  Available online January 14, 2026  
DOI: https://doi.org/10.15441/ceem.25.145    [Accepted]

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Impact of the rescuer’s posture and position, or manikin position on the efficacy and efficiency of chest compressions during cardiopulmonary resuscitation in adults: a systematic review
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Impact of the rescuer’s posture and position, or manikin position on the efficacy and efficiency of chest compressions during cardiopulmonary resuscitation in adults: a systematic review
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Background
Rescuer posture, position, and patient height during chest compressions (CC) influence its efficacy and efficiency. No clear recommendations exist on these aspects. It is essential to systematize the existing knowledge, especially for nurses and healthcare providers involved in resuscitation. Purpose: To conduct a systematic review about the impact of rescuer posture, position, and manikin/patient height on CC efficacy and efficiency.
Methods
The study followed PRISMA guidelines and was registered on PROSPERO. Eligibility criteria included peer-reviewed articles or conference papers comparing different rescuer postures, positions, or manikin/patient heights during CC performed with both hands, regarding efficacy or efficiency. Databases consulted: MEDLINE Complete, SPORTDiscus, Cochrane Reviews, and CINAHL Complete. Methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies.
Results
Of 6539 articles, only 34 met inclusion criteria. All were observational, used manikins, and were classified as weak in global methodological quality. Compared with standing, several studies suggested the kneeling posture may be associated with more effective and efficient CC. Evidence regarding the optimal patient height, including potential anthropometric-based adjustments, remains limited. Findings across the included studies indicated that variations in hand position appeared to have minimal influence on CC quality. Some studies reported decreased CC quality when rescuers performed CC while walking.
Conclusions
The available evidence suggested that performing CC while kneeling on a firm surface may be beneficial when feasible. Future research is needed to further evaluate the impact of bed height, self-selected rescuer position, and their relevance to emergency practice.

Citations

Citations to this article as recorded by  Crossref logo
  • Pediatric cardiopulmonary resuscitation quality in crib versus standard hospital bed model at a single center
    Ava R. Wilstead, Ken Tegtmeyer, Kelly Collins, Andrea R. Meisman, Kyesha James, Bin Zhang, Rashmi D. Sahay, Matthew W. Zackoff, Daniel A. Loeb, Maya L. Dewan
    Resuscitation Plus.2026; 30: 101395.     CrossRef
  • 728 View
  • 43 Download
  • 1 Crossref

Original Article

Serum lactate to albumin ratio at hospital arrival and neurological outcome of out-of-hospital cardiac arrest: a nationwide multicenter observational study
Toshinari Kawama, Toshihiro Hatakeyama, Takashi Sano, Koki Nakada, Tasuku Matsuyama, Takeyuki Kiguchi, Benjamin W. Berg, Tetsuhisa Kitamura, Hisao Matsushima
Clin Exp Emerg Med 2025;12(3):242-250.   Published online August 13, 2025
DOI: https://doi.org/10.15441/ceem.24.339

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Serum lactate to albumin ratio at hospital arrival and neurological outcome of out-of-hospital cardiac arrest: a nationwide multicenter observational study
Clin Exp Emerg Med. 2025;12(3):242-250.   Published online August 13, 2025
DOI: https://doi.org/10.15441/ceem.24.339
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Serum lactate to albumin ratio at hospital arrival and neurological outcome of out-of-hospital cardiac arrest: a nationwide multicenter observational study
Clin Exp Emerg Med. 2025;12(3):242-250.   Published online August 13, 2025
DOI: https://doi.org/10.15441/ceem.24.339
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Objective
We investigated the possible association between lower serum lactate to albumin ratio upon hospital arrival and out-of-hospital cardiac arrest (OHCA) outcome.
Methods
Records from the Japanese Association for Acute Medicine–Out-of-Hospital Cardiac Arrest (JAAM-OHCA) Registry were used for this multicenter observational study. Enrolled patients were ≥18 years old with OHCA of medical etiology who were hospitalized after spontaneous circulation returned between June 1, 2014, and December 31, 2021. We excluded those with missing data or those who failed to meet predefined inclusion criteria. The primary outcome was a cerebral performance category scale of 1 or 2 which indicated 30-day survival with favorable neurological outcome. Patients were divided into quartiles based on serum lactate to albumin ratios. The multivariable logistic regression analysis included adjustment for multiple factors.
Results
Data from 4,413 patients were analyzed. The primary outcome was achieved by 558 of 1,104 patients (50.5%) in the first quartile (lactate to albumin ratio, ≤2.23), 240 of 1,111 patients (21.6%) in the second quartile (lactate to albumin ratio >2.23–3.39), 96 of 1,096 patients (8.8%) in the third quartile (lactate to albumin ratio >3.39–4.70), and 24 of 1,102 patients (2.2%) in the fourth quartile (lactate to albumin ratio, >4.70). Adjusted odds ratios (95% confidence intervals) for the primary outcome in the second, third, and fourth quartile compared with the first quartile were 0.33 (0.26–0.42), 0.19 (0.14–0.26), and 0.07 (0.04–0.11), respectively.
Conclusion
A statistically significant association between categorization in the lower lactate to albumin ratio quartile group and favorable neurological outcome after OHCA was identified.

Citations

Citations to this article as recorded by  Crossref logo
  • Incremental Value of Adding S100B to NSE for High-Specificity Rule-in of Poor Neurological Outcome After Out-of-Hospital Cardiac Arrest
    Seokjae Hong, Seungho Lee, Jung Soo Park, Jin Hong Min, Changshin Kang, Byung Kook Lee
    Journal of Clinical Medicine.2026; 15(8): 3043.     CrossRef
  • The value of lactate-to-albumin ratio in predicting fatigue and in-hospital mortality in patients with heart failure: A retrospective study
    Xiaoting Zheng, Xingwang Yao
    Heart & Lung.2026; 79: 102842.     CrossRef
  • Serum lactate/albumin ratio at hospital arrival and neurological outcomes in patients who received targeted temperature management after out‐of‐hospital cardiac arrest: A nationwide, multicenter, observational study
    Tetsuro Nishimura, Toshinari Kawama, Toshihiro Hatakeyama, Takashi Sano, Koki Nakada, Tasuku Matsuyama, Takeyuki Kiguchi, Tetsuhisa Kitamura, Benjamin Worth Berg, Hisao Matsushima
    Hong Kong Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • 3,550 View
  • 49 Download
  • 3 Web of Science
  • 3 Crossref

Review Article

The landscape of experimental cardiac arrest research models in rats: a bibliometric analysis of the 100 most cited articles
Georgios Mavrovounis, Maria Mermiri, Ioannis Drivas, Konstantinos Drivas, Theodosis Kalamatianos, Sotirios G. Zarogiannis, Ioannis Pantazopoulos
Clin Exp Emerg Med 2025;12(3):198-211.   Published online January 14, 2025
DOI: https://doi.org/10.15441/ceem.24.290

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The landscape of experimental cardiac arrest research models in rats: a bibliometric analysis of the 100 most cited articles
Clin Exp Emerg Med. 2025;12(3):198-211.   Published online January 14, 2025
DOI: https://doi.org/10.15441/ceem.24.290
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The landscape of experimental cardiac arrest research models in rats: a bibliometric analysis of the 100 most cited articles
Clin Exp Emerg Med. 2025;12(3):198-211.   Published online January 14, 2025
DOI: https://doi.org/10.15441/ceem.24.290
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This bibliometric analysis of the 100 most cited articles on experimental cardiac arrest models in rats identifies key contributors, publication trends, research themes, and collaboration networks. A comprehensive literature search of the Web of Science database was performed on June 11, 2024, using keywords related to cardiac arrest and rat models. The top 100 most cited articles were analyzed using the biblioshiny web application from the bibliometrix R ver. 4.2.3 and categorized by primary research focus. The articles were published from 1980 to 2022 and involved 416 authors and 44 journals, averaging 106.7 citations each. The primary research themes were neurology (72%), organ transplantation (7%), cardiovascular system (6%), Cardiopulmonary resuscitation outcomes after local anesthetic toxicity (4%), and other topics (5%). The United States, Japan, and Germany were leading contributors. Major clusters identified include “cerebral ischemia and outcomes,” “brain imaging metrics,” and “blood brain barrier.” The most commonly used methodologies for cardiac arrest induction were asphyxia, induction by magnesium or potassium chloride, and electrical stimulation. This first bibliometric analysis on this topic reveals the dominance of neuroscience in experimental cardiac arrest models in rats. High-impact journals such as the Journal of Cerebral Blood Flow and Metabolism play critical roles in disseminating significant research. The study highlights substantial gaps in global research engagement, with minimal contributions from lower income countries and few international collaborations. This analysis provides a roadmap for future research and opportunities for more extensive international and interdisciplinary collaboration, always with a focus on scientific rigor.
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Case Report

Pediatrics | Resuscitation

Nonocclusive mesenteric ischemia in a toddler during hypothermia after cardiac arrest: a case report
Koji Kanno, Kentaro Watanabe, Yu Kanokogi, Marina Tsujimura, Akira Yoshida, Tomoya Hanada, Yuji Yamagami, Yusuke Ito
Clin Exp Emerg Med 2025;12(2):169-172.   Published online September 6, 2024
DOI: https://doi.org/10.15441/ceem.24.213

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Nonocclusive mesenteric ischemia in a toddler during hypothermia after cardiac arrest: a case report
Clin Exp Emerg Med. 2025;12(2):169-172.   Published online September 6, 2024
DOI: https://doi.org/10.15441/ceem.24.213
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Nonocclusive mesenteric ischemia in a toddler during hypothermia after cardiac arrest: a case report
Clin Exp Emerg Med. 2025;12(2):169-172.   Published online September 6, 2024
DOI: https://doi.org/10.15441/ceem.24.213
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While nonocclusive mesenteric ischemia (NOMI) has been reported in a significant percentage of adults who were resuscitated after cardiac arrest, it is rare in children. This report presents the first known Japanese case of pediatric NOMI after return of spontaneous circulation following cardiac arrest. A 16-month-old boy experienced cardiac arrest due to asphyxiation from foreign bodies in the airway. After receiving 10 doses of adrenaline, with a maximum arrest time of 95 minutes, the patient achieved return of spontaneous circulation. However, 40 hours after onset, the patient developed NOMI, resulting in refractory hypotensive shock with decreased blood pressure, distended abdomen, and increased intravesical pressure. The patient was successfully rescued with two laparotomies and was discharged. Although NOMI is uncommon in children, appropriate treatment can be lifesaving.

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  • Intestinal necrosis due to nonocclusive mesenteric ischemia in a child with Mycoplasma pneumoniae pneumonia: a case report
    Xuejing Li, Tingting Lin, Ken Chen, Danli Wang, Jiahui Yu, Lei Wu, Lanfang Tang
    BMC Infectious Diseases.2025;[Epub]     CrossRef
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  • 1 Crossref

Review Article

Education & Simulation | Resuscitation

Simulation intervention related to family presence during resuscitation for physicians and medical students: a scoping review
Kyung Hye Park, Jannet J. Lee-Jayaram, Melissa K. Kahili-Heede, Benjamin W. Berg
Clin Exp Emerg Med 2025;12(1):16-25.   Published online July 19, 2024
DOI: https://doi.org/10.15441/ceem.24.224

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Simulation intervention related to family presence during resuscitation for physicians and medical students: a scoping review
Clin Exp Emerg Med. 2025;12(1):16-25.   Published online July 19, 2024
DOI: https://doi.org/10.15441/ceem.24.224
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Simulation intervention related to family presence during resuscitation for physicians and medical students: a scoping review
Clin Exp Emerg Med. 2025;12(1):16-25.   Published online July 19, 2024
DOI: https://doi.org/10.15441/ceem.24.224
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Objective
Family presence during resuscitation (FPDR) is an established part of family-centered care. However, how physicians are educated about FPDR is relatively unclear. We aim to review the current status of FPDR simulation for physicians and medical students. Methods A scoping review of literature published from 1999 to May 5, 2023, and written in English was undertaken. Articles were searched for using combinations of various family-, resuscitation-, and simulation-related words as keywords, respectively. Results Eight articles were included in the final review. This review of FPDR simulation for physicians and medical students revealed findings in three categories: measuring cardiopulmonary resuscitation quality, investigating participant responses after FPDR simulation, and extracting exemplar good-communication elements. First, in four studies measuring resuscitation quality, physicians participated in adult resuscitation, and resuscitation quality was reduced with a family witness showing an overt reaction. Second, in three studies investigating the response to simulation training, interprofessional teams participating in pediatric resuscitation had negative responses to FPDR simulation. Third, in one study, good-communication elements during FPDR were observed during infant simulation, in which interprofessional teams participated. To the best of our knowledge, FPDR simulation training for medical students has not been reported. Conclusion Our literature review highlights a gap in FPDR simulation involving physicians and/ or medical students. Physicians were more concerned with resuscitation quality than supporting families during resuscitation simulations. Medical students should be considered as participants for FPDR simulation. More high-evidence studies with interprofessional teams that include physicians and/or medical students are needed to evaluate curriculum design and participant-response changes following FPDR simulation.

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  • Serum lactate/albumin ratio at hospital arrival and neurological outcomes in patients who received targeted temperature management after out‐of‐hospital cardiac arrest: A nationwide, multicenter, observational study
    Tetsuro Nishimura, Toshinari Kawama, Toshihiro Hatakeyama, Takashi Sano, Koki Nakada, Tasuku Matsuyama, Takeyuki Kiguchi, Tetsuhisa Kitamura, Benjamin Worth Berg, Hisao Matsushima
    Hong Kong Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Medical students’ experience of culturally diverse family presence during resuscitation simulation
    Kyung Hye Park, Jannet J. Lee-Jayaram, Benjamin W. Berg
    Korean Journal of Medical Education.2025; 37(1): 71.     CrossRef
  • European Resuscitation Council Guidelines 2025 Ethics in Resuscitation
    Violetta Raffay, Johannes Wittig, Leo Bossaert, Jana Djakow, Therese Djärv, Ángel Estella, Ileana Lulic, Spyros D. Mentzelopoulos, Koenraad G. Monsieurs, Patrick Van de Voorde, Kasper G. Lauridsen, Ulrik Kihlbom, Paul Swindell
    Resuscitation.2025; 215: 110734.     CrossRef
  • 5,618 View
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  • 2 Web of Science
  • 3 Crossref

Original Articles

Airway | Critical Care

Development and demonstration of the protective efficacy of a convertible respiratory barrier enclosure: a simulation study
Min Ho Park, Ki Sub Sung, Ji Hoon Kim, Jinwoo Myung, Ju Young Hong
Clin Exp Emerg Med 2024;11(1):59-67.   Published online November 29, 2023
DOI: https://doi.org/10.15441/ceem.23.067

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Development and demonstration of the protective efficacy of a convertible respiratory barrier enclosure: a simulation study
Clin Exp Emerg Med. 2024;11(1):59-67.   Published online November 29, 2023
DOI: https://doi.org/10.15441/ceem.23.067
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Development and demonstration of the protective efficacy of a convertible respiratory barrier enclosure: a simulation study
Clin Exp Emerg Med. 2024;11(1):59-67.   Published online November 29, 2023
DOI: https://doi.org/10.15441/ceem.23.067
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Objective
The efficacy of previously developed respiratory barrier enclosures to limit healthcare workers’ exposure to aerosols from COVID-19 patients remains unclear; in addition, the design of these devices is unsuitable for transportation or other emergency procedures. Therefore, we developed a novel negative pressure respiratory isolator to improve protection from patient-generated aerosols and evaluated its protective effect in conversion to systemic isolator. Methods This in vitro study simulated droplets by nebulizing 1% glycerol + 99% ethanol solution. We performed cardiopulmonary resuscitation (CPR) and converted a respiratory barrier enclosure into a systemic isolator with a respiratory barrier as well as a respiratory barrier with negative pressure generator (NPG), which were compared with control and room air. During the procedure, particles were counted for 30 seconds and the count was repeated 10 times. Results During CPR, the total number of particles in the respiratory barrier with NPG (280,529; interquartile range [IQR], 205,263–359,195; P=0.970) was similar to that in the control (308,789; IQR, 175,056–473,276). Using NPG with a respiratory barrier reduced the number of particles to 27,524 (IQR, 26,703– 28,905; P=0.001). Particle number during conversion of the respiratory barrier into a systemic isolator was also lower than in the control (25,845; IQR, 19,391– 29,772; P=0.001). Conclusion The novel isolator was converted to a systemic isolator without air leakage. The aerosol-blocking effect of the isolator was quantified using a particle counter during CPR. Further studies comparing the barrier effect of isolators within various pressure differentials are warranted.

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  • A New Method Proposed for Analyzing Airflow Dynamics in Negative Pressure Isolation Chambers Using Particle Image Velocimetry
    Min Jae Oh, Jung Min Moon, Seung Cheol Ko, Min Ji Kim, Ki Sub Sung, Jung Woo Lee, Ju Young Hong, Joon Sang Lee, Yong Hyun Kim
    Bioengineering.2025; 12(3): 302.     CrossRef
  • Enhanced Aerosol Containment Performance of a Negative Pressure Hood with an Aerodynamic Cap Design: Multi-Method Validation Using CFD, PAO Particles, and Microbial Testing
    Seungcheol Ko, Kisub Sung, Min Jae Oh, Yoonjic Kim, Min Ji Kim, Jung Woo Lee, Yoo Seok Park, Yong Hyun Kim, Ju Young Hong, Joon Sang Lee
    Bioengineering.2025; 12(6): 624.     CrossRef
  • Enhancing Aerosol Mitigation in Medical Procedures: A CFD-Informed Respiratory Barrier Enclosure
    Ju Young Hong, Seungcheol Ko, Ki Sub Sung, Min Jae Oh, Min Ji Kim, Jung Woo Lee, Yoo Seok Park, Yong Hyun Kim, Joon Sang Lee
    Bioengineering.2024; 11(11): 1104.     CrossRef
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  • 92 Download
  • 3 Web of Science
  • 3 Crossref

Resuscitation | Education & Simulation

An expert consensus–based checklist for quality appraisal of educational resources on adult basic life support: a Delphi study
Alexei Birkun, Adhish Gautam, Bernd W. Böttiger, the Delphi Study Investigators
Clin Exp Emerg Med 2023;10(4):400-409.   Published online August 25, 2023
DOI: https://doi.org/10.15441/ceem.23.049

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An expert consensus–based checklist for quality appraisal of educational resources on adult basic life support: a Delphi study
Clin Exp Emerg Med. 2023;10(4):400-409.   Published online August 25, 2023
DOI: https://doi.org/10.15441/ceem.23.049
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An expert consensus–based checklist for quality appraisal of educational resources on adult basic life support: a Delphi study
Clin Exp Emerg Med. 2023;10(4):400-409.   Published online August 25, 2023
DOI: https://doi.org/10.15441/ceem.23.049
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Objective
Given the lack of a unified tool for appraising the quality of educational resources for lay-rescuer delivery of adult basic life support (BLS), this study aimed to develop an appropriate evaluation checklist based on a consensus of international experts.
Methods
In a two-round Delphi study, participating experts completed questionnaires to rate each item of a predeveloped 72-item checklist indicating agreement that an item should be utilized to evaluate the conformance of an adult BLS educational resource with resuscitation guidelines. Consensus on item inclusion was defined as a rating of ≥7 points from ≥75% of experts. Experts were encouraged to add anonymous suggestions for modifying or adding new items.
Results
Of the 46 participants, 42 (91.3%) completed the first round (representatives of 25 countries with a median of 16 years of professional experience in resuscitation) and 40 (87.0%) completed the second round. Thirteen of 72 baseline items were excluded, 55 were included unchanged, four were included after modification, and four new items were added. The final checklist comprises 63 items under the subsections “safety” (one item), “recognition” (nine items), “call for help” (four items), “chest compressions” (12 items), “rescue breathing” (12 items), “defibrillation” (nine items), “continuation of CPR” (two items), “choking” (10 items) and “miscellaneous” (four items).
Conclusion
The produced checklist is a ready-to-use expert consensus–based tool for appraising the quality of educational content on lay-rescuer provision of adult BLS. The checklist gives content developers a tool to ensure educational resources comply with current resuscitation knowledge, and may serve as a component of a prospective standardized international framework for quality assurance in resuscitation education.

Citations

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  • Enhancing virtual reality applications for adult basic life support: insights from a comparative analysis
    Nino Fijačko, Benjamin S. Abella, Vinay M. Nadkarni, Špela Metličar, Anne-Astrid Agten, Robert Greif
    Virtual Reality.2026;[Epub]     CrossRef
  • ‘Making the Implicit Explicit’: The Recommended Steps of a Caesarean Section, a Delphi Study Among South African Experts
    Liesl de Waard, Rozemiek Neline Hannelore Wessels, Anke Heitkamp, Thomas van den Akker, G. S. Gebhardt, Karuna Sharma
    Obstetrics and Gynecology International.2026;[Epub]     CrossRef
  • Digital Misinformation on Basic Life Support: Quality Issues of Lay Educational Content Presented on Popular Websites
    Alexei A. Birkun, Adhish Gautam
    Journal of Consumer Health on the Internet.2026; : 1.     CrossRef
  • Bystander interventions and clinical outcomes among adult out-of-hospital cardiac arrest victims in South Korea over a decade: Sex-based disparities
    Kyung Hun Yoo, Jaehoon Oh, Tae Ho Lim, Hyunggoo Kang, Byuk Sung Ko, Yongil Cho, Juncheol Lee
    Public Health.2025; 242: 7.     CrossRef
  • Lack of attention to bystander first aid in mass media reports on potentially avoidable deaths
    Alexei A. Birkun, Adhish Gautam
    Journal of Emergency Management.2025; 23(4): 537.     CrossRef
  • A Delphi Consensus Checklist for Evaluating the Quality of Snakebite First Aid Education Materials
    Adhish Gautam, Alexei A. Birkun
    Tropical Medicine & International Health.2025; 30(12): 1313.     CrossRef
  • Detection and Evaluation for High-Quality Cardiopulmonary Resuscitation Based on a Three-Dimensional Motion Capture System: A Feasibility Study
    Xingyi Tang, Yan Wang, Haoming Ma, Aoqi Wang, You Zhou, Sijia Li, Runyuan Pei, Hongzhen Cui, Yunfeng Peng, Meihua Piao
    Sensors.2024; 24(7): 2154.     CrossRef
  • Popular websites as a source of misinformation on first aid in foreign body airway obstruction
    Alexei Birkun, Adhish Gautam
    Clinical and Experimental Emergency Medicine.2024; 11(3): 318.     CrossRef
  • Quality of publicly available information on the principles and methods of first aid in cardiac arrest: a structured analysis of Russian-language web resources
    A. A. Birkun, G. V. Ivanova
    Russian Journal of Cardiology.2024; 29(9): 5971.     CrossRef
  • Wikipedia is a highly accessed although unreliable source of knowledge on cardiopulmonary resuscitation
    Alexei Birkun
    Clinical and Experimental Emergency Medicine.2024; 11(4): 392.     CrossRef
  • Quality of publicly available information on the principles and methods of first aid in cardiac arrest: a structured analysis of Russian-language web resources
    A. A. Birkun, G. V. Ivanova
    Russian Journal of Cardiology.2024; 29(9): 5971.     CrossRef
  • 8,797 View
  • 228 Download
  • 8 Web of Science
  • 11 Crossref

Review Articles

Expert opinion on evidence after the 2020 Korean Cardiopulmonary Resuscitation Guidelines: a secondary publication
Sung Phil Chung, Youdong Sohn, Jisook Lee, Youngsuk Cho, Kyoung-Chul Cha, Ju Sun Heo, Ai-Rhan Ellen Kim, Jae Guk Kim, Han-Suk Kim, Hyungoo Shin, Chiwon Ahn, Ho Geol Woo, Byung Kook Lee, Yong Soo Jang, Yu Hyeon Choi, Sung Oh Hwang, on behalf of the Guideline Committee of the Korean Association of Cardiopulmonary Resuscitation (KACPR)
Clin Exp Emerg Med 2023;10(4):382-392.   Published online August 25, 2023
DOI: https://doi.org/10.15441/ceem.23.102

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Expert opinion on evidence after the 2020 Korean Cardiopulmonary Resuscitation Guidelines: a secondary publication
Clin Exp Emerg Med. 2023;10(4):382-392.   Published online August 25, 2023
DOI: https://doi.org/10.15441/ceem.23.102
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Expert opinion on evidence after the 2020 Korean Cardiopulmonary Resuscitation Guidelines: a secondary publication
Clin Exp Emerg Med. 2023;10(4):382-392.   Published online August 25, 2023
DOI: https://doi.org/10.15441/ceem.23.102
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Considerable evidence has been published since the 2020 Korean Cardiopulmonary Resuscitation Guidelines were reported. The International Liaison Committee on Resuscitation (ILCOR) also publishes the Consensus on CPR and Emergency Cardiovascular Care Science with Treatment Recommendations (CoSTR) summary annually. This review provides expert opinions by reviewing the recent evidence on CPR and ILCOR treatment recommendations. The authors reviewed the CoSTR summary published by ILCOR in 2021 and 2022. PICO (patient, intervention, comparison, outcome) questions for each topic were reviewed using a systemic or scoping review methodology. Two experts were appointed for each question and reviewed the topic independently. Topics suggested by the reviewers for revision or additional description of the guidelines were discussed at a consensus conference. Forty-three questions were reviewed, including 15 on basic life support, seven on advanced life support, two on pediatric life support, 11 on neonatal life support, six on education and teams, one on first aid, and one related to COVID-19. Finally, the current Korean CPR Guideline was maintained for 28 questions, and expert opinions were suggested for 15 questions.

Citations

Citations to this article as recorded by  Crossref logo
  • 2026 Systematic Review of Evidence-Based Guidelines for Prehospital Care
    Christian Martin-Gill, P. Daniel Patterson, Christopher T. Richards, Samuel T. Bishop, Benjamin T. Potts, Rebecca E. Cash
    Prehospital Emergency Care.2026; : 1.     CrossRef
  • Bystander interventions and clinical outcomes among adult out-of-hospital cardiac arrest victims in South Korea over a decade: Sex-based disparities
    Kyung Hun Yoo, Jaehoon Oh, Tae Ho Lim, Hyunggoo Kang, Byuk Sung Ko, Yongil Cho, Juncheol Lee
    Public Health.2025; 242: 7.     CrossRef
  • A critical reappraisal of vasopressin and steroids in in-hospital cardiac arrest
    Spyros D. Mentzelopoulos, Athanasios Chalkias
    Critical Care.2024;[Epub]     CrossRef
  • Management of post-cardiac arrest syndrome
    Mi-Jin Lee
    Journal of the Korean Medical Association.2023; 66(9): 545.     CrossRef
  • 9,322 View
  • 251 Download
  • 3 Web of Science
  • 4 Crossref
Benefits, key protocol components, and considerations for successful implementation of extracorporeal cardiopulmonary resuscitation: a review of the recent literature
Kyung Woon Jeung, Yong Hun Jung, Jorge Antonio Gumucio, David D. Salcido, James J. Menegazzi
Clin Exp Emerg Med 2023;10(3):265-279.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.063

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Benefits, key protocol components, and considerations for successful implementation of extracorporeal cardiopulmonary resuscitation: a review of the recent literature
Clin Exp Emerg Med. 2023;10(3):265-279.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.063
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Benefits, key protocol components, and considerations for successful implementation of extracorporeal cardiopulmonary resuscitation: a review of the recent literature
Clin Exp Emerg Med. 2023;10(3):265-279.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.063
Close
The application of venoarterial extracorporeal membrane oxygenation (ECMO) in patients unresponsive to conventional cardiopulmonary resuscitation (CPR) has significantly increased in recent years. To date, three published randomized trials have investigated the use of extracorporeal CPR (ECPR) in adults with refractory out-of-hospital cardiac arrest. Although these trials reported inconsistent results, they suggest that ECPR may have a significant survival benefit over conventional CPR in selected patients only when performed with strict protocol adherence in experienced emergency medical services–hospital systems. Several studies suggest that identifying suitable ECPR candidates and reducing the time from cardiac arrest to ECMO initiation are key to successful outcomes. Prehospital ECPR or the rendezvous approach may allow more patients to receive ECPR within acceptable timeframes than ECPR initiation on arrival at a capable hospital. ECPR is only one part of the system of care for resuscitation of cardiac arrest victims. Optimizing the chain of survival is critical to improving outcomes of patients receiving ECPR. Further studies are needed to find the optimal strategy for the use of ECPR.

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  • Safety and Efficacy of Stored Wet-Preprimed Extracorporeal Membrane Oxygenation Circuits: A Scoping Review
    Nicolas Sieben, Robert Nicholson, Jason Pincus, Jayesh Dhanani, Kiran Shekar, Lars Eriksson, Kevin Laupland, Mahesh Ramanan
    ASAIO Journal.2026; 72(5): 366.     CrossRef
  • Determining Access for a City‐Wide Extracorporeal Cardiopulmonary Resuscitation (ECPR) Initiative Using Geospatial Analysis
    Christiana K. Prucnal, Melissa A. Meeker, Rebecca E. Cash, Erica L. Nelson, P. Gregg Greenough, Stephen D. Hallisey, Annette M. Ilg, Christopher Kabrhel, Raghu R. Seethala, Paul S. Jansson
    Academic Emergency Medicine.2026;[Epub]     CrossRef
  • Intravenous oxygen microbubbles during cardiopulmonary resuscitation: a mechanistic simulation study
    Henrique Mendes, Marc Zentar, Rafael H. Melo
    Resuscitation.2026; : 111271.     CrossRef
  • Extra-corporeal-cardiopulmonary-resuscitation vs. conventional-cardiopulmonary-resuscitation: an in-depth look into short- and long-term neurological outcomes
    Farah Yasmin, Asad Ur Rab, Afia Salman, Muhammad Ahmed Ali Fahim, Hafsah Alim Ur Rahman, Abdul Moeed, Eman Ali, Muhammad Sohaib Asghar, Iqbal Ratnani, Salim Surani
    Journal of Cardiothoracic Surgery.2025;[Epub]     CrossRef
  • Cardiac arrest, stony heart, and cardiopulmonary resuscitation: An updated revisit
    Ayman El-Menyar, Bianca M Wahlen
    World Journal of Cardiology.2024; 16(3): 126.     CrossRef
  • Clinical Practice of Pre-Assembling and Storing of Extracorporeal Membrane Oxygenation Systems
    Patrick Winnersbach, Alexander Wallraff, Marlene Schadow, Rolf Rossaint, Rüdger Kopp, Christian Bleilevens, Lasse J. Strudthoff
    ASAIO Journal.2024; 70(11): 979.     CrossRef
  • Variability in patient selection criteria across extracorporeal cardiopulmonary resuscitation (ECPR) systems: A systematic review
    Amani Alenazi, Mohammed Aljanoubi, Joyce Yeung, Jason Madan, Samantha Johnson, Keith Couper
    Resuscitation.2024; 204: 110403.     CrossRef
  • External validation of a modified cardiovascular sequential organ failure assessment score in patients with suspected infection using the MIMIC-IV database
    Sung Yeon Hwang, Inkyu Kim, Byuk Sung Ko, Seung Mok Ryoo, Eunah Han, Hui Jai Lee, Daun Jeong, Tae Gun Shin, Kyuseok Kim, Vipa Thanachartwet
    PLOS ONE.2024; 19(11): e0312185.     CrossRef
  • 15,186 View
  • 330 Download
  • 9 Web of Science
  • 8 Crossref
Intra-arrest transesophageal echocardiography during cardiopulmonary resuscitation
Sung Oh Hwang, Woo Jin Jung, Young-Il Roh, Kyoung-Chul Cha
Clin Exp Emerg Med 2022;9(4):271-280.   Published online December 7, 2022
DOI: https://doi.org/10.15441/ceem.22.399

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Intra-arrest transesophageal echocardiography during cardiopulmonary resuscitation
Clin Exp Emerg Med. 2022;9(4):271-280.   Published online December 7, 2022
DOI: https://doi.org/10.15441/ceem.22.399
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Intra-arrest transesophageal echocardiography during cardiopulmonary resuscitation
Clin Exp Emerg Med. 2022;9(4):271-280.   Published online December 7, 2022
DOI: https://doi.org/10.15441/ceem.22.399
Close
Determining the cause of cardiac arrest (CA) and the heart status during CA is crucial for its treatment. Transesophageal echocardiography (TEE) is an imaging method that facilitates close observation of the heart without interfering with cardiopulmonary resuscitation (CPR). Intra-arrest TEE is a point-of-care ultrasound technique that is used during CPR. Intra-arrest TEE is performed to diagnose the cause of CA, determine the presence of cardiac contraction, evaluate the quality of CPR, assist with catheter insertion, and explore the mechanism of blood flow during CPR. The common causes of CA diagnosed using intra-arrest TEE include cardiac tamponade, aortic dissection, pulmonary embolism, and intracardiac thrombus, which can be observed on a few simple image planes at the mid-esophageal and upper esophageal positions. To operate an intra-arrest TEE program, it is necessary to secure a physician who is capable of performing TEE, provide appropriate training, establish implementation protocols, and prepare a plan in collaboration with the CPR team.

Citations

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  • Safety Evaluation of an Alternative Chest Compression Landmark for Cardiopulmonary Resuscitation: A Cadaveric Randomized Controlled Trial
    Kairawee Charoengan, Theerapon Tangsuwanaruk, Borwon Wittayachamnankul, Juntima Euathrongchit, Tanop Srisuwan, Tawachai Monum, Rudklao Sairai, Pimpan Usawasuraiin
    Prehospital Emergency Care.2026; 30(3): 401.     CrossRef
  • Transesophageal echocardiography in cardiac arrest: why, how, when, and where in clinical practice
    Luigi Vetrugno, Cristian Deana, Enrico Boero, Daniele Guerino Biasucci, Sean Scott, Flavio Bassi, Corrado Fiore, Yoshihisa Morita, Sabina Caciolli, Marinella Zanierato, Elena Giovanna Bignami, Stefano Romagnoli
    Journal of Anesthesia, Analgesia and Critical Care.2026;[Epub]     CrossRef
  • Transesophageal Echocardiography for Pulse Evaluation during Cardiopulmonary Resuscitation
    Semih Musa Coşkun, Mehmet Göktuğ Efgan, Ejder Saylav Bora, Serkan Bilgin, Adnan Yamanoğlu, Zeynep Karakaya
    The Journal of Emergency Medicine.2026; 87: 51.     CrossRef
  • Real-time identification of aetiology in patients able to undergo transoesophageal echocardiography with non-traumatic out-of-hospital cardiac arrest in China: a prospective, single-centre exploratory study
    PengHui Du, Xiong Liu, Qingliu Zheng, Liren Lai, Siyao Liu, Jiyan Lin
    Emergency Medicine Journal.2026; : emermed-2025-215837.     CrossRef
  • Resuscitative Point-of-Care Ultrasound in Cardiac Arrest: Current Evidence and Clinical Applications
    Michael P. Merren, Katrina Augustin, Juan G. Ripoll, Harish A. Kinni, Nathan Vinzant, Samuel I. Garcia, Jacopo D'Andria Ursoleo, Christoph G. Nabzdyk, Lattawat Eauchai, Harish Ramakrishna, Omar Elmadhoun
    Journal of Cardiothoracic and Vascular Anesthesia.2026;[Epub]     CrossRef
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    Jun Wang, Wulan Li, Qian Liu
    Asian Journal of Surgery.2025; 48(5): 3391.     CrossRef
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    Brett J Wakefield, Nakul Kumar, Andrew Shaw
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    Carsten Lott, Vlasios Karageorgos, Cristian Abelairas-Gomez, Annette Alfonzo, Joost Bierens, Steve Cantellow, Guillaume Debaty, Sharon Einav, Matthias Fischer, Violeta González-Salvado, Robert Greif, Bibiana Metelmann, Camilla Metelmann, Tim Meyer, Peter
    Resuscitation.2025; 215: 110753.     CrossRef
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    Debora Emanuela Torre, Carmelo Pirri
    Biomedicines.2025; 13(11): 2680.     CrossRef
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    Toshiya Yoshida, Shunichi Doi, Keisuke Kida, Masaki Izumo
    BMJ Case Reports.2024; 17(1): e258734.     CrossRef
  • Optimal Chest Compression Point During Pediatric Resuscitation: Implications for Pediatric Resuscitation Practice by CT Scans*
    Christine Eimer, Monika Huhndorf, Ole Sattler, Maximilian Feth, Olav Jansen, Jan-Thorsten Gräsner, Ulf Lorenzen, Martin Albrecht, Matthias Grünewald, Florian Reifferscheid, Stephan Seewald
    Pediatric Critical Care Medicine.2024; 25(10): 928.     CrossRef
  • Rapid identification of pulmonary embolism during cardiopulmonary resuscitation using transesophageal echocardiography
    Yi-Kai Fu, Yu-Chen Chiu, Sheng-En Chu, Chih-Jung Chang, Jen-Tang Sun
    Internal and Emergency Medicine.2024; 19(8): 2359.     CrossRef
  • Cardiopulmonary Resuscitation: Push Hard, Push Fast, But Where to Push?*
    Lindsay N. Shepard, Akira Nishisaki
    Pediatric Critical Care Medicine.2024; 25(10): 973.     CrossRef
  • Feasibility of resuscitative transesophageal echocardiography at out-of-hospital emergency scenes of cardiac arrest
    Mario Krammel, Thomas Hamp, Christina Hafner, Ingrid Magnet, Michael Poppe, Peter Marhofer
    Scientific Reports.2023;[Epub]     CrossRef
  • 10,788 View
  • 294 Download
  • 13 Web of Science
  • 14 Crossref

Study Protocol

Augmented-Medication CardioPulmonary Resuscitation (AMCPR) trial: a study protocol for a randomized controlled trial
Dong Kun Oh, June-sung Kim, Seung Mok Ryoo, Youn-Jung Kim, Sang Min Kim, Seok In Hong, Bora Chae, Won Young Kim
Clin Exp Emerg Med 2022;9(4):361-366.   Published online November 2, 2022
DOI: https://doi.org/10.15441/ceem.22.367

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Augmented-Medication CardioPulmonary Resuscitation (AMCPR) trial: a study protocol for a randomized controlled trial
Clin Exp Emerg Med. 2022;9(4):361-366.   Published online November 2, 2022
DOI: https://doi.org/10.15441/ceem.22.367
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Augmented-Medication CardioPulmonary Resuscitation (AMCPR) trial: a study protocol for a randomized controlled trial
Clin Exp Emerg Med. 2022;9(4):361-366.   Published online November 2, 2022
DOI: https://doi.org/10.15441/ceem.22.367
Close
Objective
Clinical trials on demodynamic-directed cardiopulmonary resuscitation have been limited. The aim of this study is to investigate whether Augmented-Medication CardioPulmonary Resuscitation (AMCPR) would improve the odds of return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest.
Methods
This is a double-blind, single-center, randomized placebo-controlled trial that will be conducted in the emergency department of a tertiary, university-affiliated hospital in Seoul, Korea. A total of 148 adult patients with nontraumatic, nonshockable, out-of-hospital cardiac arrest who have an initial diastolic blood pressure above 20 mmHg will be randomly assigned to two groups of 74 patients (a 1:1 ratio). Patients will receive an intravenous dose of 40 IU of vasopressin with epinephrine, or a placebo with epinephrine. The primary endpoint is a sustained ROSC (over 20 minutes). Secondary endpoints are enhanced diastolic blood pressure, end-tidal carbon dioxide levels, acidosis, and lactate levels during resuscitation.
Discussion
AMCPR is a trial about tailored medication for select patients during resuscitation. This is the first randomized control trial to identify patients who would benefit from vasopressin for achieving ROSC. This study will provide evidence about the effect of administration of vasopressin with epinephrine to increase ROSC rate. Trial registration ClinicalTrials.gov identifier: NCT03191240. Registered on June 19, 2017.

Citations

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  • Arterial blood gas parameters during cardiopulmonary resuscitation and sustained return of spontaneous circulation in out-of-hospital cardiac arrest: a preplanned secondary analysis of the AMCPR trial
    June-Sung Kim, Youn-Jung Kim, Won Young Kim
    Resuscitation.2026; : 111266.     CrossRef
  • Diastolic blood pressures and end tidal carbon dioxides during cardiopulmonary resuscitations and their association with outcomes in adult out-of-hospital cardiac arrest patients: A preplanned secondary analysis of the Augmented Medication CardioPulmonary
    June-sung Kim, Youn-Jung Kim, Seok In Hong, Sang-Min Kim, Bora Chae, Seung Mok Ryoo, Won Young Kim
    Resuscitation.2025; 210: 110537.     CrossRef
  • The hemodynamic response to epinephrine during CPR: a renewed call for precision resuscitation
    Ryan W. Morgan, Robert A. Berg
    Resuscitation.2025; 212: 110635.     CrossRef
  • Combined end-tidal CO2 and diastolic blood pressure–guided CPR improves survival from cardiac arrest in porcine model
    Tangxing Jiang, Yijun Sun, Huidan Zhang, Qirui Zhang, Shuyao Tang, Xu Niu, Yunyun Guo, Ke Li, Yuguo Chen, Feng Xu
    Resuscitation.2025; 216: 110745.     CrossRef
  • Augmented-Medication CardioPulmonary Resuscitation Trials in out-of-hospital cardiac arrest: a pilot randomized controlled trial
    June-sung Kim, Seung Mok Ryoo, Youn-Jung Kim, Chang Hwan Sohn, Shin Ahn, Dong Woo Seo, Seok In Hong, Sang-Min Kim, Bora Chae, Won Young Kim
    Critical Care.2022;[Epub]     CrossRef
  • 7,921 View
  • 198 Download
  • 4 Web of Science
  • 5 Crossref

Systematic Review

Effect of corticosteroid administration on cardiac arrest: a systematic review and network meta-analysis of the timing of administration
Youngchan Pyo, Tae Nyoung Chung
Clin Exp Emerg Med 2022;9(4):286-295.   Published online October 14, 2022
DOI: https://doi.org/10.15441/ceem.22.371

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Effect of corticosteroid administration on cardiac arrest: a systematic review and network meta-analysis of the timing of administration
Clin Exp Emerg Med. 2022;9(4):286-295.   Published online October 14, 2022
DOI: https://doi.org/10.15441/ceem.22.371
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Effect of corticosteroid administration on cardiac arrest: a systematic review and network meta-analysis of the timing of administration
Clin Exp Emerg Med. 2022;9(4):286-295.   Published online October 14, 2022
DOI: https://doi.org/10.15441/ceem.22.371
Close
Corticosteroids may have a beneficial effect on the outcome of cardiac arrest (CA); however, it is not known whether the timing of corticosteroid use affects the outcome. We performed a systematic review and network meta-analysis to compare the efficacy of corticosteroid administration according to the timing. A favorable final outcome, as the primary study outcome, was defined as a combination of survival with good neurologic outcome and survival for 1 year. The secondary outcome was survival to discharge. Nine clinical studies were included. Corticosteroids administered during cardiopulmonary resuscitation (CPR; odds ratio [OR], 1.29; 95% confidence interval [CI], 1.11–1.51) and post-CA (OR, 1.47; 95% CI, 1.30–1.66) had a positive effect on the favorable final outcome compared to the control protocol (no corticosteroid administration), while those used prior to CA had a negative effect. Corticosteroids administered post-CA had a positive effect on survival to discharge compared to the control protocol (OR, 1.82; 95% CI, 1.02–3.27), while those used prior to CA and during CPR had no significant effect. Post-CA was evaluated to be the best administration timing for both outcomes. In conclusion, the timing of corticosteroid administration may be an important factor for the prognosis of CA. Corticosteroids administration post-CA and during CPR may have beneficial effects on CA outcomes.

Citations

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  • Comparative effectiveness of vasopressin, steroids, and epinephrine-based regimens in cardiac arrest: A network Meta-analysis of clinical trials
    Fatemeh Saghafi, Mohammad Hossein Dehghani, Sajjad Erami, Amin Salehi-Abargouei, Mohammad Ali Omrani, Farahnaz Hoseinzade, Maryam Shojaeifard, Adeleh Sahebnasagh
    The American Journal of Emergency Medicine.2026; 99: 155.     CrossRef
  • Hydrocortisone improves post-resuscitation myocardial dysfunction by inhibiting the NF-κB pathway
    Yaqin Fang, Fenglin Song, Chunyan Gao, Zhiming Wang
    Biochemistry and Cell Biology.2025; 103: 1.     CrossRef
  • Steroid, thiamine, and ascorbic acid during post-resuscitation period for comatose out-of-hospital cardiac arrest survivors (STAR) trial: Protocol for a clinical trial
    Youn-Jung Kim, Byuk Sung Ko, Young-Il Roh, Yong Hwan Kim, Won Young Kim, Jean Baptiste Lascarrou
    PLOS ONE.2025; 20(4): e0319733.     CrossRef
  • Paciente cardiaco con asistolia: un reporte de caso
    Magaly Luna, María Morgado, Gloria Pogyo
    Religación.2024; 9(39): e2401177.     CrossRef
  • Protective role of kallistatin in oxygen-glucose deprivation and reoxygenation in human umbilical vein endothelial cells
    Young Woo Um, Woon Yong Kwon, Seung-Yong Seong, Gil Joon Suh
    Clinical and Experimental Emergency Medicine.2024; 11(1): 43.     CrossRef
  • 10,229 View
  • 314 Download
  • 4 Web of Science
  • 5 Crossref

Original Article

Emergency Medical Services | Resuscitation

The number and level of first-contact emergency medical services crew and clinical outcomes in out-of-hospital cardiac arrest with dual dispatch response
Young Su Kim, Ki Hong Kim, Kyoung Jun Song, Sang Do Shin, Jeong Ho Park
Clin Exp Emerg Med 2022;9(4):314-322.   Published online October 7, 2022
DOI: https://doi.org/10.15441/ceem.22.205

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The number and level of first-contact emergency medical services crew and clinical outcomes in out-of-hospital cardiac arrest with dual dispatch response
Clin Exp Emerg Med. 2022;9(4):314-322.   Published online October 7, 2022
DOI: https://doi.org/10.15441/ceem.22.205
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The number and level of first-contact emergency medical services crew and clinical outcomes in out-of-hospital cardiac arrest with dual dispatch response
Clin Exp Emerg Med. 2022;9(4):314-322.   Published online October 7, 2022
DOI: https://doi.org/10.15441/ceem.22.205
Close
Objective
This study aimed to evaluate the association between the number and level of emergency medical technicians (EMTs) in the first-contact emergency medical services (EMS) unit and the clinical outcomes of out-of-hospital cardiac arrest (OHCA) with a dual dispatch response.
Methods
Adult nontraumatic EMS-treated OHCAs between 2015 and 2018 in a nationwide database, were enrolled. The main exposure was the number and certification level of first-contact EMS crew: three versus two members, proportion of EMT intermediate level (EMT-I) over 50% versus under or equal to 50%. Good neurologic recovery was selected as the primary outcome. Multilevel multivariable logistic regression analysis was conducted to calculate adjusted odds ratios and confidence intervals.
Results
A total of 26,867 patients were enrolled and analyzed. Good neurologic recovery was different across the study groups: 5.4% in the two-member crews, 7.2% in the three-member crews, 5.9% in the low EMT-I proportion crews, and 6.8% in the high EMT-I proportion crews. In the main analysis, statistically significant differences for favorable outcomes were found between the three-member and two-member crews, and the high EMT-I proportion and low EMT-I proportion crews; for good neurologic recovery, adjusted odds ratios (95% confidence interval) were 1.23 (1.06–1.43) for three-member crews, and 1.28 (1.17–1.40) for a high EMT-I proportion.
Conclusion
The higher number and level of first-contact EMS crew was associated with better neurologic recovery in adult nontraumatic OHCA with a dual-dispatched EMS response.

Citations

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  • Assessing the need for quality control in direct medical oversight: a survey of emergency medical services providers and medical directors
    Daesung Lim, Sun Hyu Kim, Seong Chun Kim, Song Yi Park, Bongkyu Jeong
    Journal of EMS Medicine.2026; 5(1): 1.     CrossRef
  • Association between multiple‐ambulance dispatches and clinical outcomes for patients with dispatcher‐unrecognized out‐of‐hospital cardiac arrests
    Min Seol Seo, Ki Hong Kim, Tae Han Kim, Jeong Ho Park, Joo Jeong, Young Sun Ro, Ki Jeong Hong, Kyoung Jun Song, Sang Do Shin
    Hong Kong Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Influence of team size on the efficiency of time-critical ALS interventions in prehospital cardiac arrest – A prospective randomised multicentre simulation study
    Sophie Franziska L’habitant, Alina Schenk, Marcus Thudium, Mark Coburn, Alexander Lechleuthner, Florian Piekarski
    Resuscitation Plus.2026; 30: 101384.     CrossRef
  • Association Between the Number of Emergency Medical Services and the Chest Compression Quality in Out-of-Hospital Cardiac Arrest
    Sang A. Yoon, Ki Hong Kim, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee, Ki Jeong Hong, Young Sun Ro, Kyoung Jun Song, Sang Do Shin
    The Journal of Emergency Medicine.2025; 75: 89.     CrossRef
  • European Resuscitation Council Guidelines 2025 Adult Advanced Life Support
    Jasmeet Soar, Bernd W. Böttiger, Pierre Carli, Francesc Carmona Jiménez, Diana Cimpoesu, Gareth Cole, Keith Couper, Sonia D’Arrigo, Charles D. Deakin, Jacqueline Eleonora Ek, Mathias J. Holmberg, Aurora Magliocca, Nikolaos Nikolaou, Peter Paal, Helen Poco
    Resuscitation.2025; 215: 110769.     CrossRef
  • Part 4: Systems of Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
    Cameron Dezfulian, José G. Cabañas, Jason R. Buckley, Rebecca E. Cash, Remle P. Crowe, Ian R. Drennan, Melissa Mahgoub, Candace N. Mannarino, Teresa May, David D. Salcido, Anezi I. Uzendu, Melissa A. Vogelsong, Joshua A. Worth, Saket Girotra
    Circulation.2025;[Epub]     CrossRef
  • Impact of intravenous accessibility and prehospital epinephrine use on survival outcomes of adult nontraumatic out-of-hospital cardiac arrest patients
    Song Yi Park, Byungho Choi, Sun Hyu Kim
    BMC Emergency Medicine.2024;[Epub]     CrossRef
  • Modification of termination of resuscitation rule with compression time interval in South Korea
    Song Yi Park, Daesung Lim, Ji Ho Ryu, Yong Hwan Kim, Byungho Choi, Sun Hyu Kim
    Scientific Reports.2023;[Epub]     CrossRef
  • Impact of COVID-19 on Out-of-Hospital Cardiac Arrest in Korea
    Young Su Kim, Seung Hyo Lee, Hyouk Jae Lim, Won Pyo Hong
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Interaction effects between insomnia and depression on risk of out-of-hospital cardiac arrest: Multi-center study
    Eujene Jung, Hyun Ho Ryu, Sung Wan Kim, Jung Ho Lee, Kyoung Jun Song, Young Sun Ro, Kyoung Chul Cha, Sung Oh Hwang, Billy Morara Tsima
    PLOS ONE.2023; 18(8): e0287915.     CrossRef
  • 8,438 View
  • 209 Download
  • 9 Web of Science
  • 10 Crossref

Case Report

Resuscitation | Obstetrics and Gynecology

Successful full-term delivery after out-of-hospital cardiac arrest during the second trimester of pregnancy: a case report
Bo Ram Kim, Min Young Kim, Hye Sim Kang, Soon Sup Shim, Rina Kim
Clin Exp Emerg Med 2023;10(1):99-103.   Published online September 27, 2022
DOI: https://doi.org/10.15441/ceem.22.302

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Successful full-term delivery after out-of-hospital cardiac arrest during the second trimester of pregnancy: a case report
Clin Exp Emerg Med. 2023;10(1):99-103.   Published online September 27, 2022
DOI: https://doi.org/10.15441/ceem.22.302
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Successful full-term delivery after out-of-hospital cardiac arrest during the second trimester of pregnancy: a case report
Clin Exp Emerg Med. 2023;10(1):99-103.   Published online September 27, 2022
DOI: https://doi.org/10.15441/ceem.22.302
Close
Out-of-hospital cardiac arrest in pregnancy is extremely rare. In this case report, a 43-year-old female patient at 24.0 weeks of gestation collapsed outside her home after cardiac arrest. The paramedics performed cardiopulmonary resuscitation with defibrillation for ventricular fibrillation. Spontaneous circulation was achieved after 19 minutes. The fetus was stable during postarrest care. The patient exhibited high blood pressure with seizure-like symptoms for 2 days afterwards, which resolved with magnesium sulfate. She gradually recovered and returned to her daily activities while on treatment with beta blockers for cardiomyopathy and premature ventricular contractions until delivery. At 37.2 weeks of gestation, she underwent elective Cesarean section under spinal anesthesia. The baby weighed 2.55 kg and did not present with any complications. Here, we report a case of successful full-term delivery in a patient who underwent cardiopulmonary resuscitation for sudden cardiac arrest during the second trimester of pregnancy.

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  • Cardiac arrest and resuscitative cesarean section – A brief review
    Kiranpreet Kaur, Prashant Kumar, Monika Yadav
    Journal of Anaesthesiology Clinical Pharmacology.2026; 42(3): 345.     CrossRef
  • Maternal Cardiac Arrest in Severe Preeclampsia at 34 Weeks: Successful Resuscitation, Perimortem Cesarean Section, and Dual Survival
    Pankaj Deori, Habib Md R Karim, Sekhar J Sharma, Himangshu Malakar, Suvan K Chowdhury , Sristi Kumari, Daisy Hazarika, Namitha M Lal, Rohit Sasidharan
    Cureus.2025;[Epub]     CrossRef
  • 12,755 View
  • 277 Download
  • 1 Web of Science
  • 2 Crossref

Original Article

Neurologic outcomes of prehospital mechanical chest compression device use during transportation of out-of-hospital cardiac arrest patients: a multicenter observational study
Chanhong Min, Dong Eun Lee, Hyun Wook Ryoo, Haewon Jung, Jae Wan Cho, Yun Jeong Kim, Jae Yun Ahn, Jungbae Park, You Ho Mun, Tae Chang Jang, Sang-chan Jin
Clin Exp Emerg Med 2022;9(3):207-215.   Published online August 31, 2022
DOI: https://doi.org/10.15441/ceem.21.142

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Neurologic outcomes of prehospital mechanical chest compression device use during transportation of out-of-hospital cardiac arrest patients: a multicenter observational study
Clin Exp Emerg Med. 2022;9(3):207-215.   Published online August 31, 2022
DOI: https://doi.org/10.15441/ceem.21.142
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Neurologic outcomes of prehospital mechanical chest compression device use during transportation of out-of-hospital cardiac arrest patients: a multicenter observational study
Clin Exp Emerg Med. 2022;9(3):207-215.   Published online August 31, 2022
DOI: https://doi.org/10.15441/ceem.21.142
Close
Objective
High-quality cardiopulmonary resuscitation with chest compression is important for good neurologic outcomes during out-of-hospital cardiac arrest (OHCA). Several types of mechanical chest compression devices have recently been implemented in Korean emergency medical services. This study aimed to identify the effect of prehospital mechanical chest compression device use on the outcomes of OHCA patients.
Methods
We retrospectively analyzed data drawn from the regional cardiac arrest registry in Daegu, Korea. This registry prospectively collected data from January 2017 to December 2020. Patients aged 18 years or older who experienced cardiac arrest presumed to have a medical etiology were included. The exposure variable was the use of a prehospital mechanical device during transportation by emergency medical technicians. The outcomes measured were neurologic outcomes and survival to discharge. Logistic regression analysis was used.
Results
Among 3,230 OHCA patients, 1,111 (34.4%) and 2,119 (65.6%) were managed with manual chest compression and with a mechanical chest compression device, respectively. The mechanical chest compression group showed poorer neurologic outcomes than the manual chest compression group (adjusted odds ratio, 0.12; 95% confidence interval, 0.04–0.33) and decreased survival to discharge (adjusted odds ratio, 0.39; 95% confidence interval, 0.19–0.82) after adjustment for confounding variables.
Conclusion
Prehospital mechanical chest compression device use in OHCA was associated with poorer neurologic outcomes and survival to discharge compared to manual chest compression.

Citations

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  • Adjusting on-scene CPR duration based on transport time interval in out-of-hospital cardiac arrest: a nationwide multicenter study
    Daseul Kim, Jae Yong Yu, Minha Kim, Gun Tak Lee, Sang Do Shin, Sung Yeon Hwang, Daun Jeong
    Scientific Reports.2025;[Epub]     CrossRef
  • Mechanical versus manual cardiopulmonary resuscitation (CPR): an umbrella review of contemporary systematic reviews and more
    Ayman El-Menyar, Mashhood Naduvilekandy, Sandro Rizoli, Salvatore Di Somma, Basar Cander, Sagar Galwankar, Fatimah Lateef, Mohamed Alwi Abdul Rahman, Prabath Nanayakkara, Hassan Al-Thani
    Critical Care.2024;[Epub]     CrossRef
  • Impact of the life-sustaining treatment decision act on organ donation in out-of-hospital cardiac arrests in South Korea: a multi-centre retrospective study
    Min Jae Kim, Dong Eun Lee, Jong Kun Kim, In Hwan Yeo, Haewon Jung, Jung Ho Kim, Tae Chang Jang, Sang-Hun Lee, Jinwook Park, Deokhyeon Kim, Hyun Wook Ryoo
    BMC Medical Ethics.2024;[Epub]     CrossRef
  • Individualized decision making in on-scene resuscitation time for out-of-hospital cardiac arrest using reinforcement learning
    Dong Hyun Choi, Min Hyuk Lim, Ki Jeong Hong, Young Gyun Kim, Jeong Ho Park, Kyoung Jun Song, Sang Do Shin, Sungwan Kim
    npj Digital Medicine.2024;[Epub]     CrossRef
  • Pediatric Chest Compression Improvement Via Augmented Reality Cardiopulmonary Resuscitation Feedback in Community General Emergency Departments: A Mixed-Methods Simulation-Based Pilot Study
    Keith Kleinman, Tai Hairston, Brittany Smith, Emma Billings, Sean Tackett, Eisha Chopra, Nicholas Risko, Daniel Swedien, Blake A. Schreurs, James L. Dean, Brandon Scott, Therese Canares, Justin M. Jeffers
    The Journal of Emergency Medicine.2023; 64(6): 696.     CrossRef
  • 9,316 View
  • 287 Download
  • 7 Web of Science
  • 5 Crossref

Review Article

Global prevalence of cardiopulmonary resuscitation training among the general public: a scoping review
Alexei Birkun, Adhish Gautam, Fatima Trunkwala
Clin Exp Emerg Med 2021;8(4):255-267.   Published online December 31, 2021
DOI: https://doi.org/10.15441/ceem.21.066

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Global prevalence of cardiopulmonary resuscitation training among the general public: a scoping review
Clin Exp Emerg Med. 2021;8(4):255-267.   Published online December 31, 2021
DOI: https://doi.org/10.15441/ceem.21.066
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Global prevalence of cardiopulmonary resuscitation training among the general public: a scoping review
Clin Exp Emerg Med. 2021;8(4):255-267.   Published online December 31, 2021
DOI: https://doi.org/10.15441/ceem.21.066
Close
A scoping review was conducted to identify, map, and analyze international evidence from studies investigating the prevalence of community cardiopulmonary resuscitation (CPR) training. We searched major bibliographic databases and grey literature for original studies evaluating the prevalence of CPR training in the general population. Studies published from January 2000 to October 2020 were included without language or publication type restrictions. Seventy-three eligible papers reported a total of 61 population-based surveys conducted in 29 countries. More than three-fourths of the surveys were conducted in countries with high-income economies, and none in low-income countries. Over half of the surveys were at a subnational level. Globally, the proportion of laypeople trained in CPR varied greatly (median, 40%). For high-income countries, the median percentage was twice as high as that of upper middle-income countries (50% vs. 23%). The studies used heterogeneous survey methods and reporting patterns. Key methodological aspects were frequently not described. In summary, few studies have assessed CPR training prevalence among the general public. The rates of resuscitation training for the vast majority of countries remain unknown. High heterogeneity of studies precludes a reliable interpretation of the research. International Utstein-style consensus guidelines are needed to inform future research and reporting of public resuscitation training worldwide.

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  • Cardiac Arrest Care in Resource-Limited Settings
    Nneoma E. Okonkwo, Ssentamu John Vanglist, Hendry R. Sawe, Pavitra Kotini-Shah, Shada A. Rouhani
    Critical Care Clinics.2026; 42(1): 107.     CrossRef
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    Chaofang Wang, Yali Tong, Shuai Ma, Wenlong Dong, Bin Fan
    Applied Sciences.2026; 16(1): 555.     CrossRef
  • Public awareness of medical emergency telephone numbers: a scoping review
    Alexei A. Birkun
    Clinical and Experimental Emergency Medicine.2026; 13(1): 28.     CrossRef
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    Sabah Hammoud, Raghida Damaj, Racha Daher, George W. Booz, Mazen Kurdi
    European Journal of Emergency Medicine.2026; 33(4): 282.     CrossRef
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    Kaiqi Chen, Ruijing Xu, Huiwen Wang
    Frontiers in Public Health.2026;[Epub]     CrossRef
  • Impact of Middle-Aged Adults’ Recognition of Early Myocardial Infarction Symptoms and Training Experience on Cardiopulmonary Resuscitation Performance: A Cross-Sectional Study
    Dajung Ryu
    International Journal of Environmental Research and Public Health.2025; 22(1): 54.     CrossRef
  • Effectiveness of chain of survival for out-of-hospital-cardiac-arrest (OHCA) in resource limited countries: A systematic review
    Mirza Noor Ali Baig, Zafar Fatmi, Nadeem Ullah Khan, Uzma Rahim Khan, Ahmed Raheem, Junaid Abdul Razzak
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Original Articles

COVID-19 | Resuscitation

Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study
Jae Yun Ahn, Hyun Wook Ryoo, Jae Wan Cho, Jung Ho Kim, Sang-Hun Lee, Tae Chang Jang
Clin Exp Emerg Med 2021;8(2):137-144.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.21.008

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Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study
Clin Exp Emerg Med. 2021;8(2):137-144.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.21.008
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Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study
Clin Exp Emerg Med. 2021;8(2):137-144.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.21.008
Close
Objective
This study aimed to compare the outcomes of adult out-of-hospital cardiac arrest (OHCA) before and after the coronavirus disease 2019 (COVID-19) outbreak in a large metropolitan city.
Methods
This before-and-after observational study used a prospective citywide OHCA registry. Adult patients with emergency medical service-treated OHCA, with presumed cardiac etiology, pre- and post-COVID-19 outbreak were enrolled. The study period spanned 2 months, starting from February 18, 2020. The control period was 2 months from February 18, 2019. The primary and secondary outcomes were good neurologic outcome and survival to hospital discharge, respectively. The association between the COVID-19 outbreak and OHCA outcomes was assessed using multivariable logistic regression analysis.
Results
This study analyzed 297 OHCA patients (control period, 145; study period, 152). The bystander cardiopulmonary resuscitation rates were 64.8% and 60.5% during the control and study periods, respectively. Response and on-scene times increased by 2 minutes, supraglottic airway use increased by 35.6%, and mechanical chest compression device use increased by 13% post-COVID-19 outbreak. Good neurologic outcome was significantly lower during the study period in overall OHCAs (adjusted odds ratio, 0.23; 95% confidence interval, 0.05–0.98) and in witnessed OHCAs (adjusted odds ratio, 0.14; 95% confidence interval, 0.02–0.90). No significant difference was found in the survival to hospital discharge of OHCA patients between the two periods.
Conclusion
During the COVID-19 pandemic, the response and on-scene times were longer, and good neurologic outcome was significantly lower than that in the control period.

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Resuscitation | Public Health & Policy

Public awareness and willingness to use automated external defibrillators in a metropolitan city
Jae Hyuk Lee, Dong Eun Lee, Hyun Wook Ryoo, Sungbae Moon, Jae Wan Cho, Yun Jeong Kim, Jong Kun Kim, Jung Ho Kim, Kyung Woo Lee, Sang-chan Jin, Jun Seok Seo
Clin Exp Emerg Med 2021;8(1):1-8.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.053

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Public awareness and willingness to use automated external defibrillators in a metropolitan city
Clin Exp Emerg Med. 2021;8(1):1-8.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.053
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Public awareness and willingness to use automated external defibrillators in a metropolitan city
Clin Exp Emerg Med. 2021;8(1):1-8.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.053
Close
Objective
Early defibrillation is crucial for the survival of patients with out-of-hospital cardiac arrest. This study aimed to examine the trends and associated factors regarding public awareness and willingness to use automated external defibrillators (AEDs) through citywide surveys.
Methods
Three-round surveys were conducted in February 2012 (n=1,000), December 2016 (n=1,141), and December 2018 (n=1,001) among citizens in Daegu, South Korea, who were aged ≥19 years. The subjects were selected through a three-stage quota sampling. Awareness and willingness to use an AED were assessed in the three groups. The primary outcome was willingness to use AEDs.
Results
Of 3,142 respondents, 3,069 were eligible for analysis. The proportion of respondents who knew how to use AEDs increased from 4.7% in 2012 to 20.8% in 2018. Of the respondents in 2012, 2016, and 2018, 39.7%, 50.0%, and 43.2%, respectively, were willing to use an AED. Factors associated with willingness to use AEDs were male sex (adjusted odds ratio [AOR], 1.39; 95% confidence interval [CI], 1.10–1.75), cardiopulmonary resuscitation training experience in the previous 2 years (AOR, 1.80; 95% CI, 1.43–2.28), recognition of the Good Samaritan law (AOR, 1.45; 95% CI, 1.13–1.86), and awareness of how to use an AED (AOR, 4.40; 95% CI, 3.26–5.93).
Conclusion
To increase willingness to use AEDs, education in AED use and the Good Samaritan law, along with re-education to maintain knowledge of AED use, should be considered.

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    Zi-yun Zhou, Jin-zi Zhang, Xian-qi Zhao, Yu-yao Niu, Jing-bo Zhang, Bojunhao Feng, Pu Ge, Xin-yi Liu, Le-Shan Zhou, Yi-bo Wu
    Journal of Public Health.2024; 32(11): 2105.     CrossRef
  • Health inequalities in cardiopulmonary resuscitation and use of automated electrical defibrillators in out-of-hospital cardiac arrest
    Syeda Anum Zahra, Rozina Yasmin Choudhury, Rameez Naqvi, Adam J Boulton, C. Anwar A. Chahal, Sabrina Munir, Mafalda Carrington, Fabrizio Ricci, Mohammed Y Khanji
    Current Problems in Cardiology.2024; 49(5): 102484.     CrossRef
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    Jielu Zhang, Lan Mu, Donglan Zhang, Janani Rajbhandari-Thapa, Zhuo Chen, José A. Pagán, Yan Li, Heejung Son, Junxiu Liu
    ISPRS International Journal of Geo-Information.2023; 12(3): 91.     CrossRef
  • Knowledge and attitude of the young population towards sudden cardiac arrest: A cross-sectional study
    Sabah Hammoud, Racha Daher, Raghida Damaj, George W. Booz, Mazen Kurdi
    The American Journal of Emergency Medicine.2023; 71: 225.     CrossRef
  • Characteristics and Treatment Outcomes of Out-of-Hospital Cardiac Arrests Occurring in Public Places: A National Population-Based Observational Study
    Young Taeck Oh, Chiwon Ahn
    Journal of Personalized Medicine.2023; 13(8): 1191.     CrossRef
  • The Influence of Cardiac Arrest Floor-Level Location within a Building on Survival Outcomes
    Chiwon Ahn, Young Taeck Oh, Yeonkyung Park, Jae Hwan Kim, Sojune Hwang, Moonho Won
    Journal of Personalized Medicine.2023; 13(8): 1265.     CrossRef
  • Factors and Barriers on Cardiopulmonary Resuscitation and Automated External Defibrillator Willingness to Use among the Community: A 2016–2021 Systematic Review and Data Synthesis
    Amsyar Daud, Azmawati Mohammed Nawi, Azimatun Noor Aizuddin, Mohammad Fadhly Yahya
    Global Heart.2023;[Epub]     CrossRef
  • Acute myocardial infarction diagnosed in emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Shin Ahn, Eunsil Ko, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S42.     CrossRef
  • 13,468 View
  • 210 Download
  • 16 Web of Science
  • 18 Crossref

Education & Simulation | Resuscitation

Outcome of basic life support training among primary school students in Southeast Asia
Chananthon Suwanpairoj, Thanakorn Wongsombut, Kittipitch Maisawat, Nita Torod, Ampaka Jaengkrajan, Natchaya Sritharo, Nattikarn Atthapreyangkul, Borwon Wittayachamnankul
Clin Exp Emerg Med 2020;7(4):245-249.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.095

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Outcome of basic life support training among primary school students in Southeast Asia
Clin Exp Emerg Med. 2020;7(4):245-249.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.095
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Outcome of basic life support training among primary school students in Southeast Asia
Clin Exp Emerg Med. 2020;7(4):245-249.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.095
Close
Objective
This study aimed to evaluate how BLS courses affect primary school students’ knowledge, attitudes, and life support skills; investigate how medical students’ knowledge and competence in teaching BLS can improve by serving as instructors.
Methods
This experimental study was conducted in a rural primary school. First-year medical students conducted a BLS course for grade 4 and 5 primary school students with a 6–7:1 ratio of trainees-to-trainer. All trainers had completed a BLS course before the course. This 3.5-hour simulation-based course covered chest compressions and automated external defibrillator use. The pre- and post-course assessments included multiple choice questions toward BLS, practical skills test, and attitude test. For medical students, evaluation was conducted by attitude test, both pre- and post-teaching.
Results
The mean pre- and post-test scores increased from 5.74±0.10 to 9.43±0.13 (P<0.01). The increase in the scores was the same for both the students and the teachers (3.05±0.60 vs. 3.68±0.16, P=0.33). After the course, more than 90% of the students could perform all the procedures involved in BLS and automated external defibrillation. Medical students showed an improved understanding of CPR and confidence in performing and teaching CPR (both, P<0.01).
Conclusion
Primary school students can learn how to perform BLS through simulation-based learning. Simulation-based training can improve their attitude and provide them with knowledge and crucial skill sets, improving their confidence in performing BLS. Furthermore, teachers’ attitudes and confidence toward CPR improved after teaching CPR.

Citations

Citations to this article as recorded by  Crossref logo
  • Educational strategies and technologies for promoting knowledge, attitude, and practice of children on cardiopulmonary resuscitation: A systematic review
    Glaubervania Alves Lima, Maria Williany Silva Ventura, Thaís Aquino Carneiro, Francisca Elisângela Teixeira Lima, Paula Renata Amorim Lessa Soares, Samila Gomes Ribeiro, Mariana Cavalcante Martins, Luis Angel Cendejas Medina, Ángel López González
    Journal of Pediatric Nursing.2025; 83: 118.     CrossRef
  • To save or not to save: Knowledge, attitude, skills and effects of an experimental intervention on advancing first aid skills in high school students in Hue City, Vietnam
    Le Duc Huy, Pham Thanh Tung, Dinh Thanh Tra, Le Nguyen Quynh Nhu, Nguyen Tuan Linh, Tran Xuan Tien, Nguyen Vu Phuong Thao, Trinh Thi Le Vy, Tran Thi Hang, Huu Hai Hoang, Vo Van Khoa, Nguyen Thi Anh Phuong, Bui Phuong Linh, Trung Quang Nguyen
    PLOS One.2025; 20(4): e0322505.     CrossRef
  • Effectiveness of Basic Life Support Training Program for Knowledge and Skills of Primary School Teachers: A Quasi-experimental Study
    Duangruethai Phraibueng, Mathaka Sriklo, Malinee Youjaiyen
    Pacific Rim International Journal of Nursing Research.2024; 28(2): 240.     CrossRef
  • Six years of spreading BLSD skills in schools: empowering teachers as trainers
    Sara Calicchia, Silvia Capanna, Mariangela De Rosa, Bruno Papaleo, Alessandra Pera
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • Community Interventions for Out-of-Hospital Cardiac Arrest in Resource-Limited Settings: A Scoping Review Across Low, Middle, and High-Income Countries
    Nicholas Grubic, Braeden Hill, Katherine S. Allan, Katie N. Dainty, Amer M. Johri, Steven C. Brooks
    Prehospital Emergency Care.2023; 27(8): 1088.     CrossRef
  • The Effect of Cardiopulmonary Resuscitation (CPR) Education on the CPR Knowledge, Attitudes, Self-Efficacy, and Confidence in Performing CPR among Elementary School Students in Korea
    Jang-Sik Ko, Seon-Rye Kim, Byung-Jun Cho
    Healthcare.2023; 11(14): 2047.     CrossRef
  • Characteristics and Treatment Outcomes of Out-of-Hospital Cardiac Arrests Occurring in Public Places: A National Population-Based Observational Study
    Young Taeck Oh, Chiwon Ahn
    Journal of Personalized Medicine.2023; 13(8): 1191.     CrossRef
  • Methods to teach schoolchildren how to perform and retain cardiopulmonary resuscitation (CPR) skills: A systematic review and meta-analysis
    Katherine S. Allan, Bianca Mammarella, Mika'il Visanji, Erinda Moglica, Negin Sadeghlo, Emma O'Neil, Tiffany T. Chan, Teruko Kishibe, Theresa Aves
    Resuscitation Plus.2023; 15: 100439.     CrossRef
  • High school basic life support training: Is the trainer's experience of cardiopulmonary resuscitation in the actual setting important? A randomized control trial
    Ali Sanati, Ali Ansari Jaberi, Tayebeh Negahban Bonabi
    Journal of Education and Health Promotion.2022;[Epub]     CrossRef
  • Knowledge and attitudes toward basic life support: survey among school teachers
    Cem GUN, Hasan ALDİNC
    Journal of Health Sciences and Medicine.2022; 5(4): 984.     CrossRef
  • 9,045 View
  • 232 Download
  • 10 Web of Science
  • 10 Crossref

Resuscitation | Education & Simulation

Long-term benefits of chest compression-only cardiopulmonary resuscitation training using real-time visual feedback manikins: a randomized simulation study
Tae Chang Jang, Hyun Wook Ryoo, Sungbae Moon, Jae Yun Ahn, Dong Eun Lee, Won Kee Lee, Sang Gyu Kwak, Jung Ho Kim
Clin Exp Emerg Med 2020;7(3):206-212.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.20.022

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Long-term benefits of chest compression-only cardiopulmonary resuscitation training using real-time visual feedback manikins: a randomized simulation study
Clin Exp Emerg Med. 2020;7(3):206-212.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.20.022
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Long-term benefits of chest compression-only cardiopulmonary resuscitation training using real-time visual feedback manikins: a randomized simulation study
Clin Exp Emerg Med. 2020;7(3):206-212.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.20.022
Close
Objective
Cardiopulmonary resuscitation (CPR) education with a feedback device is known to result in better CPR skills compared to one without the feedback device. However, its long-term benefits have not been established. The purpose of this study was to evaluate the long-term CPR skill retention after training using real-time visual manikins in comparison to that of non-feedback manikins.
Methods
We recruited 120 general university students who were randomly divided into the real-time feedback group (RTFG) and the non-feedback group. Of them, 95 (RTFG, 48; non-feedback group, 47) attended basic life support and automated external defibrillation training for 1 hour. For comparison of retention of CPR skills, the two groups were evaluated based on 2-minute chest compression performed immediately after training and at 3, 6, and 9 months. The CPR parameters between the two groups were also compared using a generalized linear model.
Results
At immediately after training, the performance of RTFG was better in terms of average chest compression depth (51.9±1.1 vs. 45.5±1.1, p<0.001) and a higher percentage of adequate chest compression depth (51.0±4.1 vs. 26.9±4.2, p<0.001). This significant difference was maintained until 6 months after training, but there was no difference at 9 months after training. However, there was no significant difference in the chest compression rate and the correct hand position at any time point.
Conclusion
CPR training with a real-time visual feedback manikin improved skill acquisition in chest compression depth, but only until 6 months after the training. It could be a more effective educational method for basic life support training in laypersons.

Citations

Citations to this article as recorded by  Crossref logo
  • Technological innovations in layperson CPR education – A scoping review
    Abigail E. Schipper, Charles S.M. Sloane, Lydia B. Shimelis, Ryan T. Kim
    Resuscitation Plus.2025; 23: 100924.     CrossRef
  • Use of CPR feedback devices in resuscitation training: A systematic review and meta-analysis of randomized controlled trials
    Yiqun Lin, Andrew Lockey, Aaron Donoghue, Robert Greif, Andrea Cortegiani, Barbara Farquharson, Fahad Javaid Siddiqui, Arna Banerjee, Tasuku Matsuyama, Adam Cheng
    Resuscitation Plus.2025; 23: 100939.     CrossRef
  • O uso de simuladores para treinamento de médicos e residentes em áreas cirúrgicas: revisão sistemática
    Karlene Thayane Barros da Silva, Ruan Gabriel Pinheiro Botelho dos Santos, Kelly Cristina Costa Nascimento, Edson Yuzur Yasojima, Anderson Bentes de Lima, Marcus Vinicius Henrique Brito, Gabriel Novais Guilherme, José Maciel Caldas dos Reis
    Pará Research Medical Journal.2025;[Epub]     CrossRef
  • Education, Implementation, and Teams: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
    Robert Greif, Adam Cheng, Cristian Abelairas-Gómez, Katherine S. Allan, Jan Breckwoldt, Andrea Cortegiani, Aaron J. Donoghue, Kathryn J. Eastwood, Barbara Farquharson, Ming-Ju Hsieh, Tracy Kidd, Ying-Chih Ko, Kasper G. Lauridsen, Yiqun Lin, Andrew S. Lock
    Circulation.2025;[Epub]     CrossRef
  • Part 12: Resuscitation Education Science: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
    Aaron J. Donoghue, Marc Auerbach, Arna Banerjee, Audrey L. Blewer, Adam Cheng, Kelly D. Kadlec, Yiqun Lin, Emily Diederich, Taylor Sawyer, Devita T. Stallings, Lorrel E.B. Toft, Deborah Torman, Jaylen I. Wright, Stephen M. Schexnayder, Katie N. Dainty
    Circulation.2025;[Epub]     CrossRef
  • Executive Summary: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
    Katherine M. Berg, Janet E. Bray, Therese Djärv, Ian R. Drennan, Robert Greif, Helen G. Liley, Barnaby R. Scholefield, Dianne L. Atkins, Jestin N. Carlson, Allan R. de Caen, Eric J. Lavonas, Andrew S. Lockey, William H. Montgomery, Laurie J. Morrison, The
    Circulation.2025;[Epub]     CrossRef
  • Education, Implementation, and Teams: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
    Robert Greif, Adam Cheng, Cristian Abelairas-Gómez, Katherine S. Allan, Jan Breckwoldt, Andrea Cortegiani, Aaron J. Donoghue, Kathryn J. Eastwood, Barbara Farquharson, Ming-Ju Hsieh, Tracy Kidd, Ying-Chih Ko, Kasper G. Lauridsen, Yiqun Lin, Andrew S. Lock
    Resuscitation.2025; 215: 110807.     CrossRef
  • Executive Summary: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations
    Katherine M. Berg, Janet E. Bray, Therese Djärv, Ian R. Drennan, Robert Greif, Helen G. Liley, Barnaby R. Scholefield, Dianne L. Atkins, Jestin N. Carlson, Allan R. de Caen, Eric J. Lavonas, Andrew S. Lockey, William H. Montgomery, Laurie J. Morrison, The
    Resuscitation.2025; 215: 110805.     CrossRef
  • Görsel Geri Bildirim Simülatörünün KPR Kalite Parametrelerine Etkisi: Paramedik Örneği
    Yeliz Şapulu Alakan, Derya Aslan Huyar
    Anatolian Journal of Emergency Medicine.2025; 8(4): 177.     CrossRef
  • Influence of Training With Corrective Feedback Devices on Cardiopulmonary Resuscitation Skills Acquisition and Retention: Systematic Review and Meta-Analysis
    Abel Nicolau, Inês Jorge, Pedro Vieira-Marques, Carla Sa-Couto
    JMIR Medical Education.2024; 10: e59720.     CrossRef
  • Simulação realística em urgência e emergência na perspectiva discente
    David José Oliveira Tozetto, Nara Macedo Botelho, Carla Viana Dendasck, Guilherme de Andrade Ruela, Daniela Da Silva Santos
    Revista Científica Multidisciplinar Núcleo do Conhecimento.2023; : 25.     CrossRef
  • Effects of different cardiopulmonary resuscitation education interventions among university students: A randomized controlled trial
    Yu-Tung Chang, Kun-Chia Wu, Hsiang-Wen Yang, Chung-Yi Lin, Tzu-Fu Huang, Yi-Chi Yu, Yih-Jin Hu, Mukhtiar Baig
    PLOS ONE.2023; 18(3): e0283099.     CrossRef
  • Implementation and Evaluation of Resuscitation Training for Childcare Workers
    Jörg Michel, Tim Ilg, Felix Neunhoeffer, Michael Hofbeck, Ellen Heimberg
    Frontiers in Pediatrics.2022;[Epub]     CrossRef
  • Comparative satisfaction and effectiveness of virtual simulation and usual supervised work for postpartum hemorrhage management: a crossover randomized controlled trial
    Sandrine Voillequin, P. Rozenberg, K. Letutour, A. Rousseau
    BMC Medical Education.2022;[Epub]     CrossRef
  • 8,485 View
  • 139 Download
  • 12 Web of Science
  • 14 Crossref

Procedures | Education & Simulation

Emergency medicine physicians infrequently perform pediatric critical procedures: a national perspective
Shadd N. Cabalatungan, Henry C. Thode, Adam J. Singer
Clin Exp Emerg Med 2020;7(1):52-60.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.004

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Emergency medicine physicians infrequently perform pediatric critical procedures: a national perspective
Clin Exp Emerg Med. 2020;7(1):52-60.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.004
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Emergency medicine physicians infrequently perform pediatric critical procedures: a national perspective
Clin Exp Emerg Med. 2020;7(1):52-60.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.004
Close
Objective
To our knowledge, this is the first comprehensive study using a nationally representative database to estimate the frequency of critical procedures (endotracheal tube intubation [ETI], cardiopulmonary resuscitation [CPR], and central line insertion [CLI]) in children and adults.

Methods
The study was based on the secondary analysis of the 2010-2014 National Hospital Ambulatory Medical Care Survey. We included adult and pediatric patients undergoing critical procedures in the emergency department. We extracted demographic and clinical information, including the performance of critical procedures. For frequent procedures (≥1 per year), we estimated the annual number of critical procedures per emergency physician (EP) by dividing the total number of annual critical procedures by the total number of EPs (estimated at 40,000). For infrequent procedures, we calculated the average interval between procedures. We summarized the data with descriptive statistics and 95% confidence intervals (CIs).

Results
There were an estimated 668 million total emergency department visits (24% pediatric). On average, a single EP performed 8.6 (95% CI, 5.5 to 11.7) CLIs, 3.7 (95% CI, 2.4 to 5.0) CPRs, and 6.3 (95% CI, 5.3 to 7.4) ETIs per year in adults. In comparison, a single EP performed one pediatric CLI, CPR, and ETI every 3.2 (95% CI, 1.9 to 9.8), 5.2 (95% CI, 2.8 to 33.5), and 2.8 (95% CI, 1.6 to 8.9) years, respectively.

Conclusion
Our nationwide findings confirm those of previous smaller studies that critical procedures are significantly fewer in children than adults. We suggest that methods to retain skills in pediatric critical procedures should be developed for general EPs to ensure that they deliver the highest level of care across the entire age spectrum.

Citations

Citations to this article as recorded by  Crossref logo
  • Procedural Skills Decay in Emergency Medicine: A Scoping Review
    Kathryn Oskar, Elise Prehoda, Richard Sapp, Xin Qi, Brittany Botticelli, Janice C Palaganas
    Cureus.2026;[Epub]     CrossRef
  • Training for pediatric cannot intubate cannot oxygenate: surgical airway should replace needle cricothyrotomy
    Allison M. B. Lehman, Paul Amstutz, Jackson E. Moore, Matthew Johnson, Christopher Obersteadt, Dominique Williams, Mary J. Waxman, Morgan Blubaugh, Anaya Parikh, Timothy R. Walsh, Daniel E. Bruegger, Shawn B. Sood, Adrienne N. Malik, Andrew Pirotte
    Frontiers in Disaster and Emergency Medicine.2026;[Epub]     CrossRef
  • Medical practitioners’ confidence in performing paediatric critical procedures in the emergency department
    Shivanthra Ramdass, Matthew Zoghby, Nicholas Dufourq
    Journal of the Colleges of Medicine of South Africa.2025;[Epub]     CrossRef
  • Comparing Leadership Skills of Senior Emergency Medicine Residents in 3-Year Versus 4-Year Programs During Simulated Pediatric Resuscitation
    Kyle Schoppel, Ashley Keilman, Jabeen Fayyaz, Patricia Padlipsky, Maria Carmen G. Diaz, Robyn Wing, Mary Hughes, Marleny Franco, Nathan Swinger, Travis Whitfill, Barbara Walsh
    Pediatric Emergency Care.2024; 40(8): 591.     CrossRef
  • Procedural skill maintenance: What it means to physicians, how it motivates them, and what stops them from doing so
    Jia Le Ivan Tan, Sashikumar Ganapathy
    The Asia Pacific Scholar.2024; 9(3): 22.     CrossRef
  • Declines in the Number of Lumbar Punctures Performed at United States Children's Hospitals, 2009-2019
    Alexandra T. Geanacopoulos, John J. Porter, Kenneth A. Michelson, Rebecca S. Green, Vincent W. Chiang, Michael C. Monuteaux, Mark I. Neuman
    The Journal of Pediatrics.2021; 231: 87.     CrossRef
  • Exposure and confidence across critical airway procedures in pediatric emergency medicine: An international survey study
    Joshua Nagler, Marc Auerbach, Michael C. Monuteaux, John A. Cheek, Franz E. Babl, Ed Oakley, Lucia Nguyen, Arjun Rao, Sarah Dalton, Mark D. Lyttle, Santiago Mintegi, Rakesh D. Mistry, Andrew Dixon, Pedro Rino, Guillermo Kohn-Loncarica, Stuart R. Dalziel,
    The American Journal of Emergency Medicine.2021; 42: 70.     CrossRef
  • Procedural Applications of Point-of-Care Ultrasound in Pediatric Emergency Medicine
    Ashkon Shaahinfar, Zahra M. Ghazi-Askar
    Emergency Medicine Clinics of North America.2021; 39(3): 529.     CrossRef
  • Pediatric critical procedures in the emergency department
    Ashley Alexandra Foster, Matthew Adam Eisenberg
    Clinical and Experimental Emergency Medicine.2020; 7(3): 241.     CrossRef
  • 8,643 View
  • 129 Download
  • 8 Web of Science
  • 9 Crossref

Resuscitation

Determination of the theoretical personalized optimum chest compression point using anteroposterior chest radiography
Shinwoo Kim, Sung-Bin Chon, Won Sup Oh, Sunho Cho
Clin Exp Emerg Med 2019;6(4):303-313.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.19.016

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Determination of the theoretical personalized optimum chest compression point using anteroposterior chest radiography
Clin Exp Emerg Med. 2019;6(4):303-313.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.19.016
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Determination of the theoretical personalized optimum chest compression point using anteroposterior chest radiography
Clin Exp Emerg Med. 2019;6(4):303-313.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.19.016
Close
Objective
There is a traditional assumption that to maximize stroke volume, the point beneath which the left ventricle (LV) is at its maximum diameter (P_max.LV) should be compressed. Thus, we aimed to derive and validate rules to estimate P_max.LV using anteroposterior chest radiography (chest_AP), which is performed for critically ill patients urgently needing determination of their personalized P_max.LV.
Methods
A retrospective, cross-sectional study was performed with non-cardiac arrest adults who underwent chest_AP within 1 hour of computed tomography (derivation:validation=3:2). On chest_AP, we defined cardiac diameter (CD), distance from right cardiac border to midline (RB), and cardiac height (CH) from the carina to the uppermost point of left hemi-diaphragm. Setting point zero (0, 0) at the midpoint of the xiphisternal joint and designating leftward and upward directions as positive on x- and y-axes, we located P_max.LV (x_max.LV, y_max.LV). The coefficients of the following mathematically inferred rules were sought: x_max.LV=α0*CD-RB; y_max.LV=β0*CH+γ0 (α0: mean of [x_max.LV+RB]/CD; β0, γ0: representative coefficient and constant of linear regression model, respectively).
Results
Among 360 cases (52.0±18.3 years, 102 females), we derived: x_max.LV=0.643*CD-RB and y_max.LV=55-0.390*CH. This estimated P_max.LV (19±11 mm) was as close as the averaged P_max.LV (19±11 mm, P=0.13) and closer than the three equidistant points representing the current guidelines (67±13, 56±10, and 77±17 mm; all P<0.001) to the reference identified on computed tomography. Thus, our findings were validated.
Conclusion
Personalized P_max.LV can be estimated using chest_AP. Further studies with actual cardiac arrest victims are needed to verify the safety and effectiveness of the rule.

Citations

Citations to this article as recorded by  Crossref logo
  • Development of artificial intelligence-driven biosignal-sensitive cardiopulmonary resuscitation robot
    Taegyun Kim, Gil Joon Suh, Kyung Su Kim, Hayoung Kim, Heesu Park, Woon Yong Kwon, Jaeheung Park, Jaehoon Sim, Sungmoon Hur, Jung Chan Lee, Dong Ah Shin, Woo Sang Cho, Byung Jun Kim, Soyoon Kwon, Ye Ji Lee
    Resuscitation.2024; 202: 110354.     CrossRef
  • Optimal Landmark for Chest Compressions during Cardiopulmonary Resuscitation Derived from a Chest Computed Tomography in Arms-Down Position
    Pimpan Usawasuraiin, Borwon Wittayachamnankul, Boriboon Chenthanakij, Juntima Euathrongchit, Phichayut Phinyo, Theerapon Tangsuwanaruk
    Journal of Cardiovascular Development and Disease.2022; 9(4): 100.     CrossRef
  • Hand Placement During Chest Compressions in Parturients: A Pilot Study to Identify the Location of the Left Ventricle Using Transthoracic Echocardiography
    C. Delgado, K. Dawson, B. Schwaegler, R. Zachariah, S. Einav, L. Bollag
    Obstetric Anesthesia Digest.2021; 41(2): 84.     CrossRef
  • Optimum chest compression point might be located rightwards to the maximum diameter of the right ventricle: A preliminary, retrospective observational study
    Hyoungouk Kim, Sung‐Bin Chon, Seung Min Yoo, Himchan Choi, Kwang‐Yeol Park
    Acta Anaesthesiologica Scandinavica.2020; 64(7): 1002.     CrossRef
  • 9,430 View
  • 117 Download
  • 3 Web of Science
  • 4 Crossref

Experimental study | Resuscitation

Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
Yong Joo Park, Ki Jeong Hong, Sang Do Shin, Tae Yun Kim, Young Sun Ro, Kyoung Jun Song, Hyun Ho Ryu
Clin Exp Emerg Med 2019;6(3):250-256.   Published online September 30, 2019
DOI: https://doi.org/10.15441/ceem.18.060

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Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
Clin Exp Emerg Med. 2019;6(3):250-256.   Published online September 30, 2019
DOI: https://doi.org/10.15441/ceem.18.060
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Worsened survival in the head-up tilt position cardiopulmonary resuscitation in a porcine cardiac arrest model
Clin Exp Emerg Med. 2019;6(3):250-256.   Published online September 30, 2019
DOI: https://doi.org/10.15441/ceem.18.060
Close
Objective
Head elevation at an angle of 30° during cardiopulmonary resuscitation (CPR) was hemodynamically beneficial compared to supine position in a previous porcine cardiac arrest experimental study. However, survival benefit of head-up elevation during CPR has not been clarified. This study aimed to assess the effect of head-up tilt position during CPR on 24-hour survival in a porcine cardiac arrest experimental model.
Methods
This was a randomized experimental trial using female farm pigs (n=18, 42±3 kg) sedated, intubated, and paralyzed on a tilting surgical table. After surgical preparation, 15 minutes of untreated ventricular fibrillation was induced. Then, 6 minutes of basic life support was performed in a position randomly assigned to either head-up tilt at 30° or supine with a mechanical CPR device, LUCAS-2, and an impedance threshold device, followed by 20 minutes of advanced cardiac life support in the same position. Primary outcome was 24-hour survival, analyzed by Fisher exact test.
Results
In the 8 pigs from the head-up tilt position group, one showed return of spontaneous circulation (ROSC); all eight pigs expired within 24 hours. In the eight pigs from the supine position group, six had the ROSC; six pigs survived for 24 hours and two expired. The head-up position group showed lower 24-hour survival rate and lower ROSC rate than supine position group (P<0.01).
Conclusion
The use of head-up tilt position with 30 degrees during CPR showed lower 24-hour survival than the supine position.

Citations

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