Prehospital Resuscitative Thoracotomy feasible and improves survival in traumatic cardiac arrest : JAMA

Researchers have found in a new study that mature, physician-led, urban prehospital system can successfully perform resuscitative thoracotomy, leading to improved survival rates for patients experiencing out-of-hospital traumatic cardiac arrest (TCA). The study highlights the importance of a well-structured emergency response system in enhancing patient outcomes.

Traumatic cardiac arrest (TCA) presents a critical challenge in trauma care, often occurring rapidly after injury before effective interventions are available. A study was done to evaluate the association of prehospital resuscitative thoracotomy with survival outcomes for Traumatic cardiac arrest. This retrospective cohort study examined all cases of prehospital resuscitative thoracotomy for Traumatic cardiac arrest in London from January 1999 to December 2019. Data were analyzed from July 2022 to July 2023. The primary outcome was survival to hospital discharge. Secondary outcomes included survival to hospital admission and neurological status at discharge. Results Prehospital resuscitative thoracotomy was undertaken in 601 patients with out-of-hospital Traumatic cardiac arrest. The median (IQR) age was 25 (20-37) years; 538 (89.5%) were male and 63 (10.5%) female. A total of 529 patients (88.0%) had a penetrating mechanism of injury. Traumatic cardiac arrest occurred at a median (IQR) of 12 (6-22) minutes after the emergency call, with 491 arrests (81.7%) before the advanced trauma team’s arrival. Traumatic cardiac arrest was the result of cardiac tamponade (105 patients, 17.5%), exsanguination (418 patients, 69.6%), and exsanguination combined with cardiac tamponade (72 patients, 12.0%). Thirty patients (5.0%) survived to hospital discharge, with a favorable neurological outcome observed in 23 survivors (76.6%). Survival varied significantly with the cause of Traumatic cardiac arrest: 22 of 105 patients (21%) with cardiac tamponade, 8 of 418 patients (1.9%) with exsanguination, and none of the 72 patients with combined or other pathologies survived. There were no survivors beyond 15 minutes of Traumatic cardiac arrest for cardiac tamponade and 5 minutes after exsanguination. Multivariable analysis revealed that the cause of Traumatic cardiac arrest (adjusted odds ratio [aOR], 21.1; 95% CI, 8.1-54.7; P < .001), duration of Traumatic cardiac arrest (aOR, 20.9; 95% CI, 4.4-100.6, P < .001), and absence of the need for internal cardiac massage (AOR, 0.2; 95% CI, 0.06-0.5; P = .001) were independently associated with survival. Traumatic cardiac arrestoccurs soon after injury, with only a brief window available for effective intervention. This study found that resuscitative thoracotomy is feasible in a mature, physician-led, urban prehospital system and is associated with improved survival for patients with out-of-hospital Traumatic cardiac arrest, particularly when caused by cardiac tamponade, in situations where other treatment options are limited.

Reference:

Perkins ZB, Greenhalgh R, ter Avest E, et al. Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest. JAMA Surg. Published online February 26, 2025. doi:10.1001/jamasurg.2024.7245

Keywords:

Prehospital, Resuscitative, Thoracotomy, feasible, improves, survival, traumatic, cardiac arrest , JAMA , Perkins ZB, Greenhalgh R, ter Avest E

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Health ministry calls for ban on Tobacco, Alcohol advertisements

The Directorate General of Health Services (DGH) Atul Goel has asked IPL Chairperson Arun Singh Dhumal to impose a ban on all forms of tobacco and alcohol advertisements, including surrogate advertising and sales, during the upcoming IPL season starting on March 22.

In a letter dated March 5, Directorate General of Health Services (DGHS) Atul Goel said, “India is experiencing a significant burden of Non Communicable diseases– Cardiovascular diseases, Cancer, Chronic Lung Disease, Diabetes, Hypertension etc. which account for more than 70% deaths annually. Tobacco and alcohol use are key risk factors for NCDs.

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Vellore doctor loses Rs 2.23 crore to part-time job fraud

Kasaragod: In a shocking case of cyber fraud reported in the city, a 42-year-old doctor from Tamil Nadu’s Vellore allegedly lost an astonishing Rs 2.23 crore and 95 thousand in just 19 days to a gang of cyber fraudsters in a part-time job fraud. Altogether eight accused have been arrested from the gang so far, involving an alleged serial cybercriminal from Payyannur. 

Over 19 days, from May 17 to June 4, the doctor transferred Rs 2,23,94,993 to 18 different accounts spread across Rajasthan, Jammu & Kashmir, Bihar, West Bengal, Tamil Nadu, and Delhi.

So far, the doctor has recovered Rs 10.79 lakh through court proceedings from one of the fraudsters, along with Rs 87,125 that the scammers had initially returned to gain his trust and make the scheme appear legitimate. Cyber police are still working to track down the remaining Rs 2.23 crore.

Also read- Fruadsters Lure 2 Doctors on pretext of huge returns; Lose Rs 3.5 crore

According to Onmanorama, the scam began when the fraudsters contacted the doctor via Telegram, offering him a work-from-home job that involved reviewing businesses and products. However, the doctor asked his wife to do the job instead. 

Initially, the scamsters paid her, but soon they started demanding money upfront to offer lucrative reviewing jobs. They later added the doctor to an exclusive Telegram group, claiming it was for “premium” job offers.

To make the scam believable, the doctor was added to a Telegram group with around 30 members who all appeared to be earning well from the same platform. In reality, these were fake profiles controlled by the scammers.

Between May 17 and June 4, the doctor transferred Rs 2,23,94,993 to 18 different accounts spread across Rajasthan, Jammu & Kashmir, Bihar, West Bengal, Tamil Nadu, and Delhi. The scammers attempted to maintain his trust by refunding a small sum of Rs 87,125. 

But when the doctor realised that he was scammed, he approached Kasaragod Cyber Police Station and filed a complaint against the fraudsters. This led the police to initiate a four-member extradition team headed by Sub-Inspector Sreedasan M V. 

The investigation has led to multiple arrests, including that of Sunil Kumar Jhanwar, a 24-year-old food delivery and bike taxi driver from Jodhpur. He was caught while attending to his ailing father in the Mathura Das Mathur Hospital.

ASI Prashanth, along with senior civil police officers Narayanan and Dileesh, spent eight days tracking down Sunil Kumar Jhanwar in Jodhpur. Following the fraud, Jhanwar had relocated to an area under Bhagat Ki Kothi Police Station, but when the officers arrived, they found his rented house locked.

The breakthrough came just 45 minutes before the only weekly train was set to depart at 11:30 pm, when the Kasaragod team finally located him. The final two days of their search were spent inside the sprawling 99-acre Mathura Das Mathur Hospital complex.

“We were discreet to avoid attracting attention. When we located him, his relatives and friends tried to block us from taking him into custody,” Sreedasan said. Officers from the local Shastri Nagar Police Station came to their rescue and helped them reach the railway station on time, with the accused.​

Jhanwar had personally received Rs 18 lakh of the scammed money, which he withdrew using cheques. By the time of his arrest, his bank account was empty. He used three cheques to withdraw the funds from his account with Axis Bank in Jodhpur.

The investigation, earlier headed by the District Crime Bank, is now with District Special Branch DySP Sunil Kumar M.​ Under the District Crime Branch DySP T Uthamdas, the team had arrested two accused: Muhammed Noushad A T, an alleged serial cybercriminal from Payyannur, and Harshavardhan R of Mattancherry in Kochi.

“Noushad, though not the mastermind, is a crucial link in the scam, managing several bank accounts used to launder the ill-gotten money. He recruited unsuspecting individuals — mainly students and homemakers — convincing them to open bank accounts in exchange for commissions. Harshavardhan, a recruit of Noushad, opened 10 bank accounts that received Rs 40 lakh, said DySP Uthamdas.

Further, Uthamdas said, “Kerala High Court Judge P V Kunhikrishnan granted anticipatory bail to Harshavardhan on January 27. Noushad was arrested on February 13. In March, the investigating team traced Rs 10.79 lakh to a UCO Bank account with the Parliament Street Branch in Delhi. The money was recovered and returned to the doctor through court proceedings.”

The money received in Harshavardhan’s accounts was allegedly collected by Noushad. Police said they would seek the custody of Sunil Kumar Jhanwar to understand his role in the scam and identify his collaborators.

Also read- 31-year-old doctor swindled of Rs 10 lakh in matrimonial fraud

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Health Bulletin 11/ March/ 2025

Here are the top health news for the day:

CAG’s recommendations to address faculty shortage in Delhi’s super-speciality hospitals

The autonomous super speciality hospitals across Delhi are reeling under a shortage of teaching faculties, revealed the Comptroller and Auditor General‘s report on “Public Health Infrastructure and Management of Health Services”.

To deal with the shortage of faculties in autonomous hospitals, the CAG report has recommended that the Government review the recruitment norms to make it more attractive for teaching doctors so that a satisfied and consistent workforce of teaching doctors remains available in such hospitals.

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Confusion Over NMC Rejection, Denies Patient’s Appeal

Despite its decision to accept patient’s appeals against medical professionals, the National Medical Commission (NMC) recently turned down an appeal filed by a patient from Punjab.

Since the time the National Medical Commission (NMC) replaced the erstwhile Medical Council of India (MCI), the Commission has reportedly been rejecting patients’ appeals arguing that only medical practitioners could file an appeal before the NMC under the National Medical Commission Act 2019.

For more information, click on the link below:

Health Ministry calls for ban on Tobacco, Alcohol advertisements

The Directorate General of Health Services (DGH) Atul Goel has asked IPL Chairperson Arun Singh Dhumal to impose a ban on all forms of tobacco and alcohol advertisements, including surrogate advertising and sales, during the upcoming IPL season starting on March 22.

In a letter dated March 5, Directorate General of Health Services (DGHS) Atul Goel said, “India is experiencing a significant burden of Non Communicable diseases– Cardiovascular diseases, Cancer, Chronic Lung Disease, Diabetes, Hypertension etc. which account for more than 70% deaths annually. Tobacco and alcohol use are key risk factors for NCDs.

For more information, click on the link below:

Youth claims Rs 60K worth of medicines fraudulently under Ayushman Bharat

A routine security check at the Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh recently led to a major breakthrough, exposing a multi-state racket involving the illegal procurement of medicines valued at Rs 60,000 under the Ayushman Bharat cashless scheme. The medicines meant for patients were allegedly resold to private medical stores.

The scammers allegedly used forged documents and fake departmental stamps to obtain medicines under the scheme from PGIMER’s AMRIT Pharmacy. The case has now been transferred to the Crime Branch after initial investigation by the local police. 

For more information, click on the link below:

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Youth claims Rs 60K worth of medicines fraudulently under Ayushman Bharat

A routine security check at the Postgraduate Institute of Medical Education and Research (PGIMER) Chandigarh recently led to a major breakthrough, exposing a multi-state racket involving the illegal procurement of medicines valued at Rs 60,000 under the Ayushman Bharat cashless scheme. The medicines meant for patients were allegedly resold to private medical stores.

The scammers allegedly used forged documents and fake departmental stamps to obtain medicines under the scheme from PGIMER’s AMRIT Pharmacy. The case has now been transferred to the Crime Branch after initial investigation by the local police.

For more information, click on the link below:

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Socioeconomic factors fuel global inequalities in Alzheimer’s disease burden, analysis finds

An analysis of the global burden and temporal trends of Alzheimer’s disease and other dementias (ADODs) reveals significant cross-country inequalities associated with a series of sociodemographic development-related risk factors, such as education, income, fertility, and health expenditure.

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Adults abused as children twice as likely to develop health and mental health conditions, study finds

A study published in Child Maltreatment found that in comparison to those who had not been abused in childhood, adults who had experienced both childhood physical and sexual abuse had approximately double the odds of physical and mental health conditions, including angina, arthritis, asthma, COPD, heart attack, depression, and disability—even after considering respondents’ age, race, income, and health behaviors, as well as obesity.

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New test helps doctors predict a dangerous side effect of cancer treatment

Medical researchers in Japan have discovered a way to predict a potentially life-threatening side effect of cancer immunotherapy before it occurs. By analyzing cerebrospinal fluid collected pre-treatment, researchers at Kyushu University identified specific proteins associated with a damaging immune response that can affect the central nervous system after therapy.

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Study pinpoints the impact of prenatal stress across 27 weeks of pregnancy

A team of researchers at Michigan State University and the University of Michigan found new insights into the timing of prenatal stress and its effect on infant stress reactivity and temperament—including differences between genders.

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Prostate cancer ‘is not a death knell’: Early detection and personalized care improve outcomes, study shows

Prostate cancer statistics can look scary: 34,250 U.S. deaths in 2024. 1.4 million new cases worldwide in 2022. Dr. Bruce Montgomery, a UW Medicine oncologist, hopes that patients won’t see these numbers and just throw up their hands in fear or resignation.

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