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Two to ten percent of the children who are resuscitated in the prehospital setting survive. Survival rates for paediatric and adult OHCAs are equally poor. The incidence for paediatric out-of-hospital-cardiac-arrests (OHCA) is rather uniform throughout developed countries with 7.3-9.1-cases per 100 000 person-years. Both rules therefore appear not to be transferable to a paediatric population. The proportion of CPRs that could have been abandoned is 48.2% for the BLS-TOR and only 10.3% for the ALS-TOR-rule. ALS-TOR-criteria did not give false predictions of death. Retrospective application of the BLS-TOR-rule in our patient cohort identified the resuscitation of one later survivor as futile. ALS-TOR-criteria for death had a sensitivity of 10.3%, specificity of 100%, a PPV of 100% and an NPV of 35%. Sensitivity for BLS-TOR-criteria predicting death was 48.3%, specificity 92.9%, the PPV 93.3% and the NPV 46.4%. ResultsĢ6 patients achieved ROSC and 14 were discharged alive ( n = 7 PCPC 1/2, n = 7 PCPC 5). Morrison’s BLS- and ALS-TOR-rules as well as the Trauma-TOR-criteria by the American Association of EMS Physicians were evaluated for application in children, by calculating sensitivity, specificity, negative and positive predictive value for death-, as well as survival-prediction in our cohort. 43 paediatric patients admitted to our institution after emergency-medical-system (EMS)-confirmed OHCA from 2003 to 2013 were included. We performed a retrospective analysis of an eleven-year single centre patient cohort. Our goal was to find out to which extent existing TOR-criteria can be transferred to paediatric OHCA-patients with special regard to their prognostic value. Termination-of-resuscitation (TOR)-criteria aim to preclude futile resuscitation efforts. The duration of CPR varies considerably and transportation of patients under CPR is often unsuccessful. Only a small number of patients survive out-of-hospital-cardiac-arrest (OHCA). It doesn’t matter if you have $500 in savings or $5 million. Stock Prodigy Who Found NIO at $2… Says Buy THIS Now The opinions expressed in this article are those of the writer, subject to the Publishing Guidelines.Īnyone interested in finding out more about option-based strategies or for a weekly option and volatility newsletter can visit the Options and Volatility Newsletter website. On the date of publication, Tim Biggam did not have (either directly or indirectly) any positions in the securities mentioned in this article. It is also a hedge against the bearish call spread I recommended in my previous article on NVDA stock. This eliminates any earnings related risk. The spread expires before earnings, currently estimated for late August. It is also well below the support area at $175. The short $175 strike provides a 11% downside cushion to the $195.94 closing price of NVDA stock. Maximum gain on the trade is $35 per spread. Sell NVDA Aug $172.5/$170 put spread for a $0.35 net credit. It is so important to lower risk in this type of market environment we are currently experiencing. It allows one to position bullishly on an oversold NVDA stock in a defined risk manner. Selling an out-of-the money bull put spread makes probabilistic sense. This means option prices are more expensive, which favors option selling strategies. The recent drop in both NVDA and the overall market has caused implied volatility (IV) to pop significantly. Fortunately, the options market provides a lower-cost way to be a buyer on a further leg lower. Buying just 100 shares would still cost nearly $20,000. Now that the pullback has come to fruition, my bearish outlook has turned somewhat bullish-because price does matter.īuying NVDA stock outright is both risky and rather expensive, even after the split. 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If someone has the ability to tell you they have a mental health issue, help them.” I also hope this post makes all of us more accepting and empowered to help others in our life. “I hope this post can help you accept yours. The “Dancing With the Stars” finalist went on to say that she’s not saying people “need to run around telling each other our full diagnosis at the supermarket,” but she does think we need to stop being afraid to talk about things like this. “Mental healthfirst, everything else comes easily after,” Zee added. “You can’t just go get a diagnosis, do some deep work and then quit. Just like physical shape, mental shape takes persistence and maintenance,” writes Zee. Getting the RIGHT type of therapy was huge. Honesty with myself and being open to exposing my imperfection was step one. “Depression, eating disorder, PTSD - they are all part of the story I work on and accept about myself every day. The meteorologist goes on to say that she has to “work on” herself “every day” and she compares keeping yourself mentally in shape to keeping yourself physically in shape - it takes consistent work. It includes self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships.” In case you aren’t familiar with it, Borderline Personality Disorder is defined by the Mayo Clinic as “a mental health disorder that impacts the way you think and feel about yourself and others, causing problems functioning in everyday life. It’s also important you know that I have found healing and you deserve to too. Today, on World Mental Health Day, it’s important for yout o know that 11 years ago, I was diagnosed with Borderline Personality Disorder after checking in at Columbia’s Psych Ward. I’m the Chief Meteorologist at ABC News, manager editor of the Climate Unit, a wife, a mother and so many other things. 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