Please select the eligibility criteria that correspond to the clinical trial below.
Title: Trans-Nasal Cooling With the RhinoChill Device Following Cardiac Arrest: A Pilot Study
Brief Summary: The purpose of the study was to demonstrate the safety and feasibility of early intranasal cooling prior to return of spontaneous circulation (ROSC) in the emergency medical services (EMS) environment. It was hypothesized that cooling during the resuscitation attempt would increase ROSC and subsequent survival. The study was not powered to demonstrate statistically-significant differences in any outcome parameter, but was intended as an exploratory study only.


Options:
A: Inclusion Criteria:

* ≥18 years
* Collapse was witnessed
* No pulse
* Unresponsive to external stimuli

Exclusion Criteria:

* Have an etiology of cardiac arrest due to trauma, severe bleeding, drug overdose (OD), cerebrovascular accident (CVA), drowning, smoke inhalation, electrocution, hanging
* Already hypothermic
* Head trauma
* Cannot place intra nasal catheters
* Do Not Attempt to Resuscitate (DNAR) orders
* Known or clinically apparent pregnancy
* Have a known coagulopathy (except therapeutically induced)
* Are known to have a need for supplemental oxygen
* Achieve return of spontaneous circulation (ROSC) prior to initiating cooling
* Are reached by emergency medical services (EMS) personnel more than 20 minutes after collapse
B: Inclusion Criteria:

* Age ≥ 18 years old
* Out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause
* Return of spontaneous circulation (ROSC)
* Unconsciousness (Glasgow Coma Score \< 8) (patients not able to obey verbal commands)after sustained ROSC

Exclusion Criteria:

* In-hospital cardiac arrest
* OHCA of presumed non-cardiac cause, e.g. after trauma or dissection/rupture of major artery OR Cardiac arrest caused by initial hypoxia (i.e. drowning, suffocation, hanging).
* Known bleeding diathesis (medically induced coagulopathy (e.g warfarin, clopidogrel) does not exclude the patient).
* Suspected or confirmed acute intracranial bleeding
* Suspected or confirmed acute stroke
* Unwitnessed asystole
* Known limitations in therapy and Do Not Resuscitate-order
* Known disease making 180 days survival unlikely
* Known pre-arrest CPC 3 or 4
* Temperature \< 30°C on admission
* \> 4 hours (240 minutes) from ROSC to screening
* Systolic blood pressure \< 80 mm Hg in spite of fluid loading/vasopressor and/or inotropic medication/intra aortic balloon pump#

  * If the systolic blood pressure (SBP) is recovering during the inclusion window (220 minutes) the patient can be included.
C: Inclusion Criteria:

* successful resuscitation from out-of-hospital cardiac arrest by paramedics, defined by having a palpable pulse

Exclusion Criteria:

* traumatic cause for cardiac arrest
D: Inclusion Criteria:

* Age ≥18 years
* Collapse was witnessed (heard or seen)
* Do not have a pulse
* Are unresponsive to external stimuli

Exclusion Criteria:

* Age ≥80 years
* Have an etiology of cardiac arrest due to trauma, severe bleeding, drug overdose, cerebrovascular accident, drowning, smoke inhalation, electrocution, hanging
* Already hypothermic (e.g., avalanche victim; found in the snow)
* Have an obvious barrier to placing intra nasal catheters (e.g., intranasal obstruction)
* Do Not Attempt to Resuscitate (DNAR) orders
* Have a terminal disease
* Known or clinically apparent pregnancy
* Have a known coagulopathy (except therapeutically induced)
* Are known to have a need for supplemental oxygen
* Achieve ROSC prior to randomization
* Response time (call to arrival) of the ambulance \> 15 minutes

Answer: A