scholarly journals Improved ROSC rates in out-of-hospital cardiac arrest patients after introduction of a text message alert system for trained volunteers

2022 ◽  
Author(s):  
D. M. Oosterveer ◽  
M. de Visser ◽  
C. Heringhaus
Keyword(s):  
Cardiac Arrest ◽  
Multivariate Regression ◽  
Survival Rates ◽  
Text Message ◽  
Positive Association ◽  
Regression Analyses ◽  
Alert System ◽  
Automated External Defibrillators ◽  
Average Survival ◽  
Hospital Cardiac Arrest

Abstract Objective To evaluate whether a text message (TM) alert system for trained volunteers contributed to early cardiopulmonary resuscitation, the use of automated external defibrillators (AEDs), return of spontaneous circulation (ROSC) and survival in out-of-hospital cardiac arrest (OHCA) patients in a region with above-average survival rates. Design Data on all OHCA patients in 2012 (non-TM group) were compared with those of all OHCA patients in 2018 (TM group). The association of the presence of a TM alert system with ROSC and survival was assessed with multivariate regression analyses. Results TM responders reached 42 OHCA patients (15.9%) earlier than the first responders or ambulance. They connected 31 of these 42 OHCA patients (73.8%) to an AED before the ambulance arrived, leading to a higher percentage of AEDs being attached in 2018 compared to the 2012 non-TM group (55% vs 46%, p = 0.03). ROSC was achieved more often in the TM group (61.0% vs 29.4%, p < 0.01). Three-month and 1‑year survival did not differ significantly between the two groups (29.3% vs 24.3%, p = 0.19, and 25.9% vs 23.5%, p = 0.51). Multivariate regression analyses confirmed the positive association of ROSC with the TM alert system (odds ratio 1.49, 95% confidence interval 1.02‑2.19, p = 0.04). Conclusion A TM alert system seems to improve the chain of survival; because TM responders reached patients early, AEDs were attached more often and more OHCA patients achieved ROSC. However, the introduction of a TM alert system was not associated with improved 3‑month or 1‑year survival in a region with above-average survival rates.

scholarly journals A text message alert system for trained volunteers improves out-of-hospital cardiac arrest survival

Resuscitation ◽  
2016 ◽  
Vol 105 ◽  
pp. 182-187 ◽  
Author(s):  
Ruud W.M. Pijls ◽  
Patty J. Nelemans ◽  
Braim M. Rahel ◽  
Anton P.M. Gorgels
Keyword(s):  
Cardiac Arrest ◽  
Text Message ◽  
Alert System ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Text message alert system and resuscitation outcomes after out-of-hospital cardiac arrest: A before-and-after population-based study

Resuscitation ◽  
2019 ◽  
Vol 138 ◽  
pp. 198-207 ◽  
Author(s):  
Sun Young Lee ◽  
Sang Do Shin ◽  
Yu Jin Lee ◽  
Kyoung Jun Song ◽  
Ki Jeong Hong ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Text Message ◽  
Population Based ◽  
Alert System ◽  
Population Based Study ◽  
Before And After ◽  
Hospital Cardiac Arrest

scholarly journals Factors modifying performance of a novel citizen text message alert system in improving survival of out-of-hospital cardiac arrest

2017 ◽  
Vol 7 (5) ◽  
pp. 397-404 ◽  
Author(s):  
Ruud WM Pijls ◽  
Patty J Nelemans ◽  
Braim M Rahel ◽  
Anton PM Gorgels
Keyword(s):  
Cardiac Arrest ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Regression Models ◽  
Text Message ◽  
Alert System ◽  
Logistic Regression Models ◽  
Impact On Survival ◽  
Prolonged Delay ◽  
Hospital Cardiac Arrest

Aims: Recently we found that the text message alert system increases survival of sudden out-of-hospital cardiac arrest. The aim of the present study is to explore the contribution of the system to survival specifically in resuscitation settings with prolonged delay of start of resuscitation. Methods and results: Data were used from consecutive patients resuscitated for out-of-hospital cardiac arrest during a two-year period in the Dutch province Limburg. Survival of 291 cases with out-of-hospital cardiac arrest where one or more volunteers attended (Scenario 2) was compared with survival of 131 cases with out-of-hospital cardiac arrest where no volunteers attended and only standard care was given (Scenario 1). Multivariable logistic regression models including terms for interaction between scenario and the covariate coding for resuscitation setting were used to test for effect modification. The highest impact on survival of the alert system was observed in cases of (a) witnessed arrests (odds ratio=2.25; 95% confidence interval: 1.27–4.00; p=0.005); (b) arrests that occurred in the home (odds ratio=2.28; 95% confidence interval: 1.21–4.28; p=0.011); (c) arrival of the ambulance with a delay of 7–10 min (odds ratio=2.63; 95% confidence interval: 1.09–6.35; p=0.032); and (d) arrests at evening/night (odds ratio=3.07; 95% confidence interval: 1.34–7.03; p=0.008). Due to the low sample size, p-values from tests for interaction were non-significant. Conclusion: The contribution of the alert system to survival is most substantial in cases of witnessed arrest, in the home situation, at slightly delayed arrival of the first ambulance and during the evening/night.

Initial Development of a Tool to Measure Implementation of Community Change to Improve Out-of-Hospital Cardiac Arrest

2019 ◽  
pp. 1-8
Keyword(s):  
Cardiac Arrest ◽  
Survival Data ◽  
Survival Rates ◽  
Implementation Process ◽  
Positive Association ◽  
Community Change ◽  
Initial Development ◽  
Reduction Methods ◽  
Chain Of Survival ◽  
Hospital Cardiac Arrest

Background: The Resuscitation Academy (RA) is a training and community change program to assist communities in implementing activities to improve survival after out-of-hospital cardiac arrest. The purpose of this paper is to present data on the development of an implementation index to measure community progress in achieving survival reduction. Methods: Community representatives who attended the RA in Seattle, WA (n=258) completed an on-line survey asking about achievement of the chain of survival program components, presented in the RA, and the most helpful things that supported communities in implementing these activities. Survival data in the Cardiac Arrest Surveillance (CARES) database was used to examine the association between implementation of chain of survival components and cardiac arrest survival rates in those agencies participating CARES. Results: The15-item scale was easily implemented in online form. Internal consistency, measured by an alpha coefficient, was 0.78. Time since RA participation was significantly related to implementation index score, indicating potential to measure change. An overall implementation index showed a positive association with independently measured survival (p < 0.001). Conclusions: These data indicate that the implementation index has acceptable properties for measuring community change in the area of implementation of cardiac survival efforts. Areas for improvement include further work on measurement and documentation of the implementation process in communities, and considering tailored feedback using the tool as way of providing assistance for communities struggling to implement this program.

Different defibrillation strategies in survivors after out-of-hospital cardiac arrest

Heart ◽  
2018 ◽  
Vol 104 (23) ◽  
pp. 1929-1936 ◽  
Author(s):  
Jolande A Zijlstra ◽  
Rudolph W Koster ◽  
Marieke T Blom ◽  
Freddy K Lippert ◽  
Leif Svensson ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Medical Service ◽  
Survival Rates ◽  
First Responder ◽  
Automated External Defibrillators ◽  
Survival Status ◽  
Initial Rhythm ◽  
Hospital Cardiac Arrest ◽  
Over Time

BackgroundIn the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (AEDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. The aim of this study was to study the association between different defibrillation strategies on survival rates over time in Copenhagen, Stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-EMS defibrillation increased over time and was associated with increased survival.MethodsWe performed a retrospective analysis of four prospectively collected cohorts of out-of-hospital cardiac arrest patients between 2008 and 2013. Emergency medical service (EMS)-witnessed arrests were excluded.ResultsA total of 22 453 out-of-hospital cardiac arrest patients with known survival status were identified, of whom 2957 (13%) survived at least 30 days postresuscitation. Of all survivors with a known defibrillation status, 2289 (81%) were defibrillated, 1349 (59%) were defibrillated by EMS, 454 (20%) were defibrillated by a first responder AED and 429 (19%) were defibrillated by an onsite AED and 57 (2%) were unknown. The percentage of survivors defibrillated by first responder AEDs (from 13% in 2008 to 26% in 2013, p<0.001 for trend) and onsite AEDs (from 14% in 2008 to 30% in 2013, p<0.001 for trend) increased. The increased use of these non-EMS AEDs was associated with the increase in survival rate of patients with a shockable initial rhythm.ConclusionSurvivors of out-of-hospital cardiac arrest are increasingly defibrillated by non-EMS AEDs. This increase is primarily due to a large increase in the use of onsite AEDs as well as an increase in first-responder defibrillation over time. Non-EMS defibrillation accounted for at least part of the increase in survival rate of patients with a shockable initial rhythm.

scholarly journals P075: Impact of pit-crew CPR following out-of-hospital cardiac arrest in Saskatoon

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S103-S103
Author(s):  
S. Netherton ◽  
A. Leach ◽  
T. Hillier ◽  
R. Woods
Keyword(s):  
Cardiac Arrest ◽  
Survival Rates ◽  
The United States ◽  
Spontaneous Circulation ◽  
Full Data ◽  
Data Set ◽  
Automated External Defibrillators ◽  
Before And After ◽  
Collection Phase ◽  
Hospital Cardiac Arrest

Introduction: Between 1980 and 2008, survival rates following an out-of-hospital cardiac arrest (OHCA) have remained unchanged, averaging 7.6%. Despite the use of new and emerging technologies, new medications, and automated external defibrillators, survival remains low. Recently, a new focus in cardiopulmonary resuscitation (CPR) has shown dramatic improvements in survival post OHCA. This new model, called pit-crew CPR, focuses on minimizing interruptions in chest compressions and has each team member playing a specific role in the resuscitation, akin to the pit-crew of a car race. Certain districts in the United States and Canada have adopted the pit-crew, or a similar, high quality, maximum time-on-chest CPR model, with much success. We aim to determine whether the pit-crew model of CPR improves survival following OHCA in Saskatoon, SK. Methods: In Saskatoon, EMS and Fire crews respond to OHCAs and have been exclusively using the pit-crew model of CPR since Jan 1st, 2015. This study is a before and after retrospective chart analysis, comparing two groups - pre and post implementation of the pit-crew CPR model. The primary outcome is survival to hospital discharge post OHCA. Secondary outcomes include survival to admission and any return of spontaneous circulation (as per the Utstein definition). The inclusion criteria are patients >18 years old with a witnessed OHCA of presumed cardiac origin who receive CPR by EMS/Fire within the Saskatoon Ambulance service (MD Ambulance) catchment area. Patients were excluded if the OHCA was unwitnessed, or if there was a presumed non-cardiac cause for the arrest, e.g. trauma. Results: In the pre-pit-crew model cohort, between Jan 1st, 2011 and Sept 31st, 2014, 455 OHCAs were analyzed. In this cohort 10.5% survived to discharge, 31.9% survived to admission and ROSC was achieved in 39% of cases. The percentage of patients with initial rhythms of VF/VT, asystole or PEA were 28.5% (26%), 41.5% (1%) and 23.6% (10%) respectively, with survival to discharge shown in parentheses. The post-pit-crew cohort is still in the data collection phase. Conclusion: Our pre-pit crew cohort data has been collected and analyzed. With ongoing data acquisition for the post-pit crew cohort, we hope to have the full data set complete by the end of 2018. It will be at that time when we are able to determine whether the pit-crew model of CPR improves survival to discharge following OHCA in Saskatoon.

scholarly journals Predictive Value of Estimated Lean Body Mass for Neurological Outcomes after Out-of-Hospital Cardiac Arrest

2020 ◽  
Vol 10 (1) ◽  
pp. 71
Author(s):  
Sung Eun Lee ◽  
Hyuk Hoon Kim ◽  
Minjung Kathy Chae ◽  
Eun Jung Park ◽  
Sangchun Choi
Keyword(s):  
Cardiac Arrest ◽  
Critically Ill ◽  
Lean Body Mass ◽  
Body Mass ◽  
Multivariate Regression ◽  
Characteristic Curve ◽  
Cerebral Performance Category ◽  
High Body Mass Index ◽  
Neurological Outcomes ◽  
Hospital Cardiac Arrest

Background: Postcardiac arrest patients with a return of spontaneous circulation (ROSC) are critically ill, and high body mass index (BMI) is ascertained to be associated with good prognosis in patients with a critically ill condition. However, the exact mechanism has been unknown. To assess the effectiveness of skeletal muscles in reducing neuronal injury after the initial damage owing to cardiac arrest, we investigated the relationship between estimated lean body mass (LBM) and the prognosis of postcardiac arrest patients. Methods: This retrospective cohort study included adult patients with ROSC after out-of-hospital cardiac arrest from January 2015 to March 2020. The enrolled patients were allocated into good- and poor-outcome groups (cerebral performance category (CPC) scores 1–2 and 3–5, respectively). Estimated LBM was categorized into quartiles. Multivariate regression models were used to evaluate the association between LBM and a good CPC score. The area under the receiver operating characteristic curve (AUROC) was assessed. Results: In total, 155 patients were analyzed (CPC score 1–2 vs. 3–5, n = 70 vs. n = 85). Patients’ age, first monitored rhythm, no-flow time, presumed cause of arrest, BMI, and LBM were different (p < 0.05). Fourth-quartile LBM (≥48.98 kg) was associated with good neurological outcome of postcardiac arrest patients (odds ratio = 4.81, 95% confidence interval (CI), 1.10–25.55, p = 0.04). Initial high LBM was also a predictor of good neurological outcomes (AUROC of multivariate regression model including LBM: 0.918). Conclusions: Initial LBM above 48.98kg is a feasible prognostic factor for good neurological outcomes in postcardiac arrest patients.

scholarly journals Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chih-Hung Wang ◽  
Meng-Che Wu ◽  
Cheng-Yi Wu ◽  
Chien-Hua Huang ◽  
Min-Shan Tsai ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Tracheal Intubation ◽  
Interaction Analysis ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Optimal Time ◽  
Hypercapnic Acidosis ◽  
Blood Gas ◽  
Regression Analyses ◽  
Hospital Cardiac Arrest

AbstractTo investigate whether the optimal time to tracheal intubation (TTI) during cardiopulmonary resuscitation would differ by different blood gas phenotypes. Adult patients experiencing in-hospital cardiac arrest (IHCA) from 2006 to 2015 were retrospectively screened. Early intra-arrest blood gas analysis, performed within 10 min of resuscitation, was used to define different phenotypes. In total, 567 patients were included. Non-severe acidosis (pH≧7.15) was associated with favourable neurological outcome (odds ratio [OR]: 4.60, 95% confidence interval [CI] 1.63–12.95; p value = 0.004) and survival (OR: 3.25, 95% CI 1.72–6.15; p value < 0.001) in the multivariable logistic regression analyses. In the interaction analysis, normal blood gas phenotype (pH: 7.35–7.45, PCO2: 35–45 mm Hg, HCO3− level: 22–26 mmol/L) × TTI ≦ 6.3 min (OR: 20.40, 95% CI 2.53–164.75; p value = 0.005) and non-severe acidosis × TTI ≦ 6.3 min (OR: 3.35, 95% CI 1.00–11.23; p value = 0.05) were associated with neurological recovery while metabolic acidosis × TTI ≦ 5.7 min (OR: 3.63, 95% CI 1.36–9.67; p value = 0.01) and hypercapnic acidosis × TTI ≦ 10.4 min (OR: 2.27, 95% CI 1.20–4.28; p value = 0.01) were associated with survival. Intra-arrest blood gas analysis may help guide TTI during for patients with IHCA.

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