Abstract 12233: Comparing EMS Witnessed Cardiac Arrest in Germany and Norway

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Ingvild B Tjelmeland ◽  
Jo Kramer-johansen ◽  
Jan-Thorsten Gräsner ◽  
Stephan Seewald
Keyword(s):  
Overall Survival ◽  
Cardiac Arrest ◽  
Population Based ◽  
Spontaneous Circulation ◽  
Chi Square ◽  
Ambulance Personnel ◽  
Cross Sectional ◽  
Unique Source ◽  
Source Of Information ◽  
Hospital Cardiac Arrest

Introduction: Health registries are a unique source of information about current practice and can describe the burden of disease in a population. However, comparing data from different countries/states we are not always sure if we are comparing patients from similar populations. Method: The aim of this study was to gain a better understanding of the information in the German Resuscitation Registry (GRR) and the Norwegian Cardiac Arrest Registry (NorCAR) through a cross-sectional comparative-study of these two population-based public registries. We included all out-of-hospital cardiac arrest patients witnessed by ambulance personnel, between 1 st January 2015 and 31 st December 2019. Proportions were assessed with Chi-square tests. Results: A total of 3,688 cases from Germany and 2,016 cases from Norway were included in the analysis, resulting in an incidence of 8.6 ambulance witnessed cardiac arrests per 100,000 inhabitants in Germany and 7.8 in Norway. A higher proportion of patients had resuscitation terminated on scene in Norway, 43% vs 30% (p<0.01), while the proportion of patients arriving to hospital with spontaneous circulation was higher in Germany, 49% vs 40% (p<0.01). However, 24-hour survival and the overall survival was higher in Norway, with 24-hour survival of 36% vs 31% (p<0.01), and the overall survival of 28% vs 19% (p<0.01). Conclusion: The incidence of cardiac arrests observed by ambulance personnel was higher in Germany, but survival was higher in Norway. We speculate that the major difference between countries is in the post-resuscitation care after admission to hospital.

Abstract MP73: Emergency Call First Strategy versus Bystander Cardiopulmonary Resuscitation First Strategy for Out-of-Hospital Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Tatsuma Fukuda ◽  
Naoko Ohashi-Fukuda ◽  
Yutaka Kondo ◽  
Kei Hayashida ◽  
Ichiro Kukita
Keyword(s):  
Overall Survival ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cerebral Performance Category ◽  
Population Based ◽  
Spontaneous Circulation ◽  
Emergency Call ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

Introduction: Lay rescuers have a crucial role in successful cardiopulmonary resuscitation (CPR), specifically the first three links in the chain of survival, for out-of-hospital cardiac arrest (OHCA). However, randomized controlled trials on the priority of emergency call (Call first) versus bystander CPR (CPR first) do not exist, and comparative data are very limited. We aimed to assess the association between the priority of bystander’s action (Call first vs. CPR first) and neurologic outcome after OHCA. Methods: This nationwide population-based study of patients who experienced OHCA from January 2005 to December 2014 was based on the data from the Japanese government-managed registry of OHCA. Patients provided bystander’s action (both emergency call and bystander CPR) within 1 minute of witness were included, and Call first strategy was compared with CPR first strategy. The primary outcome was one-month neurologically favorable survival, defined as a Glasgow-Pittsburgh cerebral performance category (CPC) score of 1(good performance) or 2(moderate disability). The secondary outcomes were prehospital return of spontaneous circulation (ROSC) and one-month overall survival. Results: A total of 25,840 patients were included; 4,430 (17.1%) were treated with Call first approach, and 21,410 (82.9%) were treated with CPR first approach. Among total cohort, 2,696 (10.4%) survived with neurologically favorable status one month after OHCA. In the propensity score-matched cohort, one-month neurologically favorable survival was lower among Call first group compared with CPR first group: 364 of 4,430 patients (8.2%) vs. 457 of 4,430 patients (10.3%), respectively (Risk ratio [RR], 0.80; 95% confidence interval [CI], 0.70-0.91). Similar associations were observed for one-month overall survival (RR, 0.90; 95%CI, 0.82-0.99), although there were no significant differences in prehospital ROSC (RR, 0.94; 95%CI, 0.86-1.02) between the Call first and CPR first groups. In subgroup analyses, the association between delayed bystander CPR and worse neurological outcome did not change regardless of subgroup characteristics. Conclusions: In witnessed OHCA, Call first approach was associated with a decreased chance of one-month neurologically favorable survival compared with CPR first approach. These observational findings warrant a randomized clinical trial to determine the priority of emergency call or bystander CPR for OHCA.

Abstract 18724: Coronary Angiography After Out-of-hospital Cardiac Arrest is Associated With Improved Neurologically Intact Survival

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Tasha Hanuschak ◽  
Steven Brooks ◽  
Laurie Morrison ◽  
Paul Peng ◽  
Cathy Zhan
Keyword(s):  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Population Based ◽  
Spontaneous Circulation ◽  
Hospital Arrival ◽  
Hospital Size ◽  
Return Of Spontaneous Circulation ◽  
Randomized Controlled Studies ◽  
Neurologically Intact ◽  
Hospital Cardiac Arrest

Introduction: Evidence for the effectiveness of coronary angiography after out-of-hospital cardiac arrest (OHCA) is conflicting. Our objective was to evaluate the association between receiving coronary angiography within 72 hours of hospital arrival and survival with favorable neurologic outcome. Methods: This was a population-based retrospective cohort study of consecutive cases of adult OHCA transported to and treated at 28 hospitals in Southern Ontario between March 1, 2010 and December 31, 2014. We included patients with atraumatic OHCA, who achieved return of spontaneous circulation, and were alive 6 hours after hospital arrival. Multi-level logistic regression was used to measure the association between early coronary angiography and neurologically intact survival (Modified Rankin Score 0-2), while controlling for potential confounders and clustered data. We controlled for age, sex, initial cardiac rhythm, witness status, bystander resuscitation, EMS response time, prehospital return of spontaneous circulation, location of arrest, daytime presentation, neurologic status at hospital arrival, STEMI status, cardiac history, initiation of therapeutic hypothermia, hospital size and type, and hospital annual cardiac arrest volume. Results: During the period of study, 2678 consecutive OHCA patients met the inclusion criteria. The mean age was 66(±16), 31.7% were female, 54.1% had a bystander witnessed arrest, 35.2% received bystander CPR, 45.9% had a shockable initial rhythm, 30.1% had ST elevation on the first post arrest ECG, and 32.4% received coronary angiography. Receiving coronary angiography was strongly associated with neurologically intact survival (OR 2.30, CI95 1.69-3.15) and survival (OR 2.08, CI95 1.53-2.82). A similar association was observed in the subgroup of patients without STEMI (OR 3.24, CI95 2.16-4.87 and OR 2.66, CI95 1.78-3.99, respectively). Conclusions: Neurologically intact survival among post cardiac arrest patients may be improved with coronary angiography, particularly for patients without STEMI. This observation should be confirmed with future randomized controlled studies.

Abstract 152: Effect of the 2010 CPR Guidelines for Patients With Out-of-Hospital Cardiac Arrest Due to Non-Shockable Rhythm

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Tadashi Ashida ◽  
Tsukasa Yagi ◽  
Ken Nagao ◽  
Shigemasa Tani ◽  
Eizo Tachibana ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Multivariable Analysis ◽  
Population Based ◽  
Spontaneous Circulation ◽  
Adult Patients ◽  
Shockable Rhythm ◽  
Class Iib ◽  
Favorable Neurological Outcome ◽  
Hospital Cardiac Arrest

Background: The 2010 guidelines have stressed that systematic post-cardiac arrest care after return of spontaneous circulation (ROSC) can improve the likelihood of patient survival with good neurological outcome. However, the 2010 guidelines showed that induced therapeutic hypothermia may be considered for comatose adult patients with ROSC after out-of-hospital cardiac arrest (OHCA) with an initial rhythm of non-shockable (Class IIb). It is unknown whether the post-cardiac arrest care for patients with non-shockable cardiac arrest contributed to favorable neurological outcome. The aim of the present study was to clarify the effects of the 2010 guidelines in patients with ROSC after cardiac arrest due to non-shockable rhythm, using the data of the All-Japan Utstein Registry, a prospective, nationwide, population-based registry of OHCA. Methods: From the data of this registry between 2005 and 2015, we included adult patients with ROSC after out-of-hospital non-shockable cardiac arrest due to cardiac etiology. Study patients were divided into three groups based on the different CPR guidelines; the era of the 2000 guidelines (2000G), the era of the 2005 guidelines (2005G), and the era of the 2010 guidelines (2010G). The endpoint was favorable neurological outcome at 30 days after OHCA. Results: The 31,204 patients who met the inclusion criteria comprised 25,045 with ROSC before arrival at the hospital and 6,259 with ROSC after hospital arrival without prehospital ROSC. Figure showed favorable neurological outcome at 30 days in the three groups. Moreover, multivariable analysis showed that the 2010 guidelines were an independent predictor of favorable neurological outcome at 30 days after OHCA, respectively (Figure). Conclusion: In the patients with ROSC after out-of-hospital non-shockable cardiac arrest, the 2010 guidelines were superior to the 2005 guidelines and the 2000 guidelines, in terms of neurological benefits.

scholarly journals ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN EFIKASI DIRI REMAJA DALAM MELAKUKAN RESUSITASI JANTUNG PARU DI SMK NEGERI 2 SINGOSARI

2019 ◽  
Vol 8 (2) ◽  
pp. 8-24
Author(s):  
Ahsan Ahsan
Keyword(s):  
Cardiac Arrest ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Hospital Cardiac Arrest

  Latar Belakang Angka kematian yang terjadi di luar rumah sakit akibat henti jantung atau Out-of-Hospital Cardiac Arrest (OHCA) menjadi salah satu fokus permasalahan kesehatan dunia karena angka kejadiannya yang tinggi dan meningkat setiap tahunnya. Penyebabnya adalah terlambatnya pelaporan dan pemberian tindakan RJP. Kepercayaan diri remaja dalam melakukan RJP dipengaruhi oleh banyak hal. Oleh karena itu beberapa faktor yang sangat penting untuk meningkatkan efikasi diri pada remaja semakin ditekankan untuk meningkatkan angka keselamatan pasien yang mengalami henti jantung di luar rumah sakit. Tujuan Menganalisis faktor-faktor yang berhubungan dengan efikasi diri remaja dalam melakukan Resusitasi Jantung Paru   Metode Desain penelitian yang digunakan adalah cross-sectional study . Lokasi penelitian di SMK Negeri 2 Singosari Malang. Jumlah responden sebanyak 110 responden yang diambil dengan teknik purposive sampling. Analisa data menggunakan uji chi-square dan uji regresi logisitk.   Hasil Hasil uji Chi-Square menunjukkan p value sebagai berikut  variabel pengalaman yaitu nilai p = 0,007 (p<0,05) yang artinya ada hubungan yang signifikan antara pengalaman responden dengan efikasi diri remaja, untuk variabel persepsi didapatkan nilai p = 0,588 (p>0,05). Artinya tidak terdapat hubungan yang signifikan antara persepsi dengan efikasi diri remaja, untuk kesadaran nilai p = 0,000 (p <0,05) yang berarti hubungan yang signifikan antara kesadaran dengan efikasi diri, pada pengetahuan didapatkan nilai p = 0,663 (p>0,05), sehingga dapat disimpulkan bahwa tidak terdapat hubungan yang signifikan antara pengetahuan tentang resusitasi jantung paru dengan efikasi diri remaja. Uji regresi logistik dilakukan untuk mengetahui faktor yang paling berhubungan dengan efikasi diri remaja dalam melakukan resusitasi jantung paru adalah variabel kesadaran   Kesimpulan Kesadaran situasional tentang henti jantung merupakan faktor prediktor yang dapat digunakan untuk memprediksi efikasi diri, dimana kesadaran merupakan faktor prediktor paling dominan dalam mempengaruhi efikasi diri remaja dalam melakukan resusitasi jantung paru di SMK Negeri 2 Singosari.   Kata Kunci: Resusitasi Jantung Paru (RJP), Remaja, Efikasi Diri, Faktor Efikasi Diri        

scholarly journals ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN EFIKASI DIRI REMAJA DALAM MELAKUKAN RESUSITASI JANTUNG PARU DI SMK NEGERI 2 SINGOSARI

2017 ◽  
Vol 5 (3) ◽  
pp. 477
Author(s):  
Dudella Desnani Firman Yasin ◽  
Ahsan Ahsan ◽  
Septi Dewi Racmawati
Keyword(s):  
Cardiac Arrest ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Hospital Cardiac Arrest

Angka kematian yang terjadi di luar rumah sakit akibat henti jantung atau Out-of-Hospital Cardiac Arrest (OHCA) menjadi salah satu fokus permasalahan kesehatan dunia karena angka kejadiannya yang tinggi dan meningkat setiap tahunnya. Penyebabnya adalah terlambatnya pelaporan dan pemberian tindakan RJP. Kepercayaan diri remaja dalam melakukan RJP dipengaruhi oleh banyak hal. Oleh karena itu beberapa faktor yang sangat penting untuk meningkatkan efikasi diri pada remaja semakin ditekankan untuk meningkatkan angka keselamatan pasien yang mengalami henti jantung di luar rumah sakit.Tujuan penelitian untuk mnganalisis faktor-faktor yang berhubungan dengan efikasi diri remaja dalam melakukan Resusitasi Jantung Paru. Desain penelitian yang digunakan adalah cross-sectional study . Lokasi penelitian di SMK Negeri 2 Singosari Malang. Jumlah sampel sebanyak 110 responden yang diambil dengan teknik purposive sampling. Analisa data menggunakan uji chi-square dan uji regresi logisitk.Hasil uji Chi-Square menunjukkan p value sebagai berikut variabel pengalaman yaitu nilai p = 0,007 (p0,05), untuk kesadaran nilai p = 0,000 (p 0,05). Uji regresi logistik dilakukan untuk mengetahui faktor yang paling berhubungan dengan efikasi diri remaja dalam melakukan resusitasi jantung paru adalah variabel kesadaran Kesadaran situasional tentang henti jantung merupakan faktor prediktor yang dapat digunakan untuk memprediksi efikasi diri, dimana kesadaran merupakan faktor prediktor paling dominan dalam mempengaruhi efikasi diri remaja dalam melakukan resusitasi jantung paru di SMK Negeri 2 Singosari.

scholarly journals Association of ambient temperature with the outcomes in witnessed out-of-hospital cardiac arrest patients: a population-based observational study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Chiwon Ahn ◽  
Jihoon Kim ◽  
Wonhee Kim ◽  
In Young Kim ◽  
Hyun Young Choi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ambient Temperature ◽  
Primary Outcome ◽  
Meteorological Data ◽  
Population Based ◽  
Spontaneous Circulation ◽  
Secondary Outcome ◽  
Metropolitan Cities ◽  
Significant Difference ◽  
Hospital Cardiac Arrest

Abstract This study aimed to identify the association between ambient temperature (AT) and patient outcome of witnessed out-of-hospital cardiac arrest (OHCA) occurring outdoors. This retrospective nationwide, population-based cohort study recruited witnessed adult OHCA patients in South Korea from January 2012 to December 2016. Meteorological data of 17 metropolitan cities and provinces were retrieved from the Korea Meteorological Administration database. Primary outcome was sustained return of spontaneous circulation (ROSC) in hospital. Secondary outcome was survival to hospital discharge. By the standard of quartile categories of AT (Q1 = 7.1 °C; Q2 = 17.7 °C; Q3 = 23.5 °C), three comparative analyses for ROSC and survival were performed between low and high AT groups. Propensity score matching (1:1) was performed for both AT groups. Among the 142,906 OHCA patients, 1,295 were included. In the multivariate analysis for matched groups by the standard of 7.1 °C (Q1), proportion of ROSC was significantly higher in the high AT-Q1 group than in the low AT-Q1 group (adjusted odds ratio [aOR] 2.02, 95% confidence interval [CI] 1.19–3.44). No significant difference in survival was shown between both AT-Q1 groups (aOR 1.24, 95% CI 0.61–2.52). In the standard of 17.7 °C (Q2) and 23.5 °C (Q3), no significant differences in ROSC and survival were found between the low and high AT groups. In conclusion, no obvious correlation existed between AT and patient outcomes such as sustained ROSC or survival to discharge in this study.

Epinephrine dosing interval and neurological outcome in out-of-hospital cardiac arrest

Perfusion ◽  
2021 ◽  
pp. 026765912110251
Author(s):  
Tatsuma Fukuda ◽  
Hirotsugu Kaneshima ◽  
Aya Matsudaira ◽  
Takumi Chinen ◽  
Hiroshi Sekiguchi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Standard Dose ◽  
Population Based ◽  
Spontaneous Circulation ◽  
Time Interval ◽  
Epinephrine Administration ◽  
Dosing Interval ◽  
Using Data ◽  
Dosing Intervals ◽  
Hospital Cardiac Arrest

Objective: Current guidelines for cardiopulmonary resuscitation (CPR) recommend that standard-dose epinephrine be administered every 3–5 minutes during cardiac arrest. However, there is a knowledge gap regarding the optimal epinephrine dosing interval. This study aimed to examine the association between epinephrine dosing intervals and outcomes after out-of-hospital cardiac arrest (OHCA). Methods: This was a nationwide population-based observational study using data from a Japanese government-led registry of OHCA, including patients who experienced OHCA in Japan from 2011 to 2017. We defined the epinephrine dosing interval as the time interval between the first epinephrine administration and return of spontaneous circulation in the prehospital setting, divided by the total number of epinephrine doses. The primary outcome was 1-month neurologically favorable survival. Results: A total of 10,965 patients (mean (SD) age, 75.8 (14.3) years; 59.8% male) were included. The median epinephrine dosing interval was 3.5 minutes (IQR, 2.5–4.5; mean (SD), 3.6 (1.8)). Only approximately half of the patients received epinephrine administration with a standard dosing interval, as recommended in the current CPR guidelines. After multivariable adjustment, compared with the standard dosing interval, neither shorter nor longer epinephrine dosing intervals were associated with neurologically favorable survival after OHCA (Short vs Standard: adjusted OR 0.87 [95%CI 0.66–1.15]; and Long vs Standard: adjusted OR 1.08 [95%CI 0.76–1.55]). Similar associations were observed in propensity score-matched analyses. Conclusions: The epinephrine dosing interval was not associated with 1-month neurologically favorable survival after OHCA. Our findings do not deny the recommended epinephrine dosing interval in the current CPR guidelines.

scholarly journals PENGETAHUAN REMAJA TENTANG RESUSITASI JANTUNG PARU BERHUBUNGAN DENGAN EFIKASI DIRI REMAJA DI SMK NEGERI 2 SINGOSARI MALANG

2020 ◽  
Vol 8 (1) ◽  
pp. 116
Author(s):  
Dudella Desnani Firman Yasin ◽  
Ahsan Ahsan ◽  
Septi Dewi Racmawati
Keyword(s):  
Cardiac Arrest ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Relationship Of ◽  
The Relationship ◽  
Hospital Cardiac Arrest ◽  
Very High

The focus of current global health problems is the death rate that occurs outside the Hospital Out-of-Hospital Cardiac Arrest (OHCA) due to cardiac arrest. Every year the incidence rate is very high and increasing. Delay in reporting and providing Lung Resuscitation can result in death. Providing knowledge about CPR is expected to reduce mortality due to cardiac arrest. The purpose of this study was to determine the relationship of knowledge with adolescent self-efficacy in performing Pulmonary Resuscitation. The research design used was cross-sectional study. The research location is SMK Negeri 2 Singosari Malang. The number of respondents was 110 respondents taken by purposive sampling technique. Data analysis using chi-square test that is knowledge obtained p = 0.003 (p

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