Survival of patients suffering an out-of-hospital cardiac arrest treated by emergency services in Spain during the COVID-19 pandemic and 1 year later

Abstract Background When an Out-of-Hospital Cardiac Arrest (OHCA) incident is reported to emergency services, the 911 agent dispatches Emergency Medical Services to the location and activates responder network system (RNS), if the option is available. The RNS notifies all the registered users in the vicinity of the cardiac arrest patient by sending alerts to their mobile devices, which contains the location of the emergency. The main objective of this research is to find the best match between the user who could support the OHCA patient. Methods For performing matching among the user and the AEDs, we used Bipartite Matching and Integer Linear Programming. However, these approaches take a longer processing time; therefore, a new method Preprocessed Integer Linear Programming is proposed that solves the problem faster than the other two techniques. Results The average processing time for the experimentation data was 1850 s using Bipartite matching, 32 s using the Integer Linear Programming and 2 s when using the Preprocessed Integer Linear Programming method. The proposed algorithm performs matching among users and AEDs faster than the existing matching algorithm and thus allowing it to be used in the real world. Conclusion: This research proposes an efficient algorithm that will allow matching of users with AED in real-time during cardiac emergency. Implementation of this system can help in reducing the time to resuscitate the patient.

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When dispatcher assistance is not saving lives: assessment of process compliance, barriers and outcomes in out-of-hospital cardiac arrest in a metropolitan city in China

Emergency Medicine Journal ◽

10.1136/emermed-2019-209291 ◽

2020 ◽

pp. emermed-2019-209291 ◽

Cited By ~ 1

Author(s):

Lin Zhang ◽

Menyue Luo ◽

Helge Myklebust ◽

Chun Pan ◽

Liang Wang ◽

...

Keyword(s):

Cardiac Arrest ◽

Survival Rate ◽

Cardiopulmonary Resuscitation ◽

Emergency Services ◽

Public Awareness ◽

Survival Rates ◽

Process Compliance ◽

Barriers To Implementation ◽

Prolonged Delay ◽

Hospital Cardiac Arrest

BackgroundSeveral Chinese cities have implemented dispatcher-assisted cardiopulmonary resuscitation (DA-CPR), although out-of-hospital cardiac arrest (OHCA) survival rates remain low. We aimed to assess the process compliance, barriers and outcomes of OHCA in one of the earliest implemented (DA-CPR) programmes in China.MethodsWe retrospectively reviewed OHCA emergency dispatch records of Suzhou emergency medical service from 2014 to 2015 and included adult OHCA victims (>18 years) with a bystander-witnessed atraumatic OHCA that was subsequently confirmed by on-site emergency physician. The circumstances and DA-CPR process related to the OHCA event were analysed. Dispatch audio records were reviewed to identify potential barriers to implementation during the DA-CPR process.ResultsOf the 151 OHCA victims, none survived. The median time from patient collapse to call for emergency services and that from call to provision of cardiopulmonary resuscitation instructions was 30 (IQR 20–60) min and 115 (IQR 90–153) s, respectively. Only 110 (80.3%) bystanders/rescuers followed the dispatcher instructions; of these, 51 (46.3%) undertook persistent chest compressions. Major barriers to following the DA-CPR instructions were present in 104 (68.9%) cases, including caller disconnection of the call, distraught mood or refusal to carry out either compressions or ventilations.ConclusionsThe OHCA survival rate and the DA-CPR process were far from optimal. The zero survival rate is disproportionally low compared with survival statistics in high-income countries. The prolonged delay in calling the emergency services negated and rendered futile any DA-CPR efforts. Thus, efforts targeted at developing public awareness of OHCA, calling for help and competency in DA-CPR should be increased.

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Abstract 14806: Predictors of Survival and Favourable Functional Outcomes Following an Out of Hospital Cardiac Arrest in Patients Systematically Brought to a Dedicated Heart Attack Centre

Circulation ◽

10.1161/circ.130.suppl_2.14806 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

M Bilal Iqbal ◽

Abtehale Al-Hussaini ◽

Gareth Rosser ◽

Saleem Salehi ◽

Maria Phylactou ◽

...

Keyword(s):

Cardiac Arrest ◽

Functional Status ◽

Heart Attack ◽

Functional Outcomes ◽

Emergency Services ◽

Survival Rates ◽

Spontaneous Circulation ◽

Term Survival ◽

Poor Functional Status ◽

Hospital Cardiac Arrest

BACKGROUND: Despite advances in cardiopulmonary resuscitation, survival remains low after out of hospital cardiac arrest (OOHCA), with less than 20% of patients surviving to hospital discharge. Acute coronary ischaemia is the predominating cause and prompt delivery of patients to dedicated facilities may improve outcomes. Since 2011, all patients in London with OOHCA, in whom a cardiac aetiology is suspected, are brought to dedicated Heart Attack Centres (HACs). OBJECTIVES: We sought to determine the predictors for survival and favourable functional outcomes following OOHCA in this setting. METHODS: We analysed 182 consecutive OOHCA patients brought by the emergency services to Harefield Hospital - a designated HAC in London. Of these, 174 patients achieved return of spontaneous circulation. We analysed (a) all-cause mortality at 1 year; and (b) functional status at discharge using a modified Rankins score (mRS:0-6, where mRS0-3=favourable functional status). We used multivariate models to determine predictors of survival and favourable functional status. RESULTS: The overall survival rates were 66.7% at 30 days and 62.1% at 1 year. Of the 174 patients, 95 patients (54.5%) had favourable functional status at discharge. Patients with favourable functional status had significantly reduced mortality rates compared to those with poor functional status: 30 days (1.2% vs. 72.2%, p<0.001) and 1 year (5.3% vs. 77.2%, p<0.001). Multivariate analyses identified a shorter duration of resuscitation and absence of cardiogenic shock as consistent independent predictors of both favourable functional status and long-term survival (figure). CONCLUSIONS: The strategic delivery of OOHCA patients to HACs is associated with improved functional status and survival. Those with favourable functional status at discharge have significantly improved survival. Our study supports the standardisation of care for such patients with the widespread adoption of dedicated facilities.

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Modifiable Survival Factors of Out-of-Hospital Cardiac Arrest among Global Population: Systematic Review and Meta-Analysis

Indonesian Journal of Cardiology ◽

10.30701/ijc.1014 ◽

2020 ◽

Author(s):

Jeremy Rafael Tandaju ◽

Kareen Tayuwijaya

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

Emergency Services ◽

Public Awareness ◽

Meta Analysis ◽

Preventive Measure ◽

District Health ◽

Survival Factors ◽

Modifiable Factors ◽

Hospital Cardiac Arrest

Out-of-hospital cardiac arrest (OHCA) is the most common type of cardiac arrest and causing much mortality and burden even preventive measure has been made. Therefore, we conducted study to reduce OHCA morbidity and mortality by finding modifiable survival factors in-order to interfere them. We did systematic review of large cohort studies (n>100,000) on general population from four databases, then filtered 3,560 studies into 9 studies and appraised them using Newcastle-Ottawa scale for quality and Cochrane risk-of-bias before being synthesized. Among 486,012 subjects, we found out that age and shockable rhythm is unmodifiable but could be helped with lifestyle. Modifiable factors are grouped into two: bystander response including public location (OR=1.24; CI 95%=1.16–1.32), bystander witness (OR=1.45; CI 95%=1.36–1.56), bystander CPR (OR=1.45; CI 95%=1.36–1.56); and emergency service delivery including paramedic response <10 minutes (OR=1.55; CI 95%=1.41–1.70), ambulance physician (OR=1.52; CI 95%=1.37–1.68). Having OHCA in public means bigger chance of being resuscitated. However, resuscitation by uneducated bystander shown harmful thus public education was needed. Emergency services were considered important to arrive with competent workers, especially physicians who was trained on defibrillator usage and management regiment. Therefore, increasing public awareness, provide more ambulance and district health center facility, and training of health care workers are essential. In conclusion, management of OHCA involved multidisciplinary action throughout the nation to increase outcome of OHCA and lessen the burden. More area-specified and factor-specified studies should be conducted to improve applicability.

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Variability in the structure and operation of out-of-hospital emergency services in Spain. Spanish Registry of out-of-hospital cardiac arrest

Resuscitation ◽

10.1016/j.resuscitation.2014.03.058 ◽

2014 ◽

Vol 85 ◽

pp. S19 ◽

Cited By ~ 2

Author(s):

Fernando Rosell-Ortiz ◽

Guadalupe Inza Muñoz ◽

Marta Martínez del Valle ◽

Ma Isabel Ceniceros Rozalén ◽

Enrique Martín Sánchez ◽

...

Keyword(s):

Cardiac Arrest ◽

Emergency Services ◽

Hospital Emergency ◽

Hospital Cardiac Arrest

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Out-of-Hospital Cardiac Arrest: First Documented Experience in a Mexican Urban Setting

Prehospital and Disaster Medicine ◽

10.1017/s1049023x0000666x ◽

2009 ◽

Vol 24 (2) ◽

pp. 121-125 ◽

Cited By ~ 6

Author(s):

Juan Manuel Fraga-Sastrías ◽

Enrique Asensio-Lafuente ◽

Ricardo Martínez ◽

Iris A. Bárcenas ◽

Julio Prieto-Sagredo ◽

...

Keyword(s):

Cardiac Arrest ◽

Emergency Services ◽

Community Education ◽

Response Times ◽

Urban Setting ◽

Categorical Variables ◽

Chest Compressions ◽

Airway Control ◽

The Mean ◽

Hospital Cardiac Arrest

AbstractObjective:Out-of-hospital cardiac arrest is one of the leading causes of death in Mexico, but many survival and prognostic factors are unknown. The aim of this study was to assess out-of-hospital cardiac arrest in a Mexican city.Methods:This was a prospective, cohort study that evaluated the records of the major ambulance services in the city of Queretaro, Mexico. Means, standard deviation, and percentages for the categorical variables were obtained. Logistic regression was performed to determine the effects between interventions, times, and return of spontaneous circulation (ROSC).Results:For an 11-month period, 148 out-of-hospital cardiac arrest cases were recorded. The mean age of the victims was 54 ±22.6 years and 90 (65.3%) were males. Forty-nine cases were related to cardiac disease, 46 to other disease, 27 to trauma, 18 to terminal illnesses, and three to drowning. Twelve (8.6%) patients had a pulse upon hospital arrival, but none survived to discharge. No victims were defibrillated prior to ambulance arrival. The collapse-assessment interval was 22.5 ±19:1 minutes, the mean value for the ambulance response times was 13:6 ±10:4 minutes. Basic emergency medical technicians applied chest compressions to 40 victims (27.2%), controlled the airway in 32 (21.8%), and defibrillated seven (4.8%). Chest compressions and airway control showed an OR of 8 and 12 respectively for ROSC.Conclusions:The poor survival rate in this study emphasizes the need to improve efforts in provider training and public education. Authorities must promote actions to enhance prehospital emergency services capabilities, shorten response times, and provide community education to increase the chances of survival for out-of-hospital cardiac arrest victims in Mexico.

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