scholarly journals Out-of-hospital cardiac arrest in the home: Can area characteristics identify at-risk communities in the Republic of Ireland?

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Siobhán Masterson ◽  
Conor Teljeur ◽  
John Cullinan ◽  
Andrew W. Murphy ◽  
Conor Deasy ◽  
...  
Keyword(s):  
At Risk ◽  
Cardiac Arrest ◽  
Republic Of Ireland ◽  
The Republic ◽  
Risk Communities ◽  
Hospital Cardiac Arrest

Outcomes and prevalence of adult out-of-hospital cardiac arrest (OHCA) by population density groups in the Republic of Ireland

Resuscitation ◽  
2013 ◽  
Vol 84 ◽  
pp. S51
Author(s):  
Ashley Nadeau ◽  
Nurul Amani Mohd Noording ◽  
Gregory O’Neill ◽  
Siobhan Masterson ◽  
Akke Vellinga
Keyword(s):  
Cardiac Arrest ◽  
Population Density ◽  
Republic Of Ireland ◽  
The Republic ◽  
Hospital Cardiac Arrest

Abstract 9086: Sex Differences in the Association Between Bystander CPR and Survival for Patients With Out-of-Hospital Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Kiok Ahn ◽  
Bryan McNally ◽  
Paul Chan
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Significant Interaction ◽  
National Registry ◽  
Republic Of Korea ◽  
Secondary Outcome ◽  
Multivariable Logistic Regression ◽  
Bystander Cpr ◽  
The Republic ◽  
Hospital Cardiac Arrest

Background: Bystander cardiopulmonary resuscitation (CPR) is associated with a better survival outcome in patients with out-of-hospital cardiac arrest (OHCA). However, there may be cultural barriers in performing high-quality bystander CPR in women in some non-Western countries and the effect of bystander CPR on survival outcomes may differ by patients’ sex. Methods: Using data between 2012-2018 from a national OHCA registry from the Republic of Korea, we identified adult patients with OHCA of presumed cardiac etiology. The main exposures were bystander CPR and patients’ sex. The primary outcome was survival discharge and the secondary outcome was favorable neurological survival. Multivariable logistic regression evaluated the association between bystander CPR and survival, adjusted for patients’ age, sex, socio-economic status, year of arrest, witnessed arrest status, initial OHCA rhythm, location of arrest, urbanization level of arrest location, and type of bystander. The interaction between bystander CPR and sex was explicitly evaluated in the models. Results: Of 101,505 patients with OHCA in the cohort, 34,124 (33.6 %) were women and 67,381 (64.4 %) were men. Bystander CPR was performed on 18,481 (54.2%) women and 35,904 (53.3%) men (p=0.07). Unadjusted rates of survival discharge were 4.5% in women and 9.5 % in men (p<0.001), and rates of favorable neurological survival were 2.5% in women and 6.4% in men (p<0.001). In multivariable logistic regression models, there was a significant interaction (p=0.005) between bystander CPR and sex for survival to discharge, with an adjusted OR for bystander CPR of 1.16 (95% CI: 1.08-1.23) in men and 0.91 (95% CI: 0.80-1.02) in women. For favorable neurological survival, there was also a significant interaction (p=0.01) between sex and bystander CPR, with an adjusted OR for bystander CPR of 1.47 (95% CI: 1.36-1.60) in men and 1.16 (95% CI: 0.98- 1.37) in women. Conclusions: In a national registry of OHCA from the Republic of Korea, men who received bystander CPR were more likely to survive whereas women who received bystander CPR were not.

Identifying patients at risk of futile resuscitation: palliative care indicators in out-of-hospital cardiac arrest

2019 ◽  
pp. bmjspcare-2019-001828
Author(s):  
Mia Cokljat ◽  
Adam Lloyd ◽  
Scott Clarke ◽  
Anna Crawford ◽  
Gareth Clegg
Keyword(s):  
At Risk ◽  
Palliative Care ◽  
Cardiac Arrest ◽  
High Risk ◽  
Low Risk ◽  
Intermediate Risk ◽  
Patients At Risk ◽  
Risk Patients ◽  
Record Review ◽  
Hospital Cardiac Arrest

ObjectivesPatients with indicators for palliative care, such as those with advanced life-limiting conditions, are at risk of futile cardiopulmonary resuscitation (CPR) if they suffer out-of-hospital cardiac arrest (OHCA). Patients at risk of futile CPR could benefit from anticipatory care planning (ACP); however, the proportion of OHCA patients with indicators for palliative care is unknown. This study quantifies the extent of palliative care indicators and risk of CPR futility in OHCA patients.MethodsA retrospective medical record review was performed on all OHCA patients presenting to an emergency department (ED) in Edinburgh, Scotland in 2015. The risk of CPR futility was stratified using the Supportive and Palliative Care Indicators Tool. Patients with 0–2 indicators had a ‘low risk’ of futile CPR; 3–4 indicators had an ‘intermediate risk’; 5+ indicators had a ‘high risk’.ResultsOf the 283 OHCA patients, 12.4% (35) had a high risk of futile CPR, while 16.3% (46) had an intermediate risk and 71.4% (202) had a low risk. 84.0% (68) of intermediate-to-high risk patients were pronounced dead in the ED or ED step-down ward; only 2.5% (2) of these patients survived to discharge.ConclusionsUp to 30% of OHCA patients are being subjected to advanced resuscitation despite having at least three indicators for palliative care. More than 80% of patients with an intermediate-to-high risk of CPR futility are dying soon after conveyance to hospital, suggesting that ACP can benefit some OHCA patients. This study recommends optimising emergency treatment planning to help reduce inappropriate CPR attempts.

scholarly journals Analysis of characteristics and trends of the In-Hospital Cardiac Arrest incidence in the Republic of Korea: clinical usefulness of national health insurance claim data

2021 ◽  
Keyword(s):  
Cardiac Arrest ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Circulatory System ◽  
Claim Data ◽  
Republic Of Korea ◽  
Classification Of Diseases ◽  
The Republic ◽  
Hospital Cardiac Arrest

Backgrounds: In-Hospital Cardiac Arrest (IHCA) requires the preparation of considerable medical resources in hospitals. Furthermore, compared to Out-of-Hospital Cardiac Arrest, until recently, there have not been many studies on the incidence, characteristics, and prognosis of IHCA. This study is to examine IHCA event rates among hospitalized patients in the Republic of Korea from 2011 to 2015. Methods: The incidence of IHCA in adults was extracted from claim data of the National Health Insurance Service from 2011 to 2015, and analyzed according to age, sex, the classification under the 7th revision of the Korean Standard Classification of Diseases (KCD-7), hospital types, and provinces. Results: From 2011 to 2015, the overall incidence of IHCA in Korea was founded to be 3.00 per 1,000 hospitalizations. The overall 5-year IHCA incidence was higher in male at 3.92 cases per 1,000 hospitalizations and at female 2.19 cases per 1,000 hospitalizations. Incidence due to cardiovascular disease increased year by year, whereas incidences due to respiratory, neurological and infectious disease were decreasing, and in the case of oncologic disease, there was no change. In particular, patients with diseases of the circulatory system had at least a two times higher incidence compared to those with other diseases. The IHCA incidence in general hospitals and tertiary hospitals was at least two-fold higher than the national overall and showed an increasing trend. The provinces that showed a higher IHCA incidence than the five-year national overall were Jeju Special Self-Governing Province, Gangwon Province, and Seoul. Conclusions: The results of this study can be used as important basic data to secure patient safety by reducing the occurrence of IHCA.

scholarly journals TCT-494 Long term prognostic impact of myocardium at risk and CTO presence in the setting of myocardial infarction complicated by out-of-hospital cardiac arrest

2017 ◽  
Vol 70 (18) ◽  
pp. B204
Author(s):  
Nikolaos Magkoutis ◽  
Sebastian Voicu ◽  
Demetris Yannopoulos ◽  
Jean Guillaume Dillinger ◽  
Damien Logeart ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
At Risk ◽  
Cardiac Arrest ◽  
Prognostic Impact ◽  
Myocardium At Risk ◽  
Hospital Cardiac Arrest

scholarly journals Out-of-hospital Cardiac Arrest in the Republic of Crimea: Analysis of Epidemiology and Practice of Care

2020 ◽  
Vol 9 (3) ◽  
pp. 338-347
Author(s):  
A. A. Birkun ◽  
L. P. Frolova ◽  
G. N. Buglak ◽  
S. S. Olefirenko
Keyword(s):  
Cardiac Arrest ◽  
Response Time ◽  
Prehospital Care ◽  
Spontaneous Circulation ◽  
Annual Data ◽  
Clear Understanding ◽  
Study Results ◽  
Prehospital Management ◽  
The Republic ◽  
Hospital Cardiac Arrest

Introduction. Efficient organization of measures aimed at decreasing mortality from out-of-hospital cardiac arrest (OHCA) warrants a clear understanding of OHCA epidemiology and performance of the prehospital care system in such cases. The study was aimed at performing respective analysis and identifying the ways for improving prehospital management of OHCA in the Republic of Crimea.Material and methods. Annual data from the Crimean OHCA and Resuscitation Registry for 2018 were utilized. All OHCA cases attended by emergency medical services (EMS) with attempted cardiopulmonary resuscitation (CPR) were included, regardless of cardiac arrest etiology or patients’ age (n=419). For ensuring conformity and comparability of the study results, data collection and analysis were executed in correspondence with the statements of the Utstein recommendations.Results. The overall incidence of EMS-attended OHCA in the Republic of Crimea was 673.3 per 100,000 population per year, the incidence of OHCA with attempted CPR – 21.9 per 100,000 population per year, the proportion of CPR attempts out of all OHCA cases – 3.3%. Mean patient age was 66.9 years, and 52.7% were male. The etiology was cardiac in 42.5% cases. In 71.8% cases OHCA was witnessed by EMS, in 25.5% – by a bystander before EMS arrival. Bystanders initiated CPR in 5.7% cases. The initial rhythm was asystole in 80.4% of all cases. When excluding EMS-witnessed cases, the mean EMS response time was 13 min. 5.0% patients had a sustained return of spontaneous circulation at hospital admission. Survival was associated with lower EMS response time (p=0.027), administration of shock (p<0.001) and advanced airway management with endotracheal tube or laryngeal mask (p=0.047).Conclusion. High incidence of OHCA, low rates of CPR commencement and low rates of survival from OHCA in the Republic of Crimea determine the necessity of implementing a comprehensive program to improve prehospital care in the region. Considering the critical relevance of early intervention in OHCA and the revealed low bystander CPR rate, the measures for involving community into the process of prehospital care should form the basis of this program.

scholarly journals Resuscitation Care in Out-Of-Hospital Cardiac Arrest: a Survey of the Emergency Medical Services Personnel in the Republic of Crimea

2021 ◽  
Vol 9 (4) ◽  
pp. 612-625
Author(s):  
A. A. Birkun ◽  
L. P. Frolova ◽  
G. N. Buglak ◽  
S. S. Olefirenko ◽  
L. I. Dezhurny
Keyword(s):  
Cardiac Arrest ◽  
Emergency Medical Services ◽  
Real Life ◽  
Alternative Methods ◽  
Medical Services ◽  
Knowledge And Skills ◽  
Emergency Medical ◽  
Resuscitation Training ◽  
The Republic ◽  
Hospital Cardiac Arrest

Introduction. The choice of the ways for optimizing management of out-of-hospital cardiac arrest by emergency medical services (EMS) should be based on the evidence from existing practice of resuscitation care. The study was aimed at evaluating personal experience of cardiopulmonary resuscitation (CPR) performance, timing of last training in resuscitation and level of self-perceived knowledge and skills of CPR among the employees of the EMS of the Republic of Crimea, as well as to assess their beliefs on significance of individual CPR procedures in terms of influence on success of resuscitation and to study their perceptions on factors that may have positive or negative impact on effectiveness of resuscitation care.Material and methods. An anonymous survey of the EMS personnel of the Republic of Crimea was conducted in July–December 2019. The questionnaire was utilized to collect demographic data, information on experience of conducting CPR for the last year, on a current practice of CPR debriefings and timing of last CPR training. The participants assessed their knowledge and skills of CPR and their perception of influence of early implementation of individual CPR procedures on success of resuscitation on a 5-point Likert scale, and indicated factors, that may limit or enhance the effectiveness of resuscitation.Results. A total of 251 specialist of the EMS participated in the survey, including 63 physicians, 129 feldshers and 4 nurses of ambulance teams, 45 dispatchers and 5 senior officers of the EMS stations, which corresponds to 28.8% of physicians, 13.0% of feldsher/nursing staff and 17.4% of dispatcher specialists of the republic. Percentage of male respondents was 35.5%, mean age — 41.5 years, mean duration of EMS work experience — 15.5 years. The mean declared number of cases of CPR conducted in the last 12 months was 2.2 (range: 0–20), and 23.5% specialists of the ambulance teams have not participated in any CPR attempt over the last year. About 60.2% respondents were trained in CPR within the last year. When compared to other specialists of ambulance teams, feldshers who work alone (without a coworker), were significantly less commonly performing a real-life resuscitation (p=0.008) or receiving training in CPR (p=0.020). Dispatchers were least covered with resuscitation training (only 33.3% were trained within the last year) and had the lowest level of CPR knowledge and skills. 25.9% of the specialists had an erroneous judgement that early drug administration and/or tracheal intubation have higher influence on success of resuscitation when compared to chest compressions and/or defibrillation. The level of knowledge and skills of CPR depend on the timing of last training (p<0.001).Conclusions. The experience of participation in real-life attempts of CPR is severely limited for considerable part of the EMS employees, and many specialists have not been trained in resuscitation for a long time. The perceptions of the EMS specialists regarding the importance of individual CPR procedures are not always compliant with the statements of current international CPR guidelines. In order to enhance the effectiveness of resuscitation care in the Republic of Crimea, it is advisable to monitor the coverage of the EMS employees with resuscitation training and the rates of their participation in resuscitation attempts, as well as to perform additional targeted training in CPR, in particular, using alternative methods of education.

scholarly journals Improving Cardiac Arrest Care in Ireland

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
David Hennelly
Keyword(s):  
Cardiac Arrest ◽  
Emergency Medical Services ◽  
Ambulance Service ◽  
Standards Of Care ◽  
Collaborative Project ◽  
Life Project ◽  
The Past ◽  
The Republic ◽  
The One ◽  
Hospital Cardiac Arrest

<p>The National Ambulance Service (NAS) serves a population of almost 4.6 million people in the Republic of Ireland, the service responds to over 300,000 ambulance calls each year.  The NAS employs over 1,600 staff across 100 locations and has a fleet of approximately 500 vehicles. Emergency Medical Services attempt resuscitation on just under 2000 Out of Hospital Cardiac Arrest (OHCA) cases each year.</p><p>Over the past two years the National Ambulance service has engaged with both the country’s leading resuscitation experts and our international counterparts in a collaborative project focused on developing and expanding the National Ambulance Services response to out of hospital cardiac arrest. The One Life Project not only represents our commitment to improve standards of care it also represents our commitment to measure and publicly report on clinical outcomes of patients. </p>

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