Impact of New Resuscitation Guidelines on Out-of-hospital Cardiac Arrest Survival

2007 ◽  
Vol 14 (5 Supplement 1) ◽  
pp. S157-S158 ◽  
Author(s):  
W. Fales ◽  
R. Farrell
Keyword(s):  
Cardiac Arrest ◽  
Resuscitation Guidelines ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

scholarly journals Improvement of out-of-hospital cardiac arrest survival rate after implementation of the 2010 resuscitation guidelines

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0204169 ◽  
Author(s):  
Robert Larribau ◽  
Hélène Deham ◽  
Marc Niquille ◽  
François Pierre Sarasin
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Resuscitation Guidelines ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Abstract P82: Implementation Of New Resuscitation Guidelines Takes One-and-a-half Year

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jocelyn Berdowski ◽  
Andra Schmohl ◽  
Rudolph W Koster
Keyword(s):  
Cardiac Arrest ◽  
World Wide ◽  
Prospective Observational Study ◽  
Spontaneous Circulation ◽  
Chest Compressions ◽  
Return Of Spontaneous Circulation ◽  
Resuscitation Guidelines ◽  
Rhythm Analysis ◽  
New Guidelines ◽  
Hospital Cardiac Arrest

Objective- In November 2005, updated resuscitation guidelines were introduced world-wide, and will be revised again in 2010. This study aims to determine how long it takes to implement new guidelines. Methods- This was a prospective observational study. From July 2005 to January 2008, we included all patients with a non traumatic out-of-hospital cardiac arrest. Ambulance paramedics sent all continuous ECG registrations with impedance signal by modem. We excluded ECGs from patients with Return Of Spontaneous Circulation at arrival, incomplete ECG registrations, ECGs with technical deficits or with continuous chest compressions. The same guidelines needed to be used in over 75% of the registration time in order to be labeled. We classified ECGs as guidelines 2000 if the c:v ratio was 15:2, shock blocks were present and there was rhythm analysis after each shock; guidelines 2005 if the c:v ratio was 30:2, a single shock protocol was used and chest compressions was immediately resumed after shock or rhythm analysis in a no shock scenario. We accepted 10% deviations in the amount of compressions (13–17 for 2000 guidelines, 27–33 for 2005). Results- Of the 1703 analyzable ECGs, we classified 827 (48.6%) as guidelines 2000 and 624 (36.6%) as guidelines 2005. In the remaining 252 ECGs (14.8%) 31 used guidelines 1992, 137 applied guidelines 2000 with c:v ratio of 30:2 and 84 did not show distinguishable guideline usage. Since the introduction in November 2005, it took 17 months to apply new guidelines in over 80% of the cases (figure 1 ). Conclusion- Guideline changes are slowly implemented by professionals. This needs to be taken in consideration when new guideline revisions are considered.

Abstract 86: Association Between Hospital Postresuscitative Performance and Clinical Outcomes in Patients with Out-of-Hospital Cardiac Arrest

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Dion Stub ◽  
Robert H Schmicker ◽  
Monique L Anderson ◽  
Eric D Peterson ◽  
Clifton W Callaway ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Functional Status ◽  
Performance Metrics ◽  
Treatment Guidelines ◽  
Hospital Performance ◽  
Temperature Management ◽  
Performance Score ◽  
Resuscitation Guidelines ◽  
Care Guidelines ◽  
Hospital Cardiac Arrest

Context: Whilst performance measures have been extensively evaluated in conditions such as myocardial infarction, it remains unclear if adherence to post-resuscitation guidelines is associated with better outcome in patients hospitalized after out-of-hospital cardiac arrest (OHCA). Objectives: To assess whether survival and good functional status at discharge are associated with post-resuscitation performance score based on treatment guidelines for patients with OHCA, comprised of a) initiation of temperature management; b) target temperature 32 0 -34 0 C achieved; c) temperature management continued for more than 12 hours; d) coronary angiography performed within 24 hrs; e) life sustaining treatment not withdrawn prior to day 3. Methods: An observational analysis of hospital care in 111 North American hospitals, including 3252 patients enrolled in the Resuscitation Outcomes Consortium (ROC-PRIMED) study, between 2007 and 2009, following OHCA. Performance scores were calculated, utilizing opportunity based scoring, with each factor weighted equally and scaled from 0-1. Scores for individual patients were grouped at the hospital level, with hospitals divided for descriptive purposes into quartiles based on their median opportunity composite score. Results: Performance score varied widely (median [IQR] scores from lowest to highest hospital quartiles, 21% [20%-25%] vs 59% [55%-64%]. Adjusted survival to discharge increased with each quartile of performance score (lowest to highest: 16.2%, 20.8%, 28.5%, 34.8%, P <0.01). Similarly adjusted rates of good functional outcome improved (lowest quartile to highest: 8.3%, 13.8%, 22.2%, 25.9%, P<0.01). Hospital performance score were significantly associated with outcome after risk adjustment for established prehospital resuscitative factors (Highest versus lowest adherence quartile: adjusted OR of survival 1.64; 95% CI 1.13, 2.38) Conclusions: Increased survival and improved functional status at discharge are associated with greater adherence to recommended hospital based post-resuscitative care guidelines. Measuring, reporting and improving hospital adherence to guideline-based performance metrics could improve outcomes following OHCA.

scholarly journals Temporal trends in out-of-hospital cardiac arrest survival outcomes between two metropolitan communities: Seoul-Osaka resuscitation study

BMJ Open ◽  
2015 ◽  
Vol 5 (6) ◽  
pp. e007626-e007626 ◽  
Author(s):  
Y. S. Ro ◽  
S. D. Shin ◽  
T. Kitamura ◽  
E. J. Lee ◽  
K. Kajino ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Temporal Trends ◽  
Survival Outcomes ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

scholarly journals Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes

Resuscitation ◽  
2018 ◽  
Vol 130 ◽  
pp. 159-166 ◽  
Author(s):  
Robert M. Sutton ◽  
Ron W. Reeder ◽  
William Landis ◽  
Kathleen L. Meert ◽  
Andrew R. Yates ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Chest Compression ◽  
Survival Outcomes ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

PaRamEDIc assessment of laCTate in OHCA and survival to hospital (PREDICT protocol)

2021 ◽  
Vol 13 (3) ◽  
pp. 100-104
Author(s):  
Karl Charlton ◽  
Hayley Moore
Keyword(s):  
Cardiac Arrest ◽  
Primary Outcome ◽  
Spontaneous Circulation ◽  
Prognostic Role ◽  
Single Centre ◽  
Intravenous Access ◽  
Secondary Outcomes ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Background: Studies suggest that blood lactate differs between survivors and non-survivors of out-of-hospital cardiac arrest who are transported to hospital. The prognostic role of lactate taken during out-of-hospital cardiac arrest remains unexplored. Aims: To measure the association between lactate taken during out-of-hospital cardiac arrest, survival to hospital and 30-day mortality. Methods: This is a feasibility, single-centre, prospective cohort study. Eligible for inclusion are patients aged ≥18 years suffering out-of-hospital cardiac arrest, receiving cardiopulmonary resuscitation, in the catchment of Newcastle or Gateshead hospitals, who are attended to by a study-trained specialist paramedic. Exclusions are known/apparent pregnancy, blunt or penetrating injury as primary cause of out-of-hospital cardiac arrest and an absence of intravenous access. Between February 2020 and March 2021, 100 participants will be enrolled. Primary outcome is survival to hospital; secondary outcomes are return of spontaneous circulation at any time and 30-day mortality.

Abstract 249: The Effect of Response Time on Out-Of-Hospital Cardiac Arrest Survival Varies by Patient Subpopulation

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Clara Stoesser ◽  
Justin Boutilier ◽  
Christopher L Sun ◽  
Katie N Dainty ◽  
Steve Lin ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Regression Analysis ◽  
Response Time ◽  
Time Interval ◽  
Probability Of Survival ◽  
Subgroup Analyses ◽  
Impact On Survival ◽  
The Impact ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Itroduction: Previous research has quantified the impact of EMS response time on the probability of survival from OHCA, but the impact on different subpopulations is currently unknown. Aim: To investigate how response time affects OHCA survival for different patient subpopulations. Methods: We conducted a logistic regression analysis on non-EMS witnessed OHCAs of presumed cardiac etiology from the Toronto Regional RescuNet between January 1, 2007 and December 31, 2016. We predicted survival using age, sex, public location, presenting rhythm, bystander witnessed, bystander resuscitation, and response time, defined as the time interval from 911 call to EMS arrival at the patient. We conducted subgroup analyses to quantify the effect of response time on survival for eight different subpopulations: public, private, bystander resuscitation, no bystander resuscitation, patients ≥65, patients <65, witnessed, and unwitnessed OHCA. We also quantified the effect of response time on survival for pairwise intersections of the subpopulations. We compared our results to Valenzuela et al. (1997), which suggests survival odds decrease by 10% for each minute delay in response time. Results: We identified 22,988 OHCAs. Overall, a one-minute delay in EMS response time was associated with a 13.2% reduction in the odds of survival. The reduction varied by subpopulation, ranging from a 7.2% reduction in survival odds for unwitnessed arrests to a 16.4% reduction in survival odds for arrests with bystander resuscitation. Response time had the largest impact on survival for the subpopulation of OHCAs that were both witnessed and received bystander resuscitation (17.4% reduction in survival odds). Conclusion: The effect of a one-minute delay in EMS response on the odds of survival from OHCA can be as low as a 7.2% reduction and as high as a 17.4% reduction. This variability contrasts with the currently accepted 10% rule that is assumed across the entire population.

Abstract 19225: Impact of Change in Resuscitation Guidelines on National Out-of-hospital Cardiac Arrest Outcomes: Fulfilled Expectations?

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Shaker M Eid ◽  
Aiham Albaeni ◽  
Rebeca Rios ◽  
May Baydoun ◽  
Bolanle Akinyele ◽  
...  
Keyword(s):  
Time Series ◽  
Cardiac Arrest ◽  
Time Series Data ◽  
Statistical Significance ◽  
Interrupted Time Series ◽  
The United States ◽  
Series Data ◽  
National Database ◽  
Resuscitation Guidelines ◽  
Hospital Cardiac Arrest

Background: The intent of the 5-yearly Resuscitation Guidelines is to improve outcomes. Previous studies have yielded conflicting reports of a beneficial impact of the 2005 guidelines on out-of-hospital cardiac arrest (OHCA) survival. Using a national database, we examined survival before and after the introduction of both the 2005 and 2010 guidelines. Methods: We used the 2000 through 2012 National Inpatient Sample database to select patients ≥18 years admitted to hospitals in the United States with non-traumatic OHCA (ICD-9 CM codes 427.5 & 427.41). A quasi-experimental (interrupted time series) design was used to compare monthly survival trends. Outcomes for OHCA were compared pre- and post- 2005 and 2010 resuscitation guidelines release as follows: 01/2000-09/2005 vs. 10/2005-9/2010 and 10/2005-9/2010 vs. 10/2010-12/2012. Segmented regression analyses of interrupted time series data were performed to examine changes in survival to hospital discharge. Results: For the pre- and post- guidelines periods, 81600, 69139 and 36556 patients respectively survived to hospital admission following OHCA. Subsequent to the release of the 2005 guidelines, there was a statistically significant worsening in survival trends (β= -0.089, 95% CI -0.163 – -0.016, p =0.018) until the release of the 2010 guidelines when a sharp increase in survival was noted which persisted for the period of study (β= 0.054, 95% CI -0.143 – 0.251, p =0.588) but did not achieve statistical significance (Figure). Conclusion: National clinical guidelines developed to impact outcomes must include mechanisms to assess whether benefit actually occurs. The worsening in OHCA survival following the 2005 guidelines is thought provoking but the improvement following the release of the 2010 guidelines is reassuring and worthy of perpetuation.

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