scholarly journals Out-of-hospital cardiac arrest protocol comparison

2019 ◽  
Vol 16 ◽  
Author(s):  
Omer Perry ◽  
Oren Wacht ◽  
Eli Jaffe ◽  
Zilla Sinuany-Stern ◽  
Yuval Bitan
Keyword(s):  
Cardiac Arrest ◽  
Survival Rates ◽  
Phone Call ◽  
Healthcare Personnel ◽  
Identification Process ◽  
Emergency Medical ◽  
Emergency Medical Dispatcher ◽  
Clinical Background ◽  
Hospital Cardiac Arrest

BackgroundEarly identification of out-of-hospital cardiac arrest (OHCA) has been proven to increase survival rates. Toward this goal, emergency medical dispatchers commonly use one of two types of emergency medical dispatcher systems, each with a unique OHCA protocol. The criteria-based dispatch (CBD) protocol is a set of guidelines and prompts intended for dispatchers with clinical background and experience, while the medical priority dispatch (MPD) is a scripted caller interrogation protocol intended for non-healthcare dispatchers. The objective of this study was to compare CBD and MPD protocols in terms of accuracy and duration of the identification process.MethodsTo compare the two protocols we conducted an OHCA simulation of an emergency phone call by a bystander. Two groups participated in the simulation: 1) emergency medical technicians during paramedic vocational training, in the role of CBD dispatchers, and 2) non-healthcare personnel in the role of MPD dispatchers. Dispatchers were asked to identify whether a patient was having a cardiac arrest based on the information they received from the bystander.ResultsDuration of the OHCA identification process was significantly shorter for participants using MPD (CBD 50 seconds vs. MPD 33 seconds, p=0.003). The OHCA accuracy was 86.49% for the CBD and 82.86% for MPD, but this difference was not statistically significant (p=0.60).ConclusionThe advantages of each protocol suggest that some combination of the two protocols may optimise the OHCA identification process, leading to increased accuracy and shorter duration of the identification process.

scholarly journals Incidence and Outcomes of Out‐of‐Hospital Cardiac Arrest in Singapore and Victoria: A Collaborative Study

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Shir Lynn Lim ◽  
Karen Smith ◽  
Kylie Dyson ◽  
Siew Pang Chan ◽  
Arul Earnest ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Prehospital Care ◽  
Survival Rates ◽  
World Health ◽  
Medical Services ◽  
Emergency Medical ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

Background Incidence and outcomes of out‐of‐hospital cardiac arrest (OHCA) vary between communities. We aimed to examine differences in patient characteristics, prehospital care, and outcomes in Singapore and Victoria. Methods and Results Using the prospective Singapore Pan‐Asian Resuscitation Outcomes Study and Victorian Ambulance Cardiac Arrest Registry, we identified 11 061 and 32 003 emergency medical services‐attended adult OHCAs between 2011 and 2016 respectively. Incidence and survival rates were directly age adjusted using the World Health Organization population. Survival was analyzed with logistic regression, with model selection via backward elimination. Of the 11 061 and 14 834 emergency medical services‐treated OHCAs (overall mean age±SD 65.5±17.2; 67.4% males) in Singapore and Victoria respectively, 11 054 (99.9%) and 5595 (37.7%) were transported, and 440 (4.0%) and 2009 (13.6%) survived. Compared with Victoria, people with OHCA in Singapore were older (66.7±16.5 versus 64.6±17.7), had less shockable rhythms (17.7% versus 30.3%), and received less bystander cardiopulmonary resuscitation (45.7% versus 58.5%) and defibrillation (1.3% versus 2.5%) (all P <0.001). Age‐adjusted OHCA incidence and survival rates increased in Singapore between 2011 and 2016 ( P <0.01 for trend), but remained stable, though higher, in Victoria. Likelihood of survival increased significantly ( P <0.001) with arrest in public locations (adjusted odds ratio [aOR] 1.81), witnessed arrest (aOR 2.14), bystander cardiopulmonary resuscitation (aOR 1.72), initial shockable rhythm (aOR 9.82), and bystander defibrillation (aOR 2.04) but decreased with increasing age (aOR 0.98) and emergency medical services response time (aOR 0.91). Conclusions Singapore reported increasing OHCA incidence and survival rates between 2011 and 2016, compared with stable, albeit higher, rates in Victoria. Survival differences might be related to different emergency medical services practices including patient selection for resuscitation and transport.

The role of the witness of the incident and the role of the emergency medical dispatcher in out-of-hospital sudden cardiac arrest

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Klaudiusz Nadolny ◽  
Joanna Gotlib ◽  
Mariusz Panczyk ◽  
Lukasz Szarpak ◽  
Jerzy Robert Ladny ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Emergency Medical ◽  
Emergency Medical Dispatcher

PP27 Features of emergency medical system calls that facilitate or inhibit call-taker recognition that a patient is in, or at risk of, cardiac arrest: a systematic mixed studies review

2021 ◽  
Vol 38 (9) ◽  
pp. A12.1-A12
Author(s):  
Kim Kirby ◽  
Sarah Voss ◽  
Emma Bird ◽  
Jonathan Benger
Keyword(s):  
Cardiac Arrest ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Emergency Call ◽  
Emergency Medical ◽  
Mixed Studies Review ◽  
Emergency Medical Dispatcher ◽  
Emergency Medical Dispatchers ◽  
Hospital Cardiac Arrest ◽  
Service Call

AimTo identify and appraise evidence relating to the features of an Emergency Medicine System call interaction that enable, or inhibit, an Emergency Medical Dispatcher’s recognition that a patient is in out-of-hospital cardiac arrest, or at imminent risk of out-of-hospital cardiac arrest.MethodsAll study designs were eligible for inclusion. Data sources included Medline, BNI, CINAHL, EMBASE, PubMed, Cochrane Database of Systematic Reviews, AMED and OpenGrey. Stakeholder resources were screened and experts in resuscitation were asked to review the studies identified. Studies were appraised using the Mixed Methods Appraisal Tool. Synthesis was completed using a segregated mixed research synthesis approach.ResultsTwenty-five studies were included in the review. ‘Recognition studies’ involving patients already in out-of-hospital cardiac arrest dominated this SMSR and challenges associated with recognition of out-of-hospital cardiac arrest were apparent. Four main themes were identified: Recognising abnormal/agonal breathing during the emergency call, Managing the emergency call, Emotional distress, Patient’s colour.ConclusionA dominant finding is the difficulty in recognising abnormal/agonal breathing during the Emergency Medical Service call. The interaction between the caller and the Emergency Medical Dispatcher is critical in the recognition of patients who suffer an out-of-hospital cardiac arrest. Emergency Medical Dispatchers adapt their approach to the Emergency Medical Service call, and regular training for Emergency Medical Dispatchers is recommended to optimise out-of-hospital cardiac arrest recognition. Further research is required with a focus on the Emergency Medical Service call interaction of patients who are alive at the time of the Emergency Medical Service call and who later deteriorate into OHCA.

scholarly journals Survival after traumatic out-of-hospital cardiac arrest in Vietnam: a multicenter prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Son Ngoc Do ◽  
Chinh Quoc Luong ◽  
Dung Thi Pham ◽  
My Ha Nguyen ◽  
Tra Thanh Ton ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Survival Rates ◽  
Trauma System ◽  
First Aid ◽  
System Of Care ◽  
Healthcare Personnel ◽  
Significant Difference ◽  
Poor Outcomes ◽  
Hospital Cardiac Arrest

Abstract Background Pre-hospital services are not well developed in Vietnam, especially the lack of a trauma system of care. Thus, the prognosis of traumatic out-of-hospital cardiac arrest (OHCA) might differ from that of other countries. Although the outcome in cardiac arrest following trauma is dismal, pre-hospital resuscitation efforts are not futile and seem worthwhile. Understanding the country-specific causes, risk, and prognosis of traumatic OHCA is important to reduce mortality in Vietnam. Therefore, this study aimed to investigate the survival rate from traumatic OHCA and to measure the critical components of the chain of survival following a traumatic OHCA in the country. Methods We performed a multicenter prospective observational study of patients (> 16 years) presenting with traumatic OHCA to three central hospitals throughout Vietnam from February 2014 to December 2018. We collected data on characteristics, management, and outcomes of patients, and compared these data between patients who died before hospital discharge and patients who survived to discharge from the hospital. Results Of 111 eligible patients with traumatic OHCA, 92 (82.9%) were male and the mean age was 39.27 years (standard deviation: 16.38). Only 5.4% (6/111) survived to discharge from the hospital. Most cardiac arrests (62.2%; 69/111) occurred on the street or highway, 31.2% (29/93) were witnessed by bystanders, and 33.7% (32/95) were given cardiopulmonary resuscitation (CPR) by a bystander. Only 29 of 111 patients (26.1%) were taken by the emergency medical services (EMS), 27 of 30 patients (90%) received pre-hospital advanced airway management, and 29 of 53 patients (54.7%) were given resuscitation attempts by EMS or private ambulance. No significant difference between patients who died before hospital discharge and patients who survived to discharge from the hospital was found for bystander CPR (33.7%, 30/89 and 33.3%, 2/6, P > 0.999; respectively) and resuscitation attempts (56.3%, 27/48, and 40.0%, 2/5, P = 0.649; respectively). Conclusion In this study, patients with traumatic OHCA presented to the ED with a low rate of EMS utilization and low survival rates. The poor outcomes emphasize the need for increasing bystander first-aid, developing an organized trauma system of care, and developing a standard emergency first-aid program for both healthcare personnel and the community.

Abstract 245: Role of the Resuscitation Champion on Survival Outcomes for In-Hospital Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Jesse Chan ◽  
Brahmajee K Nallamothu ◽  
Yuanyuan Tang ◽  
Paul Chan
Keyword(s):  
Cardiac Arrest ◽  
Survival Rates ◽  
Critical Factor ◽  
Nationwide Survey ◽  
Survival Outcomes ◽  
Study Cohort ◽  
Logistic Regression Models ◽  
Final Study ◽  
Clinical Background ◽  
Hospital Cardiac Arrest

Background: Hospitals vary markedly in survival rates for their patients with in-hospital cardiac arrest (IHCA). Although many sites have resuscitation champions, whether a resuscitation champion’s clinical background and intensity of engagement distinguishes sites with higher cardiac arrest survival rates remains unknown. Methods: We conducted a nationwide survey of adult hospitals participating in GWTG-Resuscitation to elicit detailed information on resuscitation practices, including of their resuscitation champion. Risk-standardized survival rates for IHCA for 2016-2017 were calculated for each hospital, and these were then used to categorize hospitals into quintiles of performance. The association between a resuscitation champion’s clinical background and intensity of engagement (categorized as very active non-physician champion, very active physician champion, and all others) and quintiles of survival was evaluated using multivariable hierarchical proportional odds logistic regression models. Results: Overall, 200 of 218 eligible adult hospitals (91.7%) completed the study survey and 190 facilities with > 10 cases comprised the final study cohort. Risk-standardized survival rates after IHCA varied substantially (median: 24.7%; range: 9.2% to 37.5%). One-third (63/190 [33.2%]) of hospitals had a very active non-physician champion, 29 (15.3%) had a very active physician champion, and the remaining 98 (51.2%) had a resuscitation champion not perceived to be very active or had no champion. Compared to sites with very active non-physician champions, those with a very active physician champion had 5-fold higher odds (adjusted OR, 5.15 [95% CI: 2.13-12.5]) of being in a higher survival quintile category, whereas there was no difference in survival outcomes between sites with less active or no resuscitation champions and very active non-physician champions (adjusted OR, 0.94 [95% CI: 0.52-1.77]) . Conclusions: Although most hospitals have resuscitation champions, the background and engagement level of a resuscitation champion is a critical factor in a hospital’s survival outcomes for IHCA. Hospitals with the highest survival rates for IHCA are more likely to have very active physician resuscitation champions.

scholarly journals Epidemiology and Outcomes from Out-of-Hospital Cardiac Arrest in Kuwait

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Dalal Al Hasan ◽  
Ameen Yaseen ◽  
Mazen El Sayed
Keyword(s):  
Cardiac Arrest ◽  
Emergency Medical Services ◽  
Survival Rates ◽  
Medical Services ◽  
East Region ◽  
Emergency Medical ◽  
Ongoing Training ◽  
Bystander Cpr ◽  
National Emergency ◽  
Hospital Cardiac Arrest

Background. Out-of-hospital cardiac arrest (OHCA) survival remains low in most countries. Few studies examine OHCA outcomes out of the Middle East region. This is the first study to describe characteristics and outcomes of patients with OHCA treated by emergency medical services (EMS) in regions of Kuwait. Objectives. To describe characteristics and outcomes of adult patients affected with OHCA in regions of Kuwait. Methods. This was a retrospective observational study on all adult OHCA patients transported by EMS to regional emergency departments over a 10- month period (21 February–31 December 2017). Data were collected from various sources: national emergency medical services archived data, emergency department, intensive care unit, and cardiac care unit of two hospitals. Results. A total of 332 EMS-treated OHCA cases were reviewed, and 286 incidents with OHCA from cardiac aetiology were included in the study. Most were non-Kuwaiti (60.8%) males (67.1%) with mean age 61 (+−16) years. Most OHCA cases occurred at home (76%) but with low witness rate (11.5%). Bystander CPR rate was low (8.7%). ROSC was achieved in ten patients (3.5%), but only 1 (0.3%) patient survived to hospital discharge. Conclusion. OHCA survival rates in this region of Kuwait are low. Targeted measures such as creating cardiac registry, dispatcher-assisted CPR with ongoing training and quality improvement, and community-based CPR education program are needed to improve the survival rates of OHCA victims.

Sign in / Sign up

Export Citation Format

Share Document