bystander cardiopulmonary resuscitation
Recently Published Documents


TOTAL DOCUMENTS

281
(FIVE YEARS 119)

H-INDEX

33
(FIVE YEARS 7)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuling Chen ◽  
Peng Yue ◽  
Ying Wu ◽  
Jia Li ◽  
Yanni Lei ◽  
...  

Abstract Background Out-of-hospital cardiac arrest (OHCA), a global health problem with a survival rate ranging from 2 to 22% across different countries, has been a leading cause of premature death for decades. The aim of this study was to evaluate the trends of survival after OHCA over time and its relationship with bystander cardiopulmonary resuscitation (CPR), initial shockable rhythm, return of spontaneous circulation (ROSC), and survived event. Methods In this prospective observational study, data of OHCA patients were collected following the “Utstein style” by the Beijing, China, Emergency Medical Service (EMS) from January 2011 (data from February to June in 2011 was not collected) to October 2016. Patients who had a cardiac arrest and for whom an ambulance was dispatched were included in this study. All cases were followed up to determine hospital discharge or death. The trend of OHCA survival was analyzed using the Chi-square test. The relationship among bystander CPR, initial shockable rhythm, ROSC, survived event, and OHCA survival rate was analyzed using multivariate path analyses with maximum standard likelihood estimation. Results A total of 25,421 cases were transferred by the Beijing EMS; among them, 5042 (19.8%) were OHCA (median age: 78 years, interquartile range: 63–85, 60.1% male), and 484 (9.6%) received bystander CPR. The survival rate was 0.6%, which did not improve from 2012 to 2015 (P = 0.569). Overall, bystander CPR was indirectly associated with an 8.0% (β = 0.080, 95% confidence interval [CI] = 0.064–0.095, P = 0.002) increase in survival rate. The indirect effect of bystander CPR on survival rate through survived event was 6.6% (β = 0.066, 95% CI = 0.051–0.081, P = 0.002), which accounted for 82.5% (0.066 of 0.080) of the total indirect effect. With every 1 increase in survived event, the possibility of survival rate will directly increase by 53.5% (β = 0.535, 95% CI = 0.512–0.554, P = 0.003). Conclusions The survival rate after OHCA was low in Beijing which has not improved between 2012 and 2015. The effect of bystander CPR on survival rate was mainly mediated by survived event. Trial registration Chinese Clinical Trial Registry: ChiCTR-TRC-12002149 (2 May, 2012, retrospectively registered). http://www.chictr.org.cn/showproj.aspx?proj=7400


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051959
Author(s):  
Benjamin Stanley ◽  
Thomas Burton ◽  
Harriet Percival ◽  
Emily Beesley ◽  
Nicholas Coffin ◽  
...  

IntroductionSurvival from out of hospital cardiac arrest (OHCA) is lower in the UK than in several developed nations. Bystander cardiopulmonary resuscitation (CPR) is associated with increased rates of survival to hospital discharge following OHCA, prompting the introduction of several initiatives by the UK government to increase rates of bystander CPR, including the inclusion of Basic Life Support (BLS) teaching within the English national curriculum. While there is clear benefit in this, increasing evidence suggests poor retention of skills following BLS teaching. The aim of this systematic review is to summarise the literature regarding skill decay following BLS training, reporting particularly the time period over which this occurs, and which components of would-be rescuers’ performance of the BLS algorithm are most affected.Methods and analysisA search will be conducted to identify studies in which individuals have received BLS training and received subsequent assessment of their skills at a later date. A search strategy comprising relevant Medical Subject Headings (MeSH) terms and keywords has been devised with assistance from an experienced librarian. Relevant databases will be searched with titles, abstract and full-text review conducted independently by two reviewers. Data will be extracted from included studies by two reviewers, with meta-analysis conducted if the appropriate preconditions (such as limited heterogeneity) are met.Ethic and disseminationNo formal ethical approval is required for this systematic review. Results will be disseminated in the form of manuscript submission to a relevant journal and presentation at relevant meetings. To maximise the public’s access to this review’s findings, any scientific report will be accompanied by a lay summary posted via social media channels, and a press release disseminated to national and international news agencies.PROSPERO registration numberCRD42021237233.


Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Yoshikazu Goto ◽  
Akira Funada ◽  
Tetsuo Maeda ◽  
Yumiko Goto

Abstract Background The International Liaison Committee on Resuscitation recommends that dispatchers provide instructions to perform compression-only cardiopulmonary resuscitation (CPR) to callers responding to adults with out-of-hospital cardiac arrest (OHCA). This study aimed to determine the optimal dispatcher-assisted CPR (DA-CPR) instructions for OHCA. Methods We analysed the records of 24,947 adult patients (aged ≥ 18 years) who received bystander DA-CPR after bystander-witnessed OHCA. Data were obtained from a prospectively recorded Japanese nationwide Utstein-style database for a 2-year period (2016–2017). Patients were divided into compression-only DA-CPR (n = 22,778) and conventional DA-CPR (with a compression-to-ventilation ratio of 30:2, n = 2169) groups. The primary outcome measure was 1-month neurological intact survival, defined as a cerebral performance category score of 1–2 (CPC 1–2). Results The 1-month CPC 1–2 rate was significantly higher in the conventional DA-CPR group than in the compression-only DA-CPR group (before propensity score (PS) matching, 7.5% [162/2169] versus 5.8% [1309/22778], p < 0.01; after PS matching, 7.5% (162/2169) versus 5.7% (123/2169), p < 0.05). Compared with compression-only DA-CPR, conventional DA-CPR was associated with increased odds of 1-month CPC 1–2 (before PS matching, adjusted odds ratio 1.39, 95% confidence interval [CI] 1.14–1.70, p < 0.01; after PS matching, adjusted odds ratio 1.34, 95% CI 1.00–1.79, p < 0.05). Conclusion Within the limitations of this retrospective observational study, conventional DA-CPR with a compression-to-ventilation ratio of 30:2 was preferable to compression-only DA-CPR as an optimal DA-CPR instruction for coaching callers to perform bystander CPR for adult patients with bystander-witnessed OHCAs.


Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Shaveta Khosla ◽  
Marina Del Rios ◽  
Pavitra Kotini-shah ◽  
E Bradshaw B Bunney ◽  
Teri Campbell ◽  
...  

Background: Italy, France and New York City have reported an increase in out-of-hospital cardiac arrest (OHCA) incidence during the COVID-19 pandemic. The purpose of our study was to assess the effect of COVID-19 on OHCA cases in Chicago. Method: Cardiac Arrest Registry to Enhance Survival (CARES) database was used. Bivariate analysis was conducted to assess changes in demographic and other characteristics. We excluded the cases that occurred in a healthcare facility or a nursing home. We compared the cases reported in 2020 to 2019 (and prior years). ArcGIS was used to geocode incident addresses and to show the temporal distribution by community areas. Bivariate analysis was done using chi-square tests. Results: A total of 3221 OHCA cases were reported in Chicago in 2020, which is 31.5% higher than those reported in 2019 (n=2450 cases). This increase was higher than what has been noticed historically (for instance, the increase from 2018 to 2019 was only 17%). There was an increase in Hispanic OHCA cases (17.3% in 2020 vs. 13.5% in 2019, p<0.01) but a decrease in White cases (20.5% vs. 23.1%). The cases in 2020 were less likely to be reported at public location (22% vs. 26%, p<0.001) or have shockable rhythm (10% vs. 13%, p=0.0002). There was a marked increase in those that were declared dead in the field in 2020 (37% vs. 27%, p<0.001). However, there were no statistically significant differences in age distribution, gender, witnessed arrest (49% vs. 51%, p=0.07) or bystander cardiopulmonary resuscitation (BCPR) (23% vs. 22%, p=0.3). Conclusion: A better understanding of the causes of the excess cardiac arrest numbers will be important to help plan and better prepare for future public health interventions. The effect of COVID-19 on OHCA survival needs to be examined further in future studies.


Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Cherylyn Hui Xin Toh ◽  
Shir Lynn Lim ◽  
Yazid Muhammad ◽  
Nur Shahidah ◽  
Qin Xiang Ng ◽  
...  

Objective: Reduced rates of bystander cardiopulmonary resuscitation (BCPR) in out-of-hospital cardiac arrest (OHCA) were observed during the Coronavirus Disease-2019 (COVID-19) pandemic in many regions. We investigated the impact of COVID-19 on barriers to Dispatcher-Assisted Cardiopulmonary Resuscitation (DA-CPR) in Singapore. Methods: This nationwide retrospective cohort study involved all calls to our national 995 call center for adult (≥ 18 years old) OHCA not witnessed by Emergency Medical Services. We reviewed audio recordings during the pandemic (January-June 2020) and pre-pandemic (January-June 2019) periods to compare the OHCA characteristics, and the types of “barriers” to DA-CPR — the reason why DA-CPR was not performed. Our primary outcome was the presence/absence of barriers to DA-CPR. Multivariable logistics regression was used to estimate the adjusted odds ratio (aOR) for the likelihood of barriers to DA-CPR accounting for patient and event characteristics. The effect of COVID-19 on DA-CPR rates was evaluated using interrupted time series analysis. Results: There were 1481 OHCA during the pandemic (median age 73 years, 62.7% male), and 1400 prior to the pandemic (median age 72 years, 63.6% male). Residential OHCA and witnessed OHCA increased during the pandemic (78.9% vs 75.5%, p=0.03 and 56.1% vs 39.9%, p<0.01 respectively), but not BCPR and DA-CPR (64.3% vs 65.6%, p=0.44, and 49.1% vs 48.1%, p=0.57 respectively). There were increased barriers to DA-CPR during the pandemic — ‘patient status changed’ (difficulty with recognition) and ‘caller not with patient’ (witnesses calling family rather than 995) doubled in proportion during COVID-19. ‘afraid to do CPR’ fell to 3.8% during the pandemic, while the fear of COVID-19 transmission made up 0.5% of the barriers. Logistic regression showed that females and OHCAs occurring in home residences were more likely to have barriers to DA-CPR (aOR 1.27 and 2.63 respectively). COVID-19 did not have an impact on the trend of DA-CPR rates (p=0.49). Conclusion: COVID-19 did not affect callers’ willingness to perform DA-CPR. Distancing measures led to more residential arrests with an increase in proportion with barriers to DA-CPR, highlighting opportunities for public education and intervention.


2021 ◽  
Vol 10 (19) ◽  
Author(s):  
Brooke Bessen ◽  
Jason Coult ◽  
Jennifer Blackwood ◽  
Cindy H. Hsu ◽  
Peter Kudenchuk ◽  
...  

Background The mechanism by which bystander cardiopulmonary resuscitation (CPR) improves survival following out‐of‐hospital cardiac arrest is unclear. We hypothesized that ventricular fibrillation (VF) waveform measures, as surrogates of myocardial physiology, mediate the relationship between bystander CPR and survival. Methods and Results We performed a retrospective cohort study of adult, bystander‐witnessed patients with out‐of‐hospital cardiac arrest with an initial rhythm of VF who were treated by a metropolitan emergency medical services system from 2005 to 2018. Patient, resuscitation, and outcome variables were extracted from emergency medical services and hospital records. A total of 3 VF waveform measures (amplitude spectrum area, peak frequency, and median peak amplitude) were computed from a 3‐second ECG segment before the initial shock. Multivariable logistic regression estimated the association between bystander CPR and survival to hospital discharge adjusted for Utstein elements. Causal mediation analysis quantified the proportion of survival benefit that was mediated by each VF waveform measure. Of 1069 patients, survival to hospital discharge was significantly higher among the 814 patients who received bystander CPR than those who did not (0.52 versus 0.43, respectively; P <0.01). The multivariable‐adjusted odds ratio for bystander CPR and survival was 1.6 (95% CI, 1.2, 2.1), and each VF waveform measure attenuated this association. Depending on the specific waveform measure, the proportion of mediation varied: 53% for amplitude spectrum area, 31% for peak frequency, and 29% for median peak amplitude. Conclusions Bystander CPR correlated with more robust initial VF waveform measures, which in turn mediated up to one‐half of the survival benefit associated with bystander CPR. These results provide insight into the biological mechanism of bystander CPR in VF out‐of‐hospital cardiac arrest.


2021 ◽  
Author(s):  
Eleonora Casarini ◽  
Tazha Ako ◽  
Kristian Bundgaard Ringgren ◽  
Stig Nikolaj Fasmer Blomberg ◽  
Helle Collatz Christensen

Abstract Background: to design and implement a new variable, in accordance with the Utstein style – namely the variable “AED” - considering the challenges of reporting cases in which the AED did not recommend an electrical shock after analyzing cardiac arrhythmias, for use in the Danish Cardiac Arrest Registry.Participants: Patients with out-of-hospital cardiac arrest for which resuscitation was attempted between 2016 and 2019, identified in the nationwide Danish Cardiac Arrest Registry. Their medical records were reviewed to establish a positive variable in “AED”.Methods: Data from the national Danish Cardiac Arrest Registry were used to identify core features of out-of-hospital cardiac arrests medical recording in Denmark and its possible improvement. Results: Among n= 1080 cases, summary statistics on core recording variables of interest were collected. We found statistically significant differences in the two cohorts of cardiac arrests where an AED was present on the scene and recorded in the Danish Cardiac Arrest Registry, regarding age, location, emeregency medical service response time, witnesses, bystander cardiopulmonary resuscitation, first monitored rhythm, direct current cardioversion shock delivered by the medical staff and survival outcomes such as return of spontaneous circulation at any time, status at arrival at hospital and 30-day survival. Conclusions: This validation study showed an improved completeness of registration of out-of-hospital cardiac arrests when implementing the new AED-variable, in accordance with the Utstein style. Thus, the new AED-variable is a valid and substantial resource for future epidemiological studies. However, a future effort to improve registration completeness along with continuous improvement of the Danish Cardiac Arrest Registry is needed.


2021 ◽  
Vol 13 (9) ◽  
pp. 365-372
Author(s):  
Nigel Rees ◽  
Lee Beever ◽  
Neil Vaughan ◽  
Carl Powell ◽  
Adam Fletcher ◽  
...  

The UK average survival rate from out of hospital cardiac arrest (OHCA) is 8.6%, which is significantly lower than in comparable countries where survival rates can exceed 20%. A cardiac arrest victim is two to four times more likely to survive OHCA with bystander cardiopulmonary resuscitation (CPR). Mandatory teaching of CPR in schools is an effective way, endorsed by the World Health Organization, to train the entire population and improve the bystander CPR rate. Despite this, as with other UK home nations, there is significant variation in provision of CPR training within schools in Wales. Virtual reality (VR) technology offers an accessible, immersive way to teach CPR skills to schoolchildren. Computer scientists at the University of Chester and the Welsh Ambulance Services NHS Trust developed Virtual Cardio Pulmonary Resuscitation (VCPR), which can be used to teach children CPR skills. There were three stages: identifying requirements and specifications; development of a prototype; and management—development of software, further funding and exploring opportunities for commercialisation.


Sign in / Sign up

Export Citation Format

Share Document