Track topics on Twitter Track topics that are important to you
Sudden cardiac arrest is one of the most frequent causes of death in the world. In highly qualified emergency medical service (EMS) systems, including well trained emergency physicians, spontaneous circulation may be restored in up to 53% of patients at least until admission to hospital. Compared with these highly qualified EMS systems, in other systems markedly lower success rates are observed. These data clearly show that there are considerable differences between EMS systems concerning treatment success following cardiac arrest and resuscitation, although in all systems international guidelines for resuscitation are used. This study investigates the impact of response time reliability (RTR) on cardio pulmonary resuscitation (CPR) incidence and resuscitation success using return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score and data from seven German EMS systems participating in the German Resuscitation Registry.
Anonymized patient data after out of hospital cardiac arrest from 2006 to 2009 of seven EMS systems in Germany were analysed to socioeconomic factors (population, area, EMS unit hours), process quality (response time reliability, CPR incidence, special CPR measures, prehospital cooling), patient factors (age, gender, cause of cardiac arrest, bystander CPR). Endpoints were defined as ROSC, admission to hospital, 24 hour survival and hospital discharge rate. For statistical analyses, chi-square, odds-ratio and Bonferroni correction were used.
2,330 prehospital CPR from seven centres were included in this analysis. Incidence of sudden cardiac arrest differs from 36.0 to 65.1 / 100,000 inhabitants / year. We identified two EMS systems (RTR<70%) reaching the patients within eight minutes in 62.0 and 65.6% while the other five EMS systems (RTR>70%) achieved 70.4 up to 95.5%. EMS systems arriving relatively later at the patients side (RTR<70%) less frequently initiate CPR and admit fewer patients alive to hospital (calculated per 100,000 inhabitants / year)( CPR incidence [1/100.000 I/Y] RTR>70%: 57.2; RTR<70%: 36.1; p < 0.01; OR 1.586 (99%
1.383 to 1.819) ( admitted to hospital [1/100.000 I/Y] RTR>70%: 24.4; RTR<70%: 15.6; p < 0.01; OR 1.57 (99%
1.274 to 1.935)). Using ROSC rate and the multi-variate RACA score to predict outcome, the two groups did not differ, but ROSC rate were higher than predicted in both groups (ROSC [%] RTR>70%: 46.6; RTR<70%: 47.3; n.s.; OR 0.971 (95%
0.787 to 1.196)) ( ROSC RACA [%] RTR>70%: 42.4; RTR<70%: 39.5; n.s.; OR 1.127 (95%
0.911 to 1.395)).
This study demonstrates that on the level of EMS systems, faster ones will more often initiate CPR and will increase number of patients admitted to hospital alive. Furthermore it is shown that with very different approaches, all adhering to and intensely training in the ERC guidelines 2005, superior and, according to international comparison, excellent success rates following resuscitation may be achieved.
This article was published in the following journal.
Name: Critical care (London, England)
The timing of defibrillation is mostly at arbitrary intervals during cardio-pulmonary resuscitation (CPR), rather than during intervals when the out-of-hospital cardiac arrest (OOH-CA) patient is phys...
Comparisons of the Pentax-AWS, Glidescope, and Macintosh Laryngoscopes for Intubation Performance during Mechanical Chest Compressions in Left Lateral Tilt: A Randomized Simulation Study of Maternal Cardiopulmonary Resuscitation.
Purpose. Rapid advanced airway management is important in maternal cardiopulmonary resuscitation (CPR). This study aimed to compare intubation performances among Pentax-AWS (AWS), Glidescope (GVL), an...
Patients experiencing major bleeding often require both aggressive fluid resuscitation and rapid sequence tracheal intubation. The influence of hemorrhage-induced hypovolemia, and/or subsequent fluid ...
The investigators will retrospectively examine the connection between resuscitation decisions of admitted patients at the ED of the University Hospital of Basel and several demographic and...
Prospective, randomized controlled trial to be performed at one center, of term and late preterm infants requiring resuscitation. Prenatal consent will be obtained. At randomization, babie...
The investigators hypothesize that using low oxygen concentrations during resuscitation of extremely premature infants will avoid oxidative stress derived damage and improve outcome.
Cardiac arrest occurs frequently and the outcome after out-of-hospital resuscitation is often fatal. Disturbing is that more than half of the surviving patients suffer from permanent impai...
The purpose of this study is to determine whether performing active compression decompression cardiopulmonary resuscitation (ACD-CPR) with an impedance threshold device (ITD) compared to c...
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.
Success in bringing an effort to the desired end; the degree or level of success attained in some specified area (esp. scholastic) or in general.
The time from the onset of a stimulus until a response is observed.
A quantitative measure of the frequency on average with which articles in a journal have been cited in a given period of time.
Tendency toward a lessened strength of response due to practice or activity. It is independent of the effect of reward and is a direct function of time interval since the last response and the number of preceding responses.
Cardiology is a specialty of internal medicine. Cardiac electrophysiology : Study of the electrical properties and conduction diseases of the heart. Echocardiography : The use of ultrasound to study the mechanical function/physics of the h...
Pulmonary relating to or associated with the lungs eg Asthma, chronic bronchitis, emphysema, COPD, Cystic Fibrosis, Influenza, Lung Cancer, Pneumonia, Pulmonary Arterial Hypertension, Sleep Disorders etc Follow and track Lung Cancer News ...