P Jennings1, J Pasco. 1. Rural Ambulance Victoria, The Geelong Hospital, Geelong, Victoria, Australia. paul.jennings@rav.vic.gov.au
Abstract
OBJECTIVE: To study the outcome from prehospital cardiac arrest managed by ambulance personnel, and to examine overall survival rates from successful resuscitation. METHODS: A retrospective analysis was made of 115 patient care records of prehospital cardiac arrests with attempted resuscitation between July 1996 and September 1999. All cases had a presumed primary cardiac cause for their cardiac arrest. RESULTS: Overall survival, defined as admitted to hospital alive, was 22 subjects (19.1%), with five subjects (4.3%) being discharged from hospital neurologically intact. Of the patients who survived to the emergency department, six (5%) had initially presented in pulseless electrical activity and 16 (14%) presented with ventricular fibrillation. No patients presented with ventricular tachycardia and no survivors presented in asystole. Median response interval from time of call to arrival of initial crew at patient's side was 9 min. No patients survived when response interval was greater than 14 min. Bystander cardiopulmonary resuscitation was being performed on 55 patients (48%) on arrival of initial ambulance crew; 68.2% of patients surviving to hospital having had bystander cardiopulmonary resuscitation. CONCLUSION: Decreasing time delays in accessing the patient is crucial to improving outcome in out-of-hospital cardiac arrest.
OBJECTIVE: To study the outcome from prehospital cardiac arrest managed by ambulance personnel, and to examine overall survival rates from successful resuscitation. METHODS: A retrospective analysis was made of 115 patient care records of prehospital cardiac arrests with attempted resuscitation between July 1996 and September 1999. All cases had a presumed primary cardiac cause for their cardiac arrest. RESULTS: Overall survival, defined as admitted to hospital alive, was 22 subjects (19.1%), with five subjects (4.3%) being discharged from hospital neurologically intact. Of the patients who survived to the emergency department, six (5%) had initially presented in pulseless electrical activity and 16 (14%) presented with ventricular fibrillation. No patients presented with ventricular tachycardia and no survivors presented in asystole. Median response interval from time of call to arrival of initial crew at patient's side was 9 min. No patients survived when response interval was greater than 14 min. Bystander cardiopulmonary resuscitation was being performed on 55 patients (48%) on arrival of initial ambulance crew; 68.2% of patients surviving to hospital having had bystander cardiopulmonary resuscitation. CONCLUSION: Decreasing time delays in accessing the patient is crucial to improving outcome in out-of-hospital cardiac arrest.