STUDY OBJECTIVE: To discover the frequency of agonal respirations in cardiac arrest calls, the ways callers describe them, and discharge rates associated with agonal respirations. DESIGN: We reviewed taped recordings of calls reporting cardiac arrests and emergency medical technician and paramedic incident reports for 1991. Arrests after arrival of emergency medical services were excluded. SETTING: King County, Washington, excluding the city of Seattle. PARTICIPANTS: Four hundred forty-five persons with out-of-hospital cardiac arrests receiving emergency medical services. INTERVENTIONS: Telephone CPR, emergency medical technicians-defibrillation, and advanced life support by paramedics. MEASUREMENTS AND MAIN RESULTS: Any attempts at breathing described by callers were identified, as well as whether agonal respirations could be heard by dispatcher, emergency medical technicians, or paramedics. Agonal respirations occurred in 40% of 445 out-of-hospital cardiac arrests. Callers described agonal breathing in a variety of ways. Agonal respirations were present in 46% of arrests caused by cardiac etiology compared with 32% in other etiologies (P < .01). Fifty-five percent of witnessed arrests had agonal activity compared with 16% of unwitnessed arrests (P < .001). Agonal respirations occurred in 56% of arrests with a rhythm of ventricular fibrillation compared with 34% of cases with a nonventricular fibrillation rhythm (P < .001). Twenty-seven percent of patients with agonal respirations were discharged alive compared with 9% without them (P < .001). CONCLUSION: There is a high incidence of agonal activity associated with out-of-hospital cardiac arrest. Presence of agonal respirations is associated with increased survival. These findings have implications for public CPR training programs and emergency dispatcher telephone CPR programs.
STUDY OBJECTIVE: To discover the frequency of agonal respirations in cardiac arrest calls, the ways callers describe them, and discharge rates associated with agonal respirations. DESIGN: We reviewed taped recordings of calls reporting cardiac arrests and emergency medical technician and paramedic incident reports for 1991. Arrests after arrival of emergency medical services were excluded. SETTING: King County, Washington, excluding the city of Seattle. PARTICIPANTS: Four hundred forty-five persons with out-of-hospital cardiac arrests receiving emergency medical services. INTERVENTIONS: Telephone CPR, emergency medical technicians-defibrillation, and advanced life support by paramedics. MEASUREMENTS AND MAIN RESULTS: Any attempts at breathing described by callers were identified, as well as whether agonal respirations could be heard by dispatcher, emergency medical technicians, or paramedics. Agonal respirations occurred in 40% of 445 out-of-hospital cardiac arrests. Callers described agonal breathing in a variety of ways. Agonal respirations were present in 46% of arrests caused by cardiac etiology compared with 32% in other etiologies (P < .01). Fifty-five percent of witnessed arrests had agonal activity compared with 16% of unwitnessed arrests (P < .001). Agonal respirations occurred in 56% of arrests with a rhythm of ventricular fibrillation compared with 34% of cases with a nonventricular fibrillation rhythm (P < .001). Twenty-seven percent of patients with agonal respirations were discharged alive compared with 9% without them (P < .001). CONCLUSION: There is a high incidence of agonal activity associated with out-of-hospital cardiac arrest. Presence of agonal respirations is associated with increased survival. These findings have implications for public CPR training programs and emergency dispatcher telephone CPR programs.
Authors: Mathias Zuercher; Gordon A Ewy; Ronald W Hilwig; Arthur B Sanders; Charles W Otto; Robert A Berg; Karl B Kern Journal: BMC Cardiovasc Disord Date: 2010-08-09 Impact factor: 2.298
Authors: Mathias Zuercher; Gordon A Ewy; Charles W Otto; Ronald W Hilwig; Bentley J Bobrow; Lani Clark; Vatsal Chikani; Arthur B Sanders; Robert A Berg; Karl B Kern Journal: Crit Care Res Pract Date: 2010-05-31
Authors: Bentley J Bobrow; Mathias Zuercher; Gordon A Ewy; Lani Clark; Vatsal Chikani; Dan Donahue; Arthur B Sanders; Ronald W Hilwig; Robert A Berg; Karl B Kern Journal: Circulation Date: 2008-11-24 Impact factor: 29.690
Authors: Christian Vaillancourt; Jan L Jensen; Jeremy Grimshaw; Jamie C Brehaut; Manya Charette; Ann Kasaboski; Martin Osmond; George A Wells; Ian G Stiell Journal: BMC Emerg Med Date: 2009-07-31