Rachael T Fothergill1, Lynne R Watson2, Gurkamal K Virdi2, Fionna P Moore3, Mark Whitbread3. 1. Clinical Audit and Research Unit, London Ambulance Service NHS Trust, 8-20 Pocock Street, London SE1 0BW, United Kingdom. Electronic address: rachael.fothergill@lond-amb.nhs.uk. 2. Clinical Audit and Research Unit, London Ambulance Service NHS Trust, 8-20 Pocock Street, London SE1 0BW, United Kingdom. 3. Medical Directorate, London Ambulance Service NHS Trust, 220 Waterloo Road, SE1 8SD, United Kingdom.
Abstract
OBJECTIVE: This study reports survival outcomes for patients resuscitated from out-of-hospital cardiac arrest (OHCA) subsequent to ST-elevation myocardial infarction (STEMI), and who were conveyed directly by ambulance clinicians to a specialist Heart Attack Centre for expert cardiology assessment, angiography and possible percutaneous coronary intervention (PCI). METHODS: This is a retrospective descriptive review of data sourced from the London Ambulance Service's OHCA registry over a one-year period. RESULTS: We observed excellent survival rates for our cohort of patients with 66% of patients surviving to be discharged from hospital, the majority of whom were still alive after one year. Those who survived tended to be younger, to have had a witnessed arrest in a public place with an initial cardiac rhythm of VF/VT, and to have been transported to the specialist centre more quickly than those who did not. CONCLUSION: A system allowing ambulance clinicians to autonomously convey OHCA STEMI patients who achieve a return of spontaneous circulation directly to a Heart Attack Centre is highly effective and yields excellent survival outcomes.
OBJECTIVE: This study reports survival outcomes for patients resuscitated from out-of-hospital cardiac arrest (OHCA) subsequent to ST-elevation myocardial infarction (STEMI), and who were conveyed directly by ambulance clinicians to a specialist Heart Attack Centre for expert cardiology assessment, angiography and possible percutaneous coronary intervention (PCI). METHODS: This is a retrospective descriptive review of data sourced from the London Ambulance Service's OHCA registry over a one-year period. RESULTS: We observed excellent survival rates for our cohort of patients with 66% of patients surviving to be discharged from hospital, the majority of whom were still alive after one year. Those who survived tended to be younger, to have had a witnessed arrest in a public place with an initial cardiac rhythm of VF/VT, and to have been transported to the specialist centre more quickly than those who did not. CONCLUSION: A system allowing ambulance clinicians to autonomously convey OHCA STEMI patients who achieve a return of spontaneous circulation directly to a Heart Attack Centre is highly effective and yields excellent survival outcomes.
Authors: Stephen Morris; Angus I G Ramsay; Ruth J Boaden; Rachael M Hunter; Christopher McKevitt; Lizz Paley; Catherine Perry; Anthony G Rudd; Simon J Turner; Pippa J Tyrrell; Charles D A Wolfe; Naomi J Fulop Journal: BMJ Date: 2019-01-23
Authors: A H Ford; T Clark; E C Reynolds; C Ross; K Shelley; L Simmonds; J Benger; J Soar; J P Nolan; M Thomas Journal: J Intensive Care Soc Date: 2015-11-11