A model of survival following pre-hospital cardiac arrest based on the Victorian Ambulance Cardiac Arrest Register

Fridman, Masha; Barnes, Vanessa; Whyman, Andrew; Currell, Alex; Bernard, Stephen; Walker, Tony; Smith, Karen

doi:10.1016/j.resuscitation.2007.05.005

Cited by 69 publications

(55 citation statements)

References 47 publications

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“…Additional binomial variables were expressed as proportions and 95% confidence intervals (exact binomial), and groups were compared by 2 tests. Variables that approximated a normal distribution were summarized as meanϮSD, and groups were compared with t tests.…”

Section: Discussionmentioning

confidence: 99%

“…This register has been described in detail previously. 2 All "call received" and "EMS arrival" times are collected electronically. The "collapse to call" time was estimated after discussion with bystanders, and the "EMS arrival to return of spontaneous circulation" time was recorded by paramedics.…”

Section: Methodsmentioning

confidence: 99%

“…1 Despite early defibrillation and advanced cardiac life support provided by emergency medical services (EMS), fewer than half of all patients in out-ofhospital cardiac arrest (OHCA) are resuscitated successfully. 2,3 Among those who have a return of spontaneous circulation and are transported to a hospital, many have sustained severe anoxic neurological injury during the cardiac arrest, and this injury is a leading cause of subsequent death in the hospital. 4 after resuscitation in whom the initial cardiac rhythm is VF.…”

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confidence: 99%

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Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation Cardiac Arrest

et al. 2010

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Background— Therapeutic hypothermia is recommended for the treatment of neurological injury after resuscitation from out-of-hospital cardiac arrest. Laboratory studies have suggested that earlier cooling may be associated with improved neurological outcomes. We hypothesized that induction of therapeutic hypothermia by paramedics before hospital arrival would improve outcome. Methods and Results— In a prospective, randomized controlled trial, we assigned adults who had been resuscitated from out-of-hospital cardiac arrest with an initial cardiac rhythm of ventricular fibrillation to either prehospital cooling with a rapid infusion of 2 L of ice-cold lactated Ringer’s solution or cooling after hospital admission. The primary outcome measure was functional status at hospital discharge, with a favorable outcome defined as discharge either to home or to a rehabilitation facility. A total of 234 patients were randomly assigned to either paramedic cooling (118 patients) or hospital cooling (116 patients). Patients allocated to paramedic cooling received a median of 1900 mL (first quartile 1000 mL, third quartile 2000 mL) of ice-cold fluid. This resulted in a mean decrease in core temperature of 0.8°C ( P =0.01). In the paramedic-cooled group, 47.5% patients had a favorable outcome at hospital discharge compared with 52.6% in the hospital-cooled group (risk ratio 0.90, 95% confidence interval 0.70 to 1.17, P =0.43). Conclusions— In adults who have been resuscitated from out-of-hospital cardiac arrest with an initial cardiac rhythm of ventricular fibrillation, paramedic cooling with a rapid infusion of large-volume, ice-cold intravenous fluid decreased core temperature at hospital arrival but was not shown to improve outcome at hospital discharge compared with cooling commenced in the hospital. Clinical Trial Registration— URL: http://www.anzctr.org.au. Unique identifier: ACTRN12605000179639.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation Cardiac Arrest

et al. 2010

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Section: Introductionmentioning

confidence: 99%

“…Bystander CPR increases the likelihood of patients being found in a shockable cardiac rhythm and of emergency medical services attempting a resusitcation 3. In turn, shockable rhythms are treatable with defibrillation and CPR and are also associated with greater survival 3. However, bystander CPR is not provided in every instance, and recent reports have indicated the existence of significant regional variation in rates of bystander CPR 4, 5, 6…”

Section: Introductionmentioning

confidence: 99%

Regions With Low Rates of Bystander Cardiopulmonary Resuscitation (CPR) Have Lower Rates of CPR Training in Victoria, Australia

Bray

Straney

Smith

et al. 2017

JAHA

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BackgroundBystander cardiopulmonary resuscitation (CPR) more than doubles the chance of surviving an out‐of‐hospital cardiac arrest. Recent data have shown considerable regional variation in bystander CPR rates across the Australian state of Victoria. This study aims to determine whether there is associated regional variation in rates of CPR training and willingness to perform CPR in these communities.Methods and ResultsWe categorized each Victorian postcode as either a low or high bystander CPR region using data on adult, bystander‐witnessed, out‐of‐hospital cardiac arrests of presumed cardiac etiology (n=7175) from the Victorian Ambulance Cardiac Arrest Registry. We then surveyed adult Victorians (n=404) and compared CPR training data of the respondents from low and high bystander CPR regions. Of the 404 adults surveyed, 223 (55%) resided in regions with low bystander CPR. Compared with respondents from high bystander CPR regions, respondents residing in regions with low bystander CPR had lower rates of CPR training (62% versus 75%, P=0.009) and lower self‐ratings for their overall knowledge of CPR (76% versus 84%, P=0.04). There were no differences between the regions in their reasons for not having undergone CPR training or in their willingness to perform CPR. Rates of survival for bystander‐witnessed, out‐of‐hospital cardiac arrests were significantly lower in low bystander CPR regions (15.7% versus 17.0%, P<0.001).ConclusionsThis study found lower rates of CPR training and lower survival in regions with lower rates of bystander CPR in Victoria, Australia. Targeting these regions with CPR training programs may improve bystander CPR rates and out‐of‐hospital cardiac arrest outcomes.

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Einfluss der Basisreanimationsmaßnahmen durch Laien auf das Überleben nach plötzlichem Herztod

Gräsner

Wnent

Gräsner

et al. 2012

Notfall Rettungsmed

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A model of survival following pre-hospital cardiac arrest based on the Victorian Ambulance Cardiac Arrest Register

Cited by 69 publications

References 47 publications

Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation Cardiac Arrest

Induction of Therapeutic Hypothermia by Paramedics After Resuscitation From Out-of-Hospital Ventricular Fibrillation Cardiac Arrest

Regions With Low Rates of Bystander Cardiopulmonary Resuscitation (CPR) Have Lower Rates of CPR Training in Victoria, Australia

Einfluss der Basisreanimationsmaßnahmen durch Laien auf das Überleben nach plötzlichem Herztod

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