Adherence to resuscitation guidelines during prehospital care of cardiac arrest patients

Abstract

Less than 50% of out-of-hospital cardiac arrest patients received prehospital postresuscitation care compatible with the current guidelines. Markers of poor prognosis were associated with unsatisfactory care, which in turn was more frequent among the patients who did not survive to hospital discharge. The importance of the guidelines should be highlighted in the future.

Part 1: Executive Summary

“…22,53,54 Although it is not yet possible to determine the individual effect of many of these therapies, it is clear that this "bundle of care" can improve outcome. Therapeutic hypothermia has been shown independently to improve outcome after adult witnessed out-of-hospital VF cardiac arrest 11,12 and after neonatal hypoxic-ischemic insult.…”

Part 12: Education, Implementation, and Teams

“…In adult cardiac arrest, physician presence during resuscitation, compared with paramedics alone, has been reported to increase compliance with guidelines (LOE 2 307 ; LOE 4 308 ) and physicians in some systems can perform advanced resuscitation procedures more successfully (LOE 2 307,309 ; LOE 4 310 -312 ). When compared within individual systems, 4 studies suggested improved survival to hospital discharge when physicians were part of the resuscitation team (LOE 2 313,314 ; LOE 3 315,316 ) and 10 studies suggested no difference in survival of the event (LOE 2) 307,313 or survival to hospital discharge (LOE 2).…”

Part 8: Advanced Life Support

“…Before-andafter studies report increase in survival of comatose patients with sustained ROSC after out-of-hospital cardiac arrest with implementation of a comprehensive treatment protocol (LOE 2 747 ; LOE 3 748,749 ). Protocols included multiple elements such as hypothermia, glucose control, goal-directed hemodynamic optimization, ventilation, and PCI.…”