Witnessed Cardiac Arrest by Nigerian Health Workers; Improving the Outcomes

Abstract

Aim: To assess the involvement of health workers in Cross River State, Nigeria with CPR during witnessed sudden cardiac arrest and the resources available to them for intervention. Settings and Design: The study was carried out in Cross River State, Southern Nigeria which has an international boundary with Cameroon in the East. It is a descriptive, Cross sectional study among health workers. Methods and Material: Consenting health workers belonging to the various categories who met the eligibility criteria were selected using the non-probability method. They included; Doctors, Pharmacists, Nurses, Laboratory scientists, Physiotherapists, Optometrists, Radiographers and Anaesthetic Technicians. Those who declined to complete the questionnaire were excluded. Statistical analysis used: Descriptive statistics (frequency proportions, means and standard deviation) was used to summarize variables. The level of signifi cance was set at P<0.05 Results: One hundred and eighty-two (52.8%) out of the 345 respondents surveyed, had witnessed and been involved in CPR for cardiac arrest. Common sites of witness were the ward (79, 43.4%), A & E unit (36, 19.8%), theatre (27, 14.8%), home (23, 12.6%) and ICU (17, 9.4%). Approximately half of respondents (50.5%) were involved in chest compressions for cardiopulmonary resuscitation (CPR), while 45.1%, 36.3%, 31.3%, 28.6% and 22.0% were involved in oxygen therapy, IV fl uid therapy, rescue breathing, IV adrenaline therapy and transportation to hospital, respectively. Only 13.2% performed defi brillation as part of the CPR. Approximately half of respondents (48.9%) had participated in successful CPR. Contribution to successful CPR were attributed to immediate recognition (38.2%), prompt CPR (38.2%), oxygen therapy (30.3%), adrenaline administration (20.2%) and fl uid therapy (19.1%). Conclusion: Health workers will occasionally encounter SCA and participate in resuscitation. To improve resuscitation outcome, the triad of insuffi cient awareness, infrastructure and capacity building must be addressed. There is a critical need to make automated external defi brillators available especially in hospitals.