Successful treatment of out-of-hospital cardiac arrest is still based on quick activation of the chain of survival
Background and goal of studyCardiopulmonary resuscitation (CPR) in prehospital care is a major reason for emergency medical service (EMS) dispatches. CPR outcome depends on various factors, such as bystander CPR and initial heart rhythm. Our aim was to investigate whether short-term outcomes such as...
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1126503/full |
| _version_ | 1797849244666691584 |
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| author | Laura Borgstedt Stefan J. Schaller Stefan J. Schaller Daniel Goudkamp Kristina Fuest Bernhard Ulm Bettina Jungwirth Manfred Blobner Manfred Blobner Sebastian Schmid |
| author_facet | Laura Borgstedt Stefan J. Schaller Stefan J. Schaller Daniel Goudkamp Kristina Fuest Bernhard Ulm Bettina Jungwirth Manfred Blobner Manfred Blobner Sebastian Schmid |
| author_sort | Laura Borgstedt |
| collection | DOAJ |
| description | Background and goal of studyCardiopulmonary resuscitation (CPR) in prehospital care is a major reason for emergency medical service (EMS) dispatches. CPR outcome depends on various factors, such as bystander CPR and initial heart rhythm. Our aim was to investigate whether short-term outcomes such as the return of spontaneous circulation (ROSC) and hospital admission with spontaneous circulation differ depending on the location of the out-of-hospital cardiac arrest (OHCA). In addition, we assessed further aspects of CPR performance.Materials and methodsIn this monocentric retrospective study, protocols of a prehospital physician-staffed EMS located in Munich, Germany, were evaluated using the Mann–Whitney U-test, chi-square test, and a multifactor logistic regression model.Results and discussionOf the 12,073 cases between 1 January 2014 and 31 December 2017, 723 EMS responses with OHCA were analyzed. In 393 of these cases, CPR was performed. The incidence of ROSC did not differ between public and non-public spaces (p = 0.4), but patients with OHCA in public spaces were more often admitted to the hospital with spontaneous circulation (p = 0.011). Shockable initial rhythm was not different between locations (p = 0.2), but defibrillation was performed significantly more often in public places (p < 0.001). Multivariate analyses showed that hospital admission with spontaneous circulation was more likely in patients with shockable initial heart rhythm (p < 0.001) and if CPR was started by an emergency physician (p = 0.006).ConclusionThe location of OHCA did not seem to affect the incidence of ROSC, although patients in public spaces had a higher chance to be admitted to the hospital with spontaneous circulation. Shockable initial heart rhythm, defibrillation, and the start of resuscitative efforts by an emergency physician were associated with higher chances of hospital admission with spontaneous circulation. Bystander CPR and bystander use of automated external defibrillators were low overall, emphasizing the importance of bystander education and training in order to enhance the chain of survival. |
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| format | Article |
| id | doaj.art-7bd2bc6a73c947678473936f24a17dab |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-09T18:41:50Z |
| publishDate | 2023-04-01 |
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| series | Frontiers in Public Health |
| spelling | doaj.art-7bd2bc6a73c947678473936f24a17dab2023-04-11T04:29:37ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-04-011110.3389/fpubh.2023.11265031126503Successful treatment of out-of-hospital cardiac arrest is still based on quick activation of the chain of survivalLaura Borgstedt0Stefan J. Schaller1Stefan J. Schaller2Daniel Goudkamp3Kristina Fuest4Bernhard Ulm5Bettina Jungwirth6Manfred Blobner7Manfred Blobner8Sebastian Schmid9Department of Anesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Anesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Anesthesiology and Operative Intensive Care Medicine (CVK, CCM), Charité - Universitaetsmedizin Berlin, Berlin, GermanyDepartment of Anesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Anesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Anesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, University of Ulm, Ulm, GermanyDepartment of Anesthesiology and Intensive Care Medicine, School of Medicine, Technical University of Munich, Munich, GermanyDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, University of Ulm, Ulm, GermanyDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, University of Ulm, Ulm, GermanyBackground and goal of studyCardiopulmonary resuscitation (CPR) in prehospital care is a major reason for emergency medical service (EMS) dispatches. CPR outcome depends on various factors, such as bystander CPR and initial heart rhythm. Our aim was to investigate whether short-term outcomes such as the return of spontaneous circulation (ROSC) and hospital admission with spontaneous circulation differ depending on the location of the out-of-hospital cardiac arrest (OHCA). In addition, we assessed further aspects of CPR performance.Materials and methodsIn this monocentric retrospective study, protocols of a prehospital physician-staffed EMS located in Munich, Germany, were evaluated using the Mann–Whitney U-test, chi-square test, and a multifactor logistic regression model.Results and discussionOf the 12,073 cases between 1 January 2014 and 31 December 2017, 723 EMS responses with OHCA were analyzed. In 393 of these cases, CPR was performed. The incidence of ROSC did not differ between public and non-public spaces (p = 0.4), but patients with OHCA in public spaces were more often admitted to the hospital with spontaneous circulation (p = 0.011). Shockable initial rhythm was not different between locations (p = 0.2), but defibrillation was performed significantly more often in public places (p < 0.001). Multivariate analyses showed that hospital admission with spontaneous circulation was more likely in patients with shockable initial heart rhythm (p < 0.001) and if CPR was started by an emergency physician (p = 0.006).ConclusionThe location of OHCA did not seem to affect the incidence of ROSC, although patients in public spaces had a higher chance to be admitted to the hospital with spontaneous circulation. Shockable initial heart rhythm, defibrillation, and the start of resuscitative efforts by an emergency physician were associated with higher chances of hospital admission with spontaneous circulation. Bystander CPR and bystander use of automated external defibrillators were low overall, emphasizing the importance of bystander education and training in order to enhance the chain of survival.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1126503/fullout-of-hospital cardiac arrestcardiopulmonary resuscitationdefibrillationbystanderreturn of spontaneous circulationinitial heart rhythm |
| spellingShingle | Laura Borgstedt Stefan J. Schaller Stefan J. Schaller Daniel Goudkamp Kristina Fuest Bernhard Ulm Bettina Jungwirth Manfred Blobner Manfred Blobner Sebastian Schmid Successful treatment of out-of-hospital cardiac arrest is still based on quick activation of the chain of survival Frontiers in Public Health out-of-hospital cardiac arrest cardiopulmonary resuscitation defibrillation bystander return of spontaneous circulation initial heart rhythm |
| title | Successful treatment of out-of-hospital cardiac arrest is still based on quick activation of the chain of survival |
| title_full | Successful treatment of out-of-hospital cardiac arrest is still based on quick activation of the chain of survival |
| title_fullStr | Successful treatment of out-of-hospital cardiac arrest is still based on quick activation of the chain of survival |
| title_full_unstemmed | Successful treatment of out-of-hospital cardiac arrest is still based on quick activation of the chain of survival |
| title_short | Successful treatment of out-of-hospital cardiac arrest is still based on quick activation of the chain of survival |
| title_sort | successful treatment of out of hospital cardiac arrest is still based on quick activation of the chain of survival |
| topic | out-of-hospital cardiac arrest cardiopulmonary resuscitation defibrillation bystander return of spontaneous circulation initial heart rhythm |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1126503/full |
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