Limits...
Risky locations for out-of-hospital cardiopulmonary arrest in a typical urban city.

Moriwaki Y, Tahara Y, Iwashita M, Kosuge T, Suzuki N - J Emerg Trauma Shock (2014)

Bottom Line: A total of 181 OHCPA cases (11.7%) took place in the lavatory and 166 (10.7%) in the bathroom; of these, only 7 (3.9% of OHCPA in the lavatory) and none in the bath room achieved good outcomes.An unignorable population suffered from OHCPA in private locations, particularly in the lavatory and bathroom; their initial rhythm was usually asystole and their outcomes were poor, despite the high frequency of cardiac etiology in the bathroom.We should try to treat OHCPA victims and to prevent occurrence of OHCPA in these risky spaces by considering their specific conditions.

View Article: PubMed Central - PubMed

Affiliation: Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan.

ABSTRACT

Background: The aim of this study is to clarify the circumstances including the locations where critical events resulting in out-of-hospital cardiopulmonary arrest (OHCPA) occur.

Materials and methods: Subjects of this population-based observational case series study were the clinical records of patients with nontraumatic and nonneck-hanging OHCPA.

Results: Of all 1546 cases, 10.3% occurred in a public place (shop, restaurant, workplace, stations, public house, sports venue, and bus), 8.3% on the street, 73.4% in a private location (victim's home, the homes of the victims' relatives or friends or cheap bedrooms, where poor homeless people live), and 4.1% in residential institutions. In OHCPA occurring in private locations, the frequency of asystole was higher and the outcome was poorer than in other locations. A total of 181 OHCPA cases (11.7%) took place in the lavatory and 166 (10.7%) in the bathroom; of these, only 7 (3.9% of OHCPA in the lavatory) and none in the bath room achieved good outcomes. The frequencies of shockable initial rhythm occurring in the lavatory and in bath room were 3.7% and 1.1% (lower than in other locations, P = 0.011 and 0.002), and cardiac etiology in OHCPA occurring in these locations were 46.7% and 78.4% (the latter higher than in other locations, P < 0.001).

Conclusions: An unignorable population suffered from OHCPA in private locations, particularly in the lavatory and bathroom; their initial rhythm was usually asystole and their outcomes were poor, despite the high frequency of cardiac etiology in the bathroom. We should try to treat OHCPA victims and to prevent occurrence of OHCPA in these risky spaces by considering their specific conditions.

No MeSH data available.


Related in: MedlinePlus

Map of Yokohama City indicating the 12 hospitals to which the emergency medical service system transfers out-ofhospital cardiopulmonary arrest (OHCPA) patients based on the nearest emergency department and which must receive OHCPA patients. For each hospital in Yokohama including our hospital, all data concerning CPA patients are population-based
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4231265&req=5

Figure 1: Map of Yokohama City indicating the 12 hospitals to which the emergency medical service system transfers out-ofhospital cardiopulmonary arrest (OHCPA) patients based on the nearest emergency department and which must receive OHCPA patients. For each hospital in Yokohama including our hospital, all data concerning CPA patients are population-based

Mentions: We are establishing a prehospital and interhospital EMS system for critical and severe patients including OHCPA in our city.[14567] Yokohama is the second-largest city in Japan and our institute is located in the center of Yokohama. Yokohama has an area of 434 km2 and the population of Yokohama is 3.37 million. We selected 12 hospitals, whose EDs can receive and treat the severest patients including OHCPA patients, and which have to receive patients with OHCPA independent of their capacity. One EMS director (a medical doctor) who belongs to the 12 hospitals is stationed in the central operation center in the fire department of the city. This director advises ELSTs, orders treatment through them, and notifies the hospitals when OHCPA patients are being transferred to them. The hospital receiving CPA patients is decided upon based simply based on proximity that means our city is divided in 12 areas concerning transfer of patients with OHCPA and patients with OHCPA in each area are transfer to the destined hospital of 12 hospitals in each area, and that means the data concerning OHCPA consist of the case-series population based for each hospital, including ours [Figure 1].[14567] The area is defined according to the distance and interval for transfer by ambulance considering road and highway network. That means the background population of this single center study is about 0.28 million, which figure is not accurate and unclear because population is variable every hour. In our city, most people die in hospitals, who were usually transferred to some hospitals before their death.


Risky locations for out-of-hospital cardiopulmonary arrest in a typical urban city.

Moriwaki Y, Tahara Y, Iwashita M, Kosuge T, Suzuki N - J Emerg Trauma Shock (2014)

Map of Yokohama City indicating the 12 hospitals to which the emergency medical service system transfers out-ofhospital cardiopulmonary arrest (OHCPA) patients based on the nearest emergency department and which must receive OHCPA patients. For each hospital in Yokohama including our hospital, all data concerning CPA patients are population-based
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231265&req=5

Figure 1: Map of Yokohama City indicating the 12 hospitals to which the emergency medical service system transfers out-ofhospital cardiopulmonary arrest (OHCPA) patients based on the nearest emergency department and which must receive OHCPA patients. For each hospital in Yokohama including our hospital, all data concerning CPA patients are population-based
Mentions: We are establishing a prehospital and interhospital EMS system for critical and severe patients including OHCPA in our city.[14567] Yokohama is the second-largest city in Japan and our institute is located in the center of Yokohama. Yokohama has an area of 434 km2 and the population of Yokohama is 3.37 million. We selected 12 hospitals, whose EDs can receive and treat the severest patients including OHCPA patients, and which have to receive patients with OHCPA independent of their capacity. One EMS director (a medical doctor) who belongs to the 12 hospitals is stationed in the central operation center in the fire department of the city. This director advises ELSTs, orders treatment through them, and notifies the hospitals when OHCPA patients are being transferred to them. The hospital receiving CPA patients is decided upon based simply based on proximity that means our city is divided in 12 areas concerning transfer of patients with OHCPA and patients with OHCPA in each area are transfer to the destined hospital of 12 hospitals in each area, and that means the data concerning OHCPA consist of the case-series population based for each hospital, including ours [Figure 1].[14567] The area is defined according to the distance and interval for transfer by ambulance considering road and highway network. That means the background population of this single center study is about 0.28 million, which figure is not accurate and unclear because population is variable every hour. In our city, most people die in hospitals, who were usually transferred to some hospitals before their death.

Bottom Line: A total of 181 OHCPA cases (11.7%) took place in the lavatory and 166 (10.7%) in the bathroom; of these, only 7 (3.9% of OHCPA in the lavatory) and none in the bath room achieved good outcomes.An unignorable population suffered from OHCPA in private locations, particularly in the lavatory and bathroom; their initial rhythm was usually asystole and their outcomes were poor, despite the high frequency of cardiac etiology in the bathroom.We should try to treat OHCPA victims and to prevent occurrence of OHCPA in these risky spaces by considering their specific conditions.

View Article: PubMed Central - PubMed

Affiliation: Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan.

ABSTRACT

Background: The aim of this study is to clarify the circumstances including the locations where critical events resulting in out-of-hospital cardiopulmonary arrest (OHCPA) occur.

Materials and methods: Subjects of this population-based observational case series study were the clinical records of patients with nontraumatic and nonneck-hanging OHCPA.

Results: Of all 1546 cases, 10.3% occurred in a public place (shop, restaurant, workplace, stations, public house, sports venue, and bus), 8.3% on the street, 73.4% in a private location (victim's home, the homes of the victims' relatives or friends or cheap bedrooms, where poor homeless people live), and 4.1% in residential institutions. In OHCPA occurring in private locations, the frequency of asystole was higher and the outcome was poorer than in other locations. A total of 181 OHCPA cases (11.7%) took place in the lavatory and 166 (10.7%) in the bathroom; of these, only 7 (3.9% of OHCPA in the lavatory) and none in the bath room achieved good outcomes. The frequencies of shockable initial rhythm occurring in the lavatory and in bath room were 3.7% and 1.1% (lower than in other locations, P = 0.011 and 0.002), and cardiac etiology in OHCPA occurring in these locations were 46.7% and 78.4% (the latter higher than in other locations, P < 0.001).

Conclusions: An unignorable population suffered from OHCPA in private locations, particularly in the lavatory and bathroom; their initial rhythm was usually asystole and their outcomes were poor, despite the high frequency of cardiac etiology in the bathroom. We should try to treat OHCPA victims and to prevent occurrence of OHCPA in these risky spaces by considering their specific conditions.

No MeSH data available.


Related in: MedlinePlus