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Emergency dispatch process and patient outcome in bystander-witnessed out-of-hospital cardiac arrest with a shockable rhythm.

Hiltunen PV, Silfvast TO, Jäntti TH, Kuisma MJ, Kurola JO, FINNRESUSCI Prehospital Study Gro - Eur J Emerg Med (2015)

Bottom Line: This study was part of the FINNRESUSCI study focusing on the epidemiology and outcome of OHCA in Finland.The difference was not statistically significant (P=0.521).The survival rate was high in both groups.

View Article: PubMed Central - PubMed

Affiliation: aCentre for Prehospital Emergency Care, Kuopio University Hospital, Kuopio bEmergency Medical Service, Department of Anaesthesia and ICM, Helsinki University Central Hospital, Helsinki, Finland.

ABSTRACT

Objective: To describe the dispatch process for out-of-hospital cardiac arrest (OHCA) in bystander-witnessed patients with initial shockable rhythm, and to evaluate whether recognition of OHCA by the emergency medical dispatcher (EMD) has an effect on the outcome.

Methods: This study was part of the FINNRESUSCI study focusing on the epidemiology and outcome of OHCA in Finland. Witnessed [not by Emergency Medical Service (EMS)] OHCA patients with initial shockable rhythm in the southern and the eastern parts of Finland during a 6-month period from March 1 to August 31 2010, were electronically collected from eight dispatch centres and from paper case reports filled out by EMS crews.

Results: Of the 164 patients, 82.3% (n=135) were correctly recognized by the EMD as cardiac arrests. The majority of all calls (90.7%) were dispatched within 2 min. Patients were more likely to survive and be discharged from the hospital if the EMS response time was within 8 min (P<0.001). Telephone-guided cardiopulmonary resuscitation (T-CPR) was given in 53 cases (32.3%). Overall survival to hospital discharge was 43.4% (n=71). Survival to hospital discharge was 44.4% (n=60) when the EMD recognized OHCA and 37.9% (n=11) when OHCA was not recognized. The difference was not statistically significant (P=0.521).

Conclusion: The rate of recognition of cardiac arrest by EMD was high, but EMD recognition did not affect the outcome. The survival rate was high in both groups. Recognized cardiac arrest patients received bystander CPR more frequently than those for whom OHCA remained unrecognized.

No MeSH data available.


Related in: MedlinePlus

The study flow chart. aSurvival after 1 year could not be established in two patients who were discharged alive from hospital to their home countries. CPC, Cerebral Performance Category; EMS, Emergency Medical Service; OHCA, out-of-hospital cardiac arrest; ROSC, return of spontaneous circulation; T-CPR, telephone-guided cardiopulmonary resuscitation.
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Related In: Results  -  Collection


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Figure 1: The study flow chart. aSurvival after 1 year could not be established in two patients who were discharged alive from hospital to their home countries. CPC, Cerebral Performance Category; EMS, Emergency Medical Service; OHCA, out-of-hospital cardiac arrest; ROSC, return of spontaneous circulation; T-CPR, telephone-guided cardiopulmonary resuscitation.

Mentions: The dispatch centres received 885 338 emergency telephone calls during the 6-month study period. Of these, 237 295 were medical (26.8% of all telephone calls), leading to 186 420 EMS missions (78.6% of all medical telephone calls) (Fig. 1).


Emergency dispatch process and patient outcome in bystander-witnessed out-of-hospital cardiac arrest with a shockable rhythm.

Hiltunen PV, Silfvast TO, Jäntti TH, Kuisma MJ, Kurola JO, FINNRESUSCI Prehospital Study Gro - Eur J Emerg Med (2015)

The study flow chart. aSurvival after 1 year could not be established in two patients who were discharged alive from hospital to their home countries. CPC, Cerebral Performance Category; EMS, Emergency Medical Service; OHCA, out-of-hospital cardiac arrest; ROSC, return of spontaneous circulation; T-CPR, telephone-guided cardiopulmonary resuscitation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4530730&req=5

Figure 1: The study flow chart. aSurvival after 1 year could not be established in two patients who were discharged alive from hospital to their home countries. CPC, Cerebral Performance Category; EMS, Emergency Medical Service; OHCA, out-of-hospital cardiac arrest; ROSC, return of spontaneous circulation; T-CPR, telephone-guided cardiopulmonary resuscitation.
Mentions: The dispatch centres received 885 338 emergency telephone calls during the 6-month study period. Of these, 237 295 were medical (26.8% of all telephone calls), leading to 186 420 EMS missions (78.6% of all medical telephone calls) (Fig. 1).

Bottom Line: This study was part of the FINNRESUSCI study focusing on the epidemiology and outcome of OHCA in Finland.The difference was not statistically significant (P=0.521).The survival rate was high in both groups.

View Article: PubMed Central - PubMed

Affiliation: aCentre for Prehospital Emergency Care, Kuopio University Hospital, Kuopio bEmergency Medical Service, Department of Anaesthesia and ICM, Helsinki University Central Hospital, Helsinki, Finland.

ABSTRACT

Objective: To describe the dispatch process for out-of-hospital cardiac arrest (OHCA) in bystander-witnessed patients with initial shockable rhythm, and to evaluate whether recognition of OHCA by the emergency medical dispatcher (EMD) has an effect on the outcome.

Methods: This study was part of the FINNRESUSCI study focusing on the epidemiology and outcome of OHCA in Finland. Witnessed [not by Emergency Medical Service (EMS)] OHCA patients with initial shockable rhythm in the southern and the eastern parts of Finland during a 6-month period from March 1 to August 31 2010, were electronically collected from eight dispatch centres and from paper case reports filled out by EMS crews.

Results: Of the 164 patients, 82.3% (n=135) were correctly recognized by the EMD as cardiac arrests. The majority of all calls (90.7%) were dispatched within 2 min. Patients were more likely to survive and be discharged from the hospital if the EMS response time was within 8 min (P<0.001). Telephone-guided cardiopulmonary resuscitation (T-CPR) was given in 53 cases (32.3%). Overall survival to hospital discharge was 43.4% (n=71). Survival to hospital discharge was 44.4% (n=60) when the EMD recognized OHCA and 37.9% (n=11) when OHCA was not recognized. The difference was not statistically significant (P=0.521).

Conclusion: The rate of recognition of cardiac arrest by EMD was high, but EMD recognition did not affect the outcome. The survival rate was high in both groups. Recognized cardiac arrest patients received bystander CPR more frequently than those for whom OHCA remained unrecognized.

No MeSH data available.


Related in: MedlinePlus