No abstract

No abstract

Improving management and survival of out-of-hospital cardiac arrest (OHCA) is a major public health issue. 1 It has become essential to use standardized variables and implement registries to collect high quality data in the real-world setting. 2 Besides internal validity, one of the most important requirements for registries is their completeness. We aimed to compare the completeness of the Northern French Alps Cardiac Arrest Registry (RENAU AC) with data from two other emergency systems.From January 1st, 2016 to April 30th, 2016, data from one of the three counties (Haute-Savoie) of the Northern French Alps Cardiac Arrest Registry ("Register") were extracted. Manual identification allowed to link those data with the ones from the Emergency Medical Technicians from the Fire Department ("Firemen") and the ones from the Emergency Medical System from the prehospital medical system ("EMS"). Data were anonymized for the analyses. A proportional Venn diagram was used to visualize the overlap and differences between data sets. 3 During the study period, 351 OHCA were included. Fig. 1 shows the overlap between the data set. The completeness of the RENAU AC registry was estimated at 81,8% (287/351). Even after 10 years of existence, the registry accounts for more than 80% of completeness compared to the two other data sources.This study is limited by the short period of time considered and the lack of information on the type of cardiac arrest, as it was not available in the "Firemen" and "EMS" data set. Furthermore, the study was focused on one county due to unavailable data in the other counties. However, the annual proportion of recruited cardiac arrest in each county and the practices in the Northern French Alps regarding the management of OHCA do not significantly differ. Some authors also suggested that it is possible to study the completeness of a register only based on a part of its population. 4 Moreover, in this example, all centers participated in data collection, which is not always the case in published studies. 5 In conclusion, with less than 20% of missingness, the results produced by the RENAU AC register may be reliable. While there may be a potential selection bias due to under-representation of certain cases, such bias should only have a marginal impact on estimates calculated from the register. Factors associated with failure of notification should be considered when using such register.

Introduction: The management of out-of-hospital traumatic cardiac arrest (TCA) for professional rescuers entails Advanced Life Support (ALS) with specific actions to treat the potential reversible causes of the arrest: hypovolemia, hypoxemia, tension pneumothorax (TPx), and tamponade. The aim of this study was to assess the impact of specific rescue measures on short-term outcomes in the context of resuscitating patients with a TCA. Methods: This retrospective study concerns all TCA patients treated in two emergency medical units, which are part of the Northern French Alps Emergency Network (RENAU), from January 2004 through December 2017. Utstein variables and specific rescue measures in TCA were compiled: fluid expansion, pelvic stabilization, tourniquet application, bilateral thoracostomy, and thoracotomy procedures. The primary endpoint was survival rate at Day 30 with good neurological status (Cerebral Performance Category [CPC] score CPC 1 and CPC 2). Results: In total, 287 resuscitation attempts in TCA were included and 279 specific interventions were identified: 262 fluid expansions, 41 pelvic stabilizations, five tourniquets, and 175 bilateral thoracostomies (including 44 with TPx). Conclusion: Among the standard resuscitation measures to treat the reversible causes of cardiac arrest, this study found that bilateral thoracostomy and tourniquet application on a limb hemorrhage improve survival in TCA. A larger sample for pelvic stabilization is needed.

No abstract

No abstract

The management of Out of hospital Traumatic Cardiac Arrest (TCA) for professional rescuers combines advanced life support with specifics actions to treat potential reversible causes of the arrest: hypovolemia, hypoxemia, Tension Pneumothorax (TPx) and tamponade. The aim of this study was to assess the impact of specific rescue gestures on short-term outcomes in the context of resuscitation of patients with a pre-hospital TCA.Methods: We conducted a retrospective study of all TCA treated in two emergency medical units (EM unit), which are part of the Northern Alps emergency network, from January 2004 to December 2017. Utstein variables and specific rescue actions in TCA were compiled: advanced airway management, fluid administration, pelvic stabilization or tourniquet application, bilateral thoracostomy, and thoracotomy procedures. The primary end point was the survival rate at day 30 with good neurologic outcome (cerebral performance category [CPC] score 1 & 2).Results: 287 resuscitations attempt in TCA were included and 279 specific interventions were Identified: 262 Fluid expansion, 41 External Pelvic stabilizations, 5 tourniquets, 175 bilateral thoracostomies, (including 44 with TPx).Conclusion: Among standard resuscitation measures to treat reversible causes of cardiac arrest, we were able to show that bilateral thoracostomy and tourniquet application on a limb hemorrhage improves survival of TCA. A larger sample for pelvic stabilization is necessary.

No abstract