Out-of-hospital cardiac arrest: determinant factors for immediate survival after cardiopulmonary resuscitation

Morais, Daniela Aparecida; Carvalho, Daclé Vilma; Corrêa, Allana dos Reis

doi:10.1590/0104-1169.3453.2452

Cited by 14 publications

(17 citation statements)

References 13 publications

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“…12 In a Brazilian study, it was pointed out https://periodicos.ufpe.br/revistas/revistaenfermagem/index that when CRA was witnessed by someone trained in basic life support, victims were 3.5 times more likely to survive immediately. 9 It is noted in this study that 19.6% of victims received CPR prior to the arrival of SAMU, with no indication as to whether the resuscitator was a layman or someone trained in basic life support, and not demonstrating an association with the CPR outcome, contrary to the other studies presented. However, it is noteworthy that there was no such information in 66.3% of the medical records.…”

Section: Discussioncontrasting

confidence: 71%

“…Nevertheless, it was found that the calculated median age (65 years) was slightly higher than that recorded in another Brazilian study (64 years old). 9 It is shown that two Asian cities had higher medians: 69 years in Seoul and 77 in Osaka 10 . In addition, in a study that addressed much of Europe, the median was 70 years, 11 suggesting that the numbers found were similar only in researches that portray the Brazilian reality.…”

Section: Resultsmentioning

confidence: 98%

“…A similar finding was found in a Brazilian study, where 50.1% of the CRA cases attended by the SAMU of Belo Horizonte were characterized by an initial asystole rhythm, also succeeded by AESP and FV / TV, but among victims survived, most had a shockable initial rhythm. 9 In the United States, in 2016, a shockable initial rhythm was observed in 19.8% of out-ofhospital cardiopulmonary arrest events seen by the emergency service 12 and in Europe the proportion was 22.2%. 11 It is suggested that the predominance of asystole, considered the worst prognosis and the final rhythm, and the low detection of the shockable rhythm (10.4%) may be related to the poor dissemination and implementation of training programs for the lay population, in the sense of teach her to recognize and initiate CPA maneuvers, which is characteristic of the emergency response system at the scene of the incident, the time of activation and response of the ambulance, and the poor availability of AED (automatic external defibrillator) in the community.…”

Section: Discussionmentioning

confidence: 99%

“…15 In another Brazilian study, it was noted 29.1% of the CRAs were witnessed prior to the arrival of USAU from SAMU. 9 According to data obtained from a US registry system, 37% of the occurrences of CRA in a prehospital setting were witnessed by lay people in 2015 in that country, thus demonstrating a much longer survival, compared to unseen occurrences. 12 It was concluded that, in Europe, 54.3% of occurrences were witnessed, 11 being the highest proportion among the findings cited.…”

Section: Discussionmentioning

confidence: 99%

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Parada cardiorrespiratória pré-hospitalar: avaliação dos atendimentos segundo o utstein style*

Zandomenighi

Martins

2019

Rev enferm UFPE on line.

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Objetivo: analisar as ocorrências, respostas e desfechos da parada cardiorrespiratória pré-hospitalar segundo o Utstein Style e identificar os fatores associados à sobrevida. Método: trata-se de um estudo quantitativo, documental e transversal, com vítimas de parada cardiorrespiratória atendidas nas unidades de suporte avançado de vida, no ano de 2015. Coletaram-se os dados a partir dos relatórios de atendimento do socorrista, organizando-os e analisando-os de acordo com o Utstein Style. Apresentaram-se os resultados em forma de tabelas. Resultados: verificaram-se 163 atendimentos, predominando o sexo masculino, não havendo associação entre idade e os desfechos. Identificou-se a maioria das PCRs como sendo de causa clínica, na residência e em assistolia, sendo entubação orotraqueal, acesso venoso periférico e administração de adrenalina os procedimentos mais frequentes. Constatou-se que as ocorrências presenciadas por espectadores leigos e o tempo-resposta da ambulância demonstraram uma associação com o desfecho sobrevida. Calculou-se a taxa de sobrevida em 25,1%. Conclusão: avaliou-se o serviço por meio da análise das ocorrências segundo o Utstein Style e verificaram-se associações entre o desfecho e as lacunas no atendimento, havendo a necessidade de intervenções em cada elo da corrente de sobrevivência. Descritores: Parada Cardíaca Extra-Hospitalar; Ressuscitação Cardiopulmonar; Serviços Médicos de Emergência; Ambulâncias; Emergências; Avaliação de Resultados. ABSTRACTObjective: to analyze the occurrences, responses and outcomes of prehospital cardiopulmonary arrest according to Utstein Style and to identify factors associated with survival. Method: this is a quantitative, documentary and cross-sectional study with victims of cardiopulmonary arrest treated at the advanced life support units in 2015. Data were collected from the rescuer's care reports and organized. and analyzing them according to Utstein Style. Results were presented in tables. Results: 163 cases were observed, predominantly male, with no association between age and outcomes. Most CRPs were identified as being of clinical cause, at home and in asystole, with orotracheal intubation, peripheral venous access and epinephrine administration being the most frequent procedures. It was found that the occurrences witnessed by lay spectators and the ambulance response time demonstrated an association with the survival outcome. The survival rate was calculated at 25.1%. Conclusion: the service was evaluated by analyzing the occurrences according to the Utstein Style and there were associations between the outcome and the gaps in care, requiring interventions in each link of the survival chain. Descriptors: Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Emergency Medical Services; Ambulances; Emergencies; Outcome Assessment. RESUMENObjetivo: analizar las ocurrencias, las respuestas y los resultados del paro cardiopulmonar prehospitalario según el Utstein Style e identificar los factores asociados con la supervivencia. Método: este es un estudio cuantitativo, documental y transversal con víctimas de paro cardiopulmonar tratadas en las unidades de soporte vital avanzado en 2015. Los datos se recopilaron de los informes de atención del rescatista, organizándolos y analizándolos según el Utstein Style. Los resultados se presentaron en tablas. Resultados: se observaron 163 casos, predominantemente masculinos, sin asociación entre la edad y los resultados. La mayoría de las PCRs se identificaron como de causa clínica, en el hogar y en la asistolia, siendo los procedimientos más frecuentes la intubación orotraqueal, el acceso venoso periférico y la administración de adrenalina los procedimientos más frecuentes. Se descubrió que las ocurrencias presenciadas por espectadores legos y el tiempo de respuesta de la ambulancia demostraron una asociación con el resultado de supervivencia. La tasa de supervivencia se calculó en 25.1%. Conclusión: el servicio se evaluó analizando las ocurrencias según el Utstein Style y hubo asociaciones entre el resultado y las brechas en la atención, lo que requiere intervenciones en cada eslabón de la cadena de supervivencia. Descriptores: Paro Cardíaco Extra-Hospitalario; Reanimación Cardiopulmonar; Servicios Médicos de Urgencia; Ambulancias, Urgencias Médicas, Evaluación de Resultado.

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Section: Discussioncontrasting

confidence: 71%

Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Parada cardiorrespiratória pré-hospitalar: avaliação dos atendimentos segundo o utstein style*

Zandomenighi

Martins

2019

Rev enferm UFPE on line.

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“…[17242526] A third factor that might result in higher survival rates is the level of training of the resuscitation team members and their adherence to resuscitation guidelines. Many previously published studies reported better survival rates after formal resuscitation training,[2728293031] while Curry and Gass[32] found that the death rate was not lower when resuscitation was performed by BLS-trained staff in comparison to untrained staff.…”

Section: Discussionmentioning

confidence: 99%

An audit of in-hospital cardiopulmonary resuscitation in a teaching hospital in Saudi Arabia: A retrospective study

et al. 2017

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Objectives:Data reflecting cardiopulmonary resuscitation (CPR) efforts in Saudi Arabia are limited. In this study, we analyzed the characteristics, and estimated the outcome, of in-hospital CPR in a teaching hospital in Saudi Arabia over 4 years.Methods:A retrospective, observational study was conducted between January 2009 and December 2012 and included 4361 patients with sudden cardiopulmonary arrest. Resuscitation forms were reviewed. Demographic data, resuscitation characteristics, and survival outcomes were recorded.Results:The mean ± standard deviation age of arrested patient was 40 ± 31 years. The immediate survival rate was 64%, 43% at 24 h, and 30% at discharge. The death rate was 70%. Respiratory type of arrest, time and place of arrest, short duration of arrest, witnessed arrest, the use of epinephrine and atropine boluses, and shockable arrhythmias were associated with higher 24-h survival rates. A low survival rate was found among patients with cardiac types of arrest, and those with a longer duration of arrest, pulseless electrical activity, and asystole. Comorbidities were present in 3786 patients with cardiac arrest and contributed to a poor survival rate (P < 0.001).Conclusions:The study confirms the findings of previously published studies in highly developed countries and provides some reflection on the practice of resuscitation in Saudi Arabia.

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Clinical outcomes from out-of-hospital cardiac arrest in low-resource settings — A scoping review

Schnaubelt

Monsieurs

Semeraro³

et al. 2020

Resuscitation

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Aim of the scoping review: Scientific recommendations on resuscitation are typically formulated from the perspective of an ideal resource environment, with little consideration of applicability in lower-income countries. We aimed to determine clinical outcomes from out-of-hospital cardiac arrest (OHCA) in low-resource countries, to identify shortcomings related to resuscitation in these areas and possible solutions, and to suggest future research priorities.Data sources: This scoping review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR), and was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We identified low-resource countries as countries with a low-or middle gross national income per capita (World Bank data). We performed a literature search on outcomes after OHCA in these countries, and we extracted data on the outcome. We applied descriptive statistics and conducted a post-hoc correlation analysis of cohort size and ROSC rates.Results: We defined 24 eligible studies originating from middle-income countries, but none from low-income regions, suggesting a reporting bias. The number of reported patients in these studies ranged from 54 to 3214. Utstein-style reporting was rarely used. Return of spontaneous circulation varied from 0% to 62%. Fifteen studies reported on survival to hospital discharge (between 1.0 and 16.7%) or favourable neurological outcome (between 1.0 and 9.3%). An inverse correlation was found for study cohort size and the rate of return of spontaneous circulation (r = À0.48, p = 0.034). Conclusion:Studies of OHCA outcomes in low-resource countries are heterogeneous and may be compromised by reporting bias. Minimum cardiopulmonary resuscitation standards for low-resource settings should be developed collaboratively involving local experts, respecting culture and context while balancing competing health priorities.

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Out-of-hospital cardiac arrest: determinant factors for immediate survival after cardiopulmonary resuscitation

Cited by 14 publications

References 13 publications

Parada cardiorrespiratória pré-hospitalar: avaliação dos atendimentos segundo o utstein style*

Parada cardiorrespiratória pré-hospitalar: avaliação dos atendimentos segundo o utstein style*

An audit of in-hospital cardiopulmonary resuscitation in a teaching hospital in Saudi Arabia: A retrospective study

Clinical outcomes from out-of-hospital cardiac arrest in low-resource settings — A scoping review

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