368: Predicting Survival from Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis of Presenting Rhythm

Sasson, Comilla; Vijan, S.G.; Dahl, Jason; Rogers, Maggie

doi:10.1016/j.annemergmed.2008.06.395

Cited by 24 publications

(33 citation statements)

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“…Prehospital factors such as the initial cardiac arrest rhythm, witnessed arrest and bystander cardiopulmonary resuscitation (CPR) have been shown to be associated with improved outcomes. 2 In more recent times, the qualities of CPR and post-resuscitation care have been shown to be important. 3 It has been suggested that serum lactate can be used as a surrogate marker for tissue perfusion in patients suffering cardiac arrest after return of spontaneous circulation (ROSC).…”

Section: Introductionmentioning

confidence: 99%

Use of serum lactate levels to predict survival for patients with out‐of‐hospital cardiac arrest: A cohort study

Williams

Martin

Celenza

et al. 2016

Emerg Medicine Australasia

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In OHCA patients who had serum lactate levels measured, both lower initial serum lactate and early lactate clearance in the first 48 h following OHCA were associated with increased likelihood of survival. However, the use of lactate in isolation as a predictor of survival or neurological outcome is not recommended. Prospective studies that minimise selection bias are required to determine the clinical utility of serum lactate levels in OHCA patients.

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Section: Introductionmentioning

confidence: 99%

Use of serum lactate levels to predict survival for patients with out‐of‐hospital cardiac arrest: A cohort study

Williams

Martin

Celenza

et al. 2016

Emerg Medicine Australasia

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“…34 Fifty-three percent of CAs were witnessed by a bystander; however, only 32% of victims actually received BCPR before arrival of EMS. 35 Because most OHCA events were witnessed, efforts to improve survival should focus on prompt delivery of interventions of known effectiveness by bystanders. This research demonstrated that DA-BCPR could improve the probability of BCPR.…”

Section: Discussionmentioning

confidence: 99%

Impact of Dispatcher-Assisted Bystander Cardiopulmonary Resuscitation with Out-of-Hospital Cardiac Arrest: A Systemic Review and Meta-Analysis

Wang

Zhang

Zhao

et al. 2020

Prehosp. Disaster med.

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Objective:This systemic review and meta-analysis was conducted to explore the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on bystander cardiopulmonary resuscitation (BCPR) probability, survival, and neurological outcomes with out-of-hospital cardiac arrest (OHCA).Methods:Electronically searching of PubMed, Embase, and Cochrane Library, along with manual retrieval, were done for clinical trials about the impact of DA-BCPR which were published from the date of inception to December 2018. The literature was screened according to inclusion and exclusion criteria, the baseline information, and interested outcomes were extracted. Two reviewers assessed the methodological quality of the included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated by STATA version 13.1.Results:In 13 studies, 235,550 patients were enrolled. Compared with no dispatcher instruction, DA-BCPR tended to be effective in improving BCPR rate (I2 = 98.2%; OR = 5.84; 95% CI, 4.58-7.46; P <.01), return of spontaneous circulation (ROSC) before admission (I2 = 36.0%; OR = 1.17; 95% CI, 1.06-1.29; P <.01), discharge or 30-day survival rate (I2 = 47.7%; OR = 1.25; 95% CI, 1.06-1.46; P <.01), and good neurological outcome (I2 = 30.9%; OR = 1.24; 95% CI, 1.04-1.48; P = .01). However, no significant difference in hospital admission was found (I2 = 29.0%; OR = 1.09; 95% CI, 0.91-1.30; P = .36).Conclusion:This review shows DA-BPCR plays a positive role for OHCA as a critical section in the life chain. It is effective in improving the probability of BCPR, survival, ROSC before admission, and neurological outcome.

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“…Survival and favourable outcome after outof-hospital cardiac arrest (OHCA) substantially increase if bystander cardiopulmonary resuscitation (CPR) is performed, with a twofold to fourfold gain in survival. [1][2][3] Such outcomes have also been shown to be associated with CPR quality, 4 which is most importantly ensured by high-quality chest compressions (CCs). A precondition to effectively performing CCs is to position the victim supine on a firm surface.…”

Section: Introductionmentioning

confidence: 99%

In out-of-hospital cardiac arrest, is the positioning of victims by bystanders adequate for CPR? A cohort study

et al. 2020

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ObjectivesOutcome from out-of-hospital cardiac arrest (OHCA) highly depends on bystander cardiopulmonary resuscitation (CPR) with high-quality chest compressions (CCs). Precondition is a supine position of the victim on a firm surface. Until now, no study has systematically analysed whether bystanders of OHCA apply appropriate positions to victims and whether the position is associated with a particular outcome.DesignProspective observational cohort study.SettingMetropolitan emergency medical services (EMS) serving a population of 400 000; dispatcher-assisted CPR was implemented. We obtained information from the first EMS vehicle arriving on scene and matched this with data from semi-structured interviews with witnesses of the arrest.ParticipantsBystanders of all OHCAs occurring during a 12-month period (July 2006–July 2007). From 201 eligible missions, 200 missions were fully reported by EMS. Data from 138 bystander interviews were included.Primary and secondary outcome measuresProportion of positions suitable for effective CCs; related survival with favourable neurological outcome at 3 months.ResultsPositioning of victims at EMS arrival was ‘supine on firm surface’ in 64 cases (32.0%), ‘recovery position (RP)’ in 37 cases (18.5%) and other positions unsuitable for CCs in 99 cases (49.5%). Survival with favourable outcome at 3 months was 17.2% when ‘supine position’ had been applied, 13.5% with ‘RP’ and 6.1% with ‘other positions unsuitable for CCs’; a statistically significant association could not be shown (p=0.740, Fisher’s exact test). However, after ‘effective CCs’ favourable outcome at 3 months was 32.0% compared with 5.3% if no actions were taken. The OR was 5.87 (p=0.02).ConclusionIn OHCA, two-thirds of all victims were found in positions not suitable for effective CCs. This was associated with inferior outcomes. A substantial proportion of the victims was placed in RP. More attention should be paid to the correct positioning of victims in OHCA. This applies to CPR training for laypersons and dispatcher-assisted CPR.

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368: Predicting Survival from Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis of Presenting Rhythm

Cited by 24 publications

References 0 publications

Use of serum lactate levels to predict survival for patients with out‐of‐hospital cardiac arrest: A cohort study

Use of serum lactate levels to predict survival for patients with out‐of‐hospital cardiac arrest: A cohort study

Impact of Dispatcher-Assisted Bystander Cardiopulmonary Resuscitation with Out-of-Hospital Cardiac Arrest: A Systemic Review and Meta-Analysis

In out-of-hospital cardiac arrest, is the positioning of victims by bystanders adequate for CPR? A cohort study

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