Comparison of the early effects of out-of-hospital resuscitation in selected urban and rural areas in Poland. A preliminary report from the Polish Cardiac Arrest Registry by the Polish Resuscitation Council

Abstract

A b s t r a c t Background:The chain of survival is a set of most important factors affecting survival after an out-of-hospital cardiac arrest (OHCA). Recognising the difficulties in applying the chain is the key to improving outcomes. Early return of spontaneous circulation (ROSC) after a cardiac arrest is a fundamental factor for patient survival.Aim: To assess the degree to which the location of OHCA affects ROSC during resuscitation efforts. Results: Over the time period covered by the study, 5185 cases of OHCA were reported. Resuscitation was attempted in 2415 (46.6%) cases. ROSC was achieved in 736 (30.48%) cases, including 374 (32.13%) cases in urban areas and 362 (28.94%) cases in rural areas. This difference was not statistically significant. Compared to urban areas, event witnesses in rural areas were more likely to perform bystander resuscitation and receive instructions from the EMS dispatchers. In the whole study group, cardiac disorders were the most common underlying cause of cardiac arrest (70.35%). The median time of ambulance arrival to the scene was significantly shorter in urban areas compared to rural areas (median time 6 min and 12 min, respectively). Conclusions:No significant relation was found between the location of OHCA and ROSC despite the fact that the time to ambulance arrival was significantly shorter in urban areas. In rural areas, resuscitation was more frequently initiated by the event witnesses. Both in urban and rural areas, OHCA was most commonly due to cardiac causes, and the initial recorded cardiac rhythm was a non-shockable one.

Polish Helicopter Emergency Medical Service (HEMS) Response to Out-of-Hospital Cardiac Arrest (OHCA): A Retrospective Study

“…In the present study, the cause of cardiac arrest was most commonly cardiac. This finding is corroborated by a number of studies analyzing OHCA in Europe and in other regions of the world [ 2 , 10 , 15 – 17 ]. The large proportion of OHCA cases of cardiac origin is largely due to the Utstein definition of CA origin, in which “cardiac origin” comprises both cases with an obvious cardiac cause and cases where signs of other causes were absent [ 18 ].…”

“…The identification of cardiac arrest etiology depends on multiple factors, including the region where a study was performed, or care in establishing the cause of cardiac arrest. In many cases, this information is difficult to obtain [ 10 , 15 ]. In the present study, the cause of cardiac arrest was most commonly cardiac.…”

EuReCa ONE⿿27 Nations, ONE Europe, ONE Registry

“…[3][4][5][6] During the last decades a number of registries for OHCA have been implemented in Europe. [7][8][9][10][11][12][13][14][15][16][17] These registries cover varied parts of the participating countries. The greater part of Europe however is not included in a registry with the aim of continuous reporting of OHCA.…”

Return of spontaneous circulation and heart rhythm during the first analysis of the heart electrical activity

“…However 15.3% of cases service on the even site turned out to be efficient and led to return of spontaneous circulation. Such a low percentage was observed in rural areas, whereas an increase in ROSC was observed in town and cities [6,11]. Taking into consideration return of spontaneous circulation and patients' age, the carried-out analysis showed statistically significant difference.…”