Effect of national implementation of utstein recommendation from the global resuscitation alliance on ten steps to improve outcomes from Out-of-Hospital cardiac arrest: a ten-year observational study in Korea

Abstract

ObjectivesThe Utstein ten-step implementation strategy (UTIS) proposed by the Global Resuscitation Alliance, a bundle of community cardiopulmonary resuscitation (CPR) programs to improve outcomes after out-of-hospital cardiac arrests (OHCAs), has been developed. However, it is not documented whether UTIS programs are associated with better outcomes or not. The study aimed to test the association between the UTIS programme and better outcomes after OHCA.MethodsThe study was a before- and after-intervention study. Adults OHCAs treated by emergency medical service (EMS) from 2006 to 2015 in Korea were collected, excluding patients witnessed by ambulance personnel and without outcomes. Phase 1 (2009–2011) after implementing three programs (national OHCA registry, obligatory CPR education, and public report of OHCA outcomes), and phase 2 (2012–2015) after implementing two programs (telephone-assisted CPR and EMS quality assurance programme) were compared with the control period (2006–2008) when no UTIS programme were implemented. The primary outcome was good neurological recovery (cerebral performance scale 1 or 2). We tested the association between the phases and outcomes, adjusting for confounders using a multivariate logistic regression model to calculate adjusted odds ratios (AORs) with 95% confidence intervals (CIs).ResultsA total of 1 28 888 eligible patients were analysed. The control, phase 1, and phase two study groups were 19.4%, 30.5%, and 50.0% of the whole, respectively. There were significant changes in pre-hospital ROSC (0.8% in 2006 and 7.1% in 2015), survival to discharge (3.0% in 2006 and 6.1% in 2015), and good neurological recovery (1.2% in 2006 and 4.1% in 2015). The AORs (95% CIs) for good neurological recovery were 1.82 (1.53–2.15) or phase 1 and 2.21 (1.78–2.75) for phase two compared with control phase.ConclusionThe national implementation of the five UTIS programs was significantly associated with better OHCA outcomes in Korea.

Clinical Investigations External Validation of Multimodal Termination of Resuscitation Rules for Out-of-hospital Cardiac Arrest Patients in the Covid-19 Era

“…Our ndings, although preliminary, showed that survival outcomes of OHCA patients in Daegu during the peak of the COVID-19 outbreak (4.1%) were signi cantly lower than those reported nationwide (9.8%) or in the city (8.8%) in 2018 [18]. We could not describe the broken chain of survivaland the negative effects on high-quality CPR in the results of the present study;however, due to this pandemic, the risk-bene t balance for CPRshould be reconsidered [2].Other studies have also raised the question of how CPRmust be performed for IHCA patients with con rmed COVID-19.Considering the lower survival rate, physicians should be concerned about the goals of care or CPR preferences to reduce futile resuscitation by stratifying survivability of the IHCA patients, regardless of their COVID-19 status, at the time of hospital admission [5,19].…”

Factors Associated with High-Quality Cardiopulmonary Resuscitation Performed by Bystander

“…Since 2008, we have enacted the Good Samaritan Law and maintained the mandated first responder and school CPR programs. Since 2011, the DACPR system has been operated by the national EMS [6]. erefore, the bystander CPR rate has increased dramatically, as seen in this study.…”

“…e elderly are generally physically weaker than younger people. In a 2008 study, the participants of a mandatory training program for CPR were students and first responders [6]. Retired elderly were likely to lack CPR knowledge because they had fewer educational opportunities.…”

“…To promote bystander CPR, we have augmented dispatcherassisted CPR (DACPR) and CPR education programs for laypersons. Consequently, the rate of bystander CPR has increased [6]. In addition, many studies have indicated the importance of CPR quality.…”

The knowledge, attitude and confidence on first aid response among childcare providers following FAT4CP© training in negeri sembilan, Malaysia

“…First aid is the assistance given to a person suffering from sudden illness or injury, to preserve life, prevent the condition from worsening, and reducing the severity of injuries (Helsloot and Ruitenberg, 2004). The 2015 International Liaison Committee on Resuscitation (ILCOR) Consensus on Science and Treatment Recommendations and reviews by Red Cross Red Crescent National Societies reported a signi icant increase in survival rates and reduced time to resolution of symptoms for ill or injured persons after a comprehensive irst aid training (Singletary et al, 2015;Kim et al, 2017). Children are more vulnerable to unintentional injuries due to the fact that they are less acquainted of themselves and environmental dangers.…”