Estimating the effect of bystander-initiated cardiopulmonary resuscitation in Japan

Sekimoto, Miho; Noguchi, Yoshinori; Rahman, Mahbubur; Hira, Kenji; Fukui, Michihiko; Enzan, K; Inaba, Hideo; Fukui, Tsuguya

doi:10.1016/s0300-9572(01)00330-6

Cited by 26 publications

(16 citation statements)

References 41 publications

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“…It is remarkable that in Germany bystanders too rarely initiate CPR before EMS arrival, even when they witness the collapse. The positive influence of bystander CPR on survival rate has been demonstrated frequently [45-47]. Previous studies have shown similar setups in German and European systems [9,48].…”

Section: Discussionmentioning

confidence: 77%

The impact of response time reliability on CPR incidence and resuscitation success: a benchmark study from the German Resuscitation Registry

et al. 2011

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IntroductionSudden cardiac arrest is one of the most frequent causes of death in the world. In highly qualified emergency medical service (EMS) systems, including well-trained emergency physicians, spontaneous circulation may be restored in up to 53% of patients at least until admission to hospital. Compared with these highly qualified EMS systems, markedly lower success rates are observed in other systems. These data clearly show that there are considerable differences between EMS systems concerning treatment success following cardiac arrest and resuscitation, although in all systems international guidelines for resuscitation are used. In this study, we investigated the impact of response time reliability (RTR) on cardiopulmonary resuscitation (CPR) incidence and resuscitation success by using the return of spontaneous circulation (ROSC) after cardiac arrest (RACA) scores and data from seven German EMS systems participating in the German Resuscitation Registry.MethodsAnonymised patient data after out-of-hospital cardiac arrest gathered from seven EMS systems in Germany from 2006 to 2009 were analysed with regard to socioeconomic factors (population, area and EMS unit-hours), process quality (RTR, CPR incidence, special CPR measures and prehospital cooling), patient factors (age, gender, cause of cardiac arrest and bystander CPR). End points were defined as ROSC, admission to hospital, 24-hour survival and hospital discharge rate. χ2 tests, odds ratios and the Bonferroni correction were used for statistical analyses.ResultsOur present study comprised 2,330 prehospital CPR patients at seven centres. The incidence of sudden cardiac arrest ranged from 36.0 to 65.1/100,000 inhabitants/year. We identified two EMS systems (RTR < 70%) that reached patients within 8 minutes of the call to the dispatch centre 62.0% and 65.6% of the time, respectively. The other five EMS systems (RTR > 70%) reached patients within 8 minutes of the call to the dispatch centre 70.4% up to 95.5% of the time. EMS systems arriving relatively later at the patients side (RTR < 70%) initiate CPR less frequently and admit fewer patients alive to hospital (calculated per 100,000 inhabitants/year) (CPR incidence (1/100,000 inhabitants/year) RTR > 70% = 57.2 vs RTR < 70% = 36.1, OR = 1.586 (99% CI = 1.383 to 1.819); P < 0.01) (admitted to hospital with ROSC (1/100,000 inhabitants/year) RTR > 70% = 24.4 vs RTR < 70% = 15.6, OR = 1.57 (99% CI = 1.274 to 1.935); P < 0.01). Using ROSC rate and the multivariate RACA score to predict outcomes, we found that the two groups did not differ, but ROSC rates were higher than predicted in both groups (ROSC RTR > 70% = 46.6% vs RTR < 70% = 47.3%, OR = 0.971 (95% CI = 0.787 to 1.196); P = n.s.) (ROSC RACA RTR > 70% = 42.4% vs RTR < 70% = 39.5%, OR = 1.127 (95% CI = 0.911 to 1.395); P = n.s.)ConclusionThis study demonstrates that, on the level of EMS systems, faster ones more often initiate CPR and increase the number of patients admitted to hospital alive. Furthermore, we show that, with very different approaches, a...

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Section: Discussionmentioning

confidence: 77%

The impact of response time reliability on CPR incidence and resuscitation success: a benchmark study from the German Resuscitation Registry

et al. 2011

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“…heart failure, diabetes, hypertension, chronic pulmonary disease, cancer, gastrointestinal disease, obesity). [7][8][9][10][11][12][13] Some of these factors may be inter-related.…”

Section: Discussionmentioning

confidence: 99%

A Six-Year Prospective Study of Out-of-Hospital Cardiac Arrest Managed by a Voluntary Ambulance Organisation

Chung¹,

Wong²

2005

Hong Kong Journal of Emergency Medicine

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Objective:To obtain a database on the epidemiology of prehospital cardiac arrest and its management by a voluntary ambulance service, with the view for developing future strategies and service improvement. Design: A 6-year prospective study from December 1998 to November 2004, using the Utstein-style template. Setting: A voluntary ambulance service in Hong Kong. Subjects and methods: Ambulance members had to complete and submit a specially designed data form after managing a cardiac arrest case, together with the ambulance run record and the automated external defibrillator (AED) computer printout, if appropriate. Main outcome measures: Survival to hospital discharge and return of spontaneous circulation after resuscitation. Results: A total of 72 cardiac arrests occurred during the period, with patients' age ranging from 29 to 106 years (mean 73.4). Most cardiac arrests occurred at home (46 or 63.9%). There were 58 witnessed cardiac arrests (80.5%), but bystander cardiopulmonary resuscitation (CPR) was started in only nine cases (15.5%) before the arrival of the ambulance crew. Six patients had evidence of rigor mortis or dependent lividity on ambulance arrival. For the 61 patients with electrocardiogram strips, the initial presenting rhythm on the AED was asystole in 45 (73.8%), pulseless electrical activity in 5 (8.2%), and ventricular fibrillation (VF) in 11 (18.0%). The median call-to-arrival time for VF cases (4.0 minutes) was significantly shorter than that of non-VF rhythms (8.5 minutes) [Mann-Whitney U test p=0.008]. Five patients had return of spontaneous circulation after resuscitation, but only one survived to hospital discharge. Conclusions: Bystander CPR and ambulance response time are two areas requiring urgent improvement in our locality. As the majority of cardiac arrests occurred at home, the cost-effectiveness of public access defibrillation for Hong Kong is unclear. However, strategic placement of AED at 'high incidence' locations should be seriously considered.

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“…The validity of rapid initiation of cardiopulmonary resuscitation (CPR) in rescue of patients with out-of-hospital cardiopulmonary arrest (OHCA) has been widely reported. [1][2][3][4][5] Early basic life support (BLS) can be more effective than early advanced cardiac life support by physicians because the time intervals from emergency call to emergency medical services (EMS) arrival and from emergency call to arrival in hospital are becoming longer year by year in Japan. 6 Bystander-initiated CPR has been reported to increase the possibility of neurologically favorable survival in many communities.…”

Section: Introductionmentioning

confidence: 99%

Do dispatcher instructions facilitate bystander-initiated cardiopulmonary resuscitation and improve outcomes in patients with out-of-hospital cardiac arrest? A comparison of family and non-family bystanders

et al. 2014

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Estimating the effect of bystander-initiated cardiopulmonary resuscitation in Japan

Cited by 26 publications

References 41 publications

The impact of response time reliability on CPR incidence and resuscitation success: a benchmark study from the German Resuscitation Registry

The impact of response time reliability on CPR incidence and resuscitation success: a benchmark study from the German Resuscitation Registry

A Six-Year Prospective Study of Out-of-Hospital Cardiac Arrest Managed by a Voluntary Ambulance Organisation

Do dispatcher instructions facilitate bystander-initiated cardiopulmonary resuscitation and improve outcomes in patients with out-of-hospital cardiac arrest? A comparison of family and non-family bystanders

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