Impact of Bystander Cardiopulmonary Resuscitation and Dispatcher Assistance on Survival After Out-of-Hospital Cardiac Arrest Among Adult Patients by Location of Arrest

Abstract

We investigated the impact of bystander-initiated cardiopulmonary resuscitation (CPR), dispatcher assistance (DA), and location of arrest on survival and outcomes after out-of-hospital cardiac arrest (OHCA). From a nationwide population-based registry of OHCA patients in Japan, we enrolled adult patients with bystander-witnessed OHCA of medical origin between 2013 and 2015. The primary outcome measure was a neurologically favorable outcome, defined by cerebral performance category 1 or 2. Multivariable logistic regression analysis was used to assess the effects of bystander CPR and DA by location of arrest. A total of 104,621 cases were included (15,984 bystander CPR without DA [15.3%], 40,087 bystander CPR with DA [38.3%], and 48,550 no bystander CPR [46.4%]). In public locations, both the bystander-CPR-with-DA group (22.9% [1,068/4,665]; adjusted odds ratio (AOR), 1.62; 95% confidence interval (CI), 1.43-1.85) and the bystander-CPR-without-DA group (25.8% [918/3,557]; AOR, 1.43; 95% CI, 1.24-1.65) had neurologically favorable outcomes compared with the no-bystander-CPR group (9.9% [610/6,133]). In residential locations, the AORs were 1.44 (95% CI, 1.22-1.70) in the bystander-CPR-without-DA group and 1.60 (95% CI, 1.45-1.77) in the bystander-CPR-with-DA group. However, in nursing homes, bystander CPR was not associated with improved outcomes of OHCA, regardless of the implementation of DA. Bystander CPR with or without DA had better outcomes after OHCA in residential and public locations but not in nursing homes.

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study

“…The study showed that the greatest influence on the return of spontaneous circulation concerning ineffective resuscitation was observed when ventricular fibrillation or pulseless ventricular tachycardia was observed as the first monitored cardiac arrest rhythm (odds ratio = 0.43; 95% CI 0.18-1.04). This is also confirmed by numerous studies [25,26].…”

Effectiveness of bystander cardiopulmonary resuscitation in improving the survival and neurological recovery of patients with out-of-hospital cardiac arrest: A nationwide patient cohort study

“…The other study showed that the AORs of BCPR without and with dispatcher assist were 1.44 (95% CI: 1.22-1.70) and 1.60 (95% CI: 1.45-1.77) on neurologic recovery, respectively, compared with no BCPR in private places. Additionally, they were comparable to 1.43 (95% CI: 1.24-1.65) and 1.62 (95% CI: 1.43-1.85) in public places [33]. There would be no conflict with the present study even if the BCPR effect was higher in public places in other studies because the outcome estimates in our study were obtained from models considering the interaction between confounding variables, unlike those in other studies.…”

“…These findings seem to be contrary to the previous studies reporting poor outcomes of OHCA at private places. However, few studies have directly demonstrated a variation in the effect of BCPR on the outcomes of OHCA based on place, while at-home OHCA is well known to have a poorer prognosis than OHCA at public place [32,33]. A study revealed that BCPR provision and neurologic recovery increased by 2.45-and 1.51-fold in the daytime if friends witnessed OHCA compared with those if family members witnessed OHCA (95% CI: 2.31-2.58, 95% CI: 1.36-1.68) [32].…”

Parada Cardiorrespiratória: caracterização do atendimento no serviço de atendimento móvel de urgência

“…(1) As chaves para o tratamento da PCR são o reconhecimento precoce, o acionamento do serviço médico de emergência, o início das compressões torácicas e a desfibrilação precoce. (2,3,4) Os quatro passos descritos anteriormente são considerados procedimentos de baixa complexidade, entretanto, a população brasileira não recebe treinamentos periódicos para reconhecer e conduzir as compressões torácicas até a chegada da equipe de emergência. As consequências geram baixas taxas de sobrevida que perpassam entre 1% parada cardíaca Brandão, P.C.…”

“…(2) Instruções adequadas pelo despachante, ao telefone, e parada cardíaca assistida demonstram resultados promissores em locais públicos. (4) A continuidade da assistência se dá, estrategicamente, com a chegada da equipe do SAMU, que inicia o atendimento com a realização de Suporte Básico e Avançado de Vida. O objetivo é aumentar a sobrevida do paciente, com a realização de intervenções precoces como a manutenção de compressões torácicas efetivas, uso de via aérea avançada, medicações específicas para cada caso, e, com o sucesso da reanimação, encaminhamento para uma unidade hospitalar que possa dar continuidade ao tratamento.…”