Out of hospital cardiac arrest resuscitation outcome in North India — CARO study

Abstract

BACKGROUND:To evaluate the outcome of cardiopulmonary resuscitation (CPR) in out-ofhospital cardiac arrests (OHCA) in India and factors infl uencing the outcome. METHODS:The outcome and related factors like demographics, aspects of the OHCA event, return of spontaneous circulation (ROSC) and survival to discharge, among the 80 adult patients presenting to emergency department experiencing OHCA considered for resuscitation between January 2014 to April 2015, were analyzed, according to the guidelines of the Utstein consensus conference. RESULTS:The survival rate to hospital admission was 32.5%, the survival rate to hospital discharge was 8.8% and with good cerebral performance category (CPC1) neurological status was 3.8%. Majority of OHCA was seen in elderly individuals between 51 to 60 years, predominately in males. Majority of OHCA were witnessed arrests (56.5%) with 1.3% bystander CPR rate, 92.5% arrests occurred at home, 96% presented with initial non-shockable rhythm and 92.5% with presumed cardiac etiology but survival was better in those who experienced OHCA at public place, in witnessed arrests, in patients who had shockable presenting rhythm and in those where CPR duration was ≤20 minutes. CONCLUSION:Witnessed arrests, early initiation of CPR by bystanders, CPR duration ≤20 minutes, initial presenting shockable rhythm, OHCA with non-cardiac etiology are associated with a good outcome. To improve the outcome of CPR and the low survival rates after an OHCA event in India, focused strategies should be designed to set up an emergency medical system (EMS), to boost the rates of bystander CPR and education of the lay public in basic CPR.

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

“…The present analysis also shows that in women and in patients younger than 40, resuscitation was successful and ROSC was achieved significantly more often. The present findings are also consistent with those reported by Kupari et al (2017), Krishna et al (2017), Requena-Morales et al (2017), and Fan et al (2017) in studies on OHCA [ 1 , 11 – 13 ].…”

“…A comparison of cases with shockable and non-shockable rhythms demonstrated that ROSC was achieved more often in cases where the initial rhythm was shockable. The studies by Cebula et al (2016), Krishna et al (2017), Hawkes et al (2017), Schewe et al (2017), Hess et al (2007), Requena-Morales et al (2017), and Fan et al (2017) corroborate the present findings, confirming the overall upward trend in the number of non-shockable rhythm cases in OHCA, as well as the higher effectiveness of resuscitation and higher percentage of ROSC [ 11 – 13 , 15 , 19 – 21 ].…”

Education, Implementation, and Teams

“…The 24 identified studies 140À163 originated from diverse geographical areas, and there were large differences in the number of studies per region. No studies from low-income countries were eligible; 4 studies were from lowerÀmiddle income countries 144,145,158,159 all others were from upperÀmiddle income economies.…”

Theoretical knowledge and psychomotor skill acquisition of basic life support training programme among secondary school students

“…Unlike advanced countries, the incidence rates and survival from OHCA in Africa remain undefi ned despite carrying over 80% of the cardiac disease's burden. [18] Waiting for health personnel who is trained in BLS in victims of SCA would mean brain damage and death. [19] Therefore, this placed an emphasis on the need to train non-medical persons on the administration of BLS most especially in the schools where all kinds of activities take place.…”