Outcome of Early Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest Managed in Universiti Kebangsaan Malaysia Medical Centre

Abstract

ABSTRAK Mangsa serangan jantung di luar hospital (OHCA) memerlukan bantuan bantu mula jantung (CPR) dan defibrilasi dengan segera sebelum ketibaan di Jabatan ABSTRACTOut-of-hospital cardiac arrest (OHCA) patients require immediate cardiopulmonary resuscitation (CPR). Early initiation of CPR and defibrillation before arrival at Emergency Department (ED) increases the chance of survival from sudden cardiac arrest. The main objective of this study was to identify the factors that influenced the outcome of early cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) patients managed at the ED of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The second objective was to determine the incidence of CPR initiated by the public prior to ambulance arrival. The present study was a one-year cross-sectional study. The OHCA patients were identified from the ED resuscitation logbook. Patients' medical records were used to obtain details of the resuscitation. Factors recorded included: aetiology of arrest, initiation of on-scene CPR, use of automated external defibrillators (AEDs), mode of transportation and the incidence of return of spontaneous circulation (ROSC) in the ED. Categorical data was analysed using chi-square and Fisher exact tests. Nine patients out of 98 had early CPR. Three patients achieved ROSC. Gender was significantly associated with ROSC (p-value=0.015). More patients who received early CPR achieved ROSC compared to those who received late CPR. The provision of early CPR and usage of AEDs by the public is still low. Female gender had a positive influence on ROSC. Efforts are required to increase the awareness and involvement of the public in initiating early CPR prior to the arrival of ambulance service.

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“…The time taken for CPR to be administered also affects the survivability rates of patients. Early CPR administration was shown to be 33% effective in increasing survival rates as opposed to late CPR administration (20%) [ 11 ]. Based on all the data, it is imperative to maintain public confidence in performing quality BCPR.…”

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“…The causes of cardiac arrests can be cardiac or noncardiac, for instance, trauma, primary respiratory arrest, overdose and others. The cardiac etiology predominates and has been reported in 70-85% of cases (Ismail et al, 2016). Out of hospital cardiac arrest is a major cause of death worldwide (Holmberg et al, 1999), including Malaysia.…”

“…Asia has the lowest survival rates (Berdowski et al, 2010). Thus, all out of hospital cardiac arrest patients require immediate emergency medical intervention and high-quality cardiopulmonary resuscitation as chances of survival rate reduces with each minute delay in initiating cardiopulmonary resuscitation Ismail et al (2016). Early cardiopulmonary resuscitation have a higher rate of return of spontaneous circulation compared to late cardiopulmonary resuscitation, 33% and 20% respectively (Ismail et al, 2016).…”

“…Thus, all out of hospital cardiac arrest patients require immediate emergency medical intervention and high-quality cardiopulmonary resuscitation as chances of survival rate reduces with each minute delay in initiating cardiopulmonary resuscitation Ismail et al (2016). Early cardiopulmonary resuscitation have a higher rate of return of spontaneous circulation compared to late cardiopulmonary resuscitation, 33% and 20% respectively (Ismail et al, 2016). In addition, Hasselqvist-Ax, Ingela, et al found that there was a signi icant association between the time of cardiopulmonary resuscitation initiation and the 30 days survival rate.…”