Probability of a Shockable Presenting Rhythm as a Function of EMS Response Time

Renkiewicz, Ginny K; Hubble, Michael W.; Wesley, Daniel R; Dorian, Patricia A; Losh, Matthew J; Swain, Robert; Taylor, Stephen

doi:10.3109/10903127.2013.851308

Cited by 40 publications

(23 citation statements)

References 19 publications

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“…Only if an EMS dispatcher is notified in time and suspects OHCA, the caller will be instructed to give bystander resuscitation and ambulances are sent 41 . When OHCA cases with SIR are left untreated, SIR quickly dissolves into asystole, marking significantly reduced survival chances 42 , 43 . The swiftness of the pre-hospital resuscitation response therefore influences the likelihood of presence of SIR upon connection of a defibrillator.…”

Section: Discussionmentioning

confidence: 99%

Women have lower chances than men to be resuscitated and survive out-of-hospital cardiac arrest

Blom

Oving

Berdowski

et al. 2019

European Heart Journal

123

115

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Aims Previous studies on sex differences in out-of-hospital cardiac arrest (OHCA) had limited scope and yielded conflicting results. We aimed to provide a comprehensive overall view on sex differences in care utilization, and outcome of OHCA. Methods and results We performed a population-based cohort-study, analysing all emergency medical service (EMS) treated resuscitation attempts in one province of the Netherlands (2006–2012). We calculated odds ratios (ORs) for the association of sex and chance of a resuscitation attempt by EMS, shockable initial rhythm (SIR), and in-hospital treatment using logistic regression analysis. Additionally, we provided an overview of sex differences in overall survival and survival at successive stages of care, in the entire study population and in patients with SIR. We identified 5717 EMS-treated OHCAs (28.0% female). Women with OHCA were less likely than men to receive a resuscitation attempt by a bystander (67.9% vs. 72.7%; P < 0.001), even when OHCA was witnessed (69.2% vs. 73.9%; P < 0.001). Women who were resuscitated had lower odds than men for overall survival to hospital discharge [OR 0.57; 95% confidence interval (CI) 0.48–0.67; 12.5% vs. 20.1%; P < 0.001], survival from OHCA to hospital admission (OR 0.88; 95% CI 0.78–0.99; 33.6% vs. 36.6%; P = 0.033), and survival from hospital admission to discharge (OR 0.49, 95% CI 0.40–0.60; 33.1% vs. 51.7%). This was explained by a lower rate of SIR in women (33.7% vs. 52.7%; P < 0.001). After adjustment for resuscitation parameters, female sex remained independently associated with lower SIR rate. Conclusion In case of OHCA, women are less often resuscitated by bystanders than men. When resuscitation is attempted, women have lower survival rates at each successive stage of care. These sex gaps are likely explained by lower rate of SIR in women, which can only partly be explained by resuscitation characteristics.

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Section: Discussionmentioning

confidence: 99%

Women have lower chances than men to be resuscitated and survive out-of-hospital cardiac arrest

Blom

Oving

Berdowski

et al. 2019

European Heart Journal

123

115

View full text Add to dashboard Cite

show abstract

“…[19] For a victim to have a good chance, a bystander must start CPR early and effectively since emergency medical service providers generally can't get to a scene within 6 to 8 minutes. [20,21] Thousands of lives could be saved every year by implementing bystander CPR because effective bystander CPR provided immediately after sudden cardiac arrest could double or triple a victim's chance of survival. [22] Vol 6, No 3, 2015 However, the quality of chest compressions is influenced by age, gender, body weight and time passed since the most recent BLS training of the bystanders.…”

Section: Discussionmentioning

confidence: 99%

Performance of cardiopulmonary resuscitation during prolonged basic life support in military medical university students: A manikin study

Wang

Zhuo

Zhang

et al. 2015

World Journal of Emergency Medicine

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“…This delay to patient contact could explain the smaller proportion of patients with an initial shockable rhythm found on the higher floors. After a patient collapses in cardiac arrest, deterioration from a shockable to a nonshockable rhythm occurs rapidly, 21 and the presence of an initial shockable rhythm is one of the most important determinants of survival. 22 With a rapidly deteriorating heart rhythm, and in the absence of defibrillation, cardiac arrests occurring on higher floors had a lower probability of survival because of the delay to patient contact by 911-initiated first responders.…”

Section: Discussionmentioning

confidence: 99%

Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival

Drennan

Strum

Byers

et al. 2016

CMAJ

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Probability of a Shockable Presenting Rhythm as a Function of EMS Response Time

Abstract: We found that for every one minute of added ambulance response time, the odds of shockable presenting rhythm declined by 8%. This information could prove useful for EMS managers tasked with developing EMS system response strategies for cardiac arrest management.

Cited by 40 publications

References 19 publications

Women have lower chances than men to be resuscitated and survive out-of-hospital cardiac arrest

Women have lower chances than men to be resuscitated and survive out-of-hospital cardiac arrest

Performance of cardiopulmonary resuscitation during prolonged basic life support in military medical university students: A manikin study

Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival

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