Sep 2, 2011

Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest

The New England Journal of Medicine
Ian G StiellROC Investigators

Abstract

In a departure from the previous strategy of immediate defibrillation, the 2005 resuscitation guidelines from the American Heart Association-International Liaison Committee on Resuscitation suggested that emergency medical service (EMS) personnel could provide 2 minutes of cardiopulmonary resuscitation (CPR) before the first analysis of cardiac rhythm. We compared the strategy of a brief period of CPR with early analysis of rhythm with the strategy of a longer period of CPR with delayed analysis of rhythm. We conducted a cluster-randomized trial involving adults with out-of-hospital cardiac arrest at 10 Resuscitation Outcomes Consortium sites in the United States and Canada. Patients in the early-analysis group were assigned to receive 30 to 60 seconds of EMS-administered CPR and those in the later-analysis group were assigned to receive 180 seconds of CPR, before the initial electrocardiographic analysis. The primary outcome was survival to hospital discharge with satisfactory functional status (a modified Rankin scale score of ≤3, on a scale of 0 to 6, with higher scores indicating greater disability). We included 9933 patients, of whom 5290 were assigned to early analysis of cardiac rhythm and 4643 to later analysis. A total...Continue Reading

Mentioned in this Paper

Lung
Emergency Care
Basic Cardiac Life Support
Cardiac Rhythm Type
Lung Diseases
Cardiopulmonary
Subgroup A Nepoviruses
Confounding Factors (Epidemiology)
Entire Lung
Heart Diseases

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