May 6, 2009

Improved patient survival using a modified resuscitation protocol for out-of-hospital cardiac arrest

Circulation
Alex G GarzaRex Archer

Abstract

Cardiac arrest continues to have poor survival in the United States. Recent studies have questioned current practice in resuscitation. Our emergency medical services system made significant changes to the adult cardiac arrest resuscitation protocol, including minimizing chest compression interruptions, increasing the ratio of compressions to ventilation, deemphasizing or delaying intubation, and advocating chest compressions before initial countershock. This retrospective observational cohort study reviewed all adult primary ventricular fibrillation and pulseless ventricular tachycardia cardiac arrests 36 months before and 12 months after the protocol change. Primary outcome was survival to discharge; secondary outcomes were return of spontaneous circulation and cerebral performance category. Survival of out-of-hospital arrest of presumed primary cardiac origin improved from 7.5% (82 of 1097) in the historical cohort to 13.9% (47 of 339) in the revised protocol cohort (odds ratio, 1.80; 95% confidence interval, 1.19 to 2.70). Similar increases in return of spontaneous circulation were achieved for the subset of witnessed cardiac arrest patients with initial rhythm of ventricular fibrillation from 37.8% (54 of 143) to 59.6% (34 ...Continue Reading

  • References34
  • Citations59

Mentioned in this Paper

Ventricular Fibrillation
Treatment Protocols
Emergency Care
Brain
Survival Analysis
Basic Cardiac Life Support
American Heart Association
Anterior Thoracic Region
Intubation, Intratracheal
Chest

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