Dec 17, 2008

Progressing from initial non-shockable rhythms to a shockable rhythm is associated with improved outcome after out-of-hospital cardiac arrest

Resuscitation
Theresa M OlasveengenKjetil Sunde

Abstract

Cardiac arrest patients with initial non-shockable rhythm progressing to shockable rhythm have been reported to have inferior outcome to those remaining non-shockable. We wanted to confirm this observation in our prospectively collected database, and assess whether differences in cardiopulmonary resuscitation (CPR) quality could help to explain any such difference in outcome. All out-of-hospital cardiac arrest (OHCA) cases in the Oslo EMS between May 2003 and April 2008 were retrospectively studied, and cases with initial asystole or pulseless electrical activity (PEA) were selected. Pre-hospital and hospital records, Utstein forms, and continuous ECGs were reviewed. Quality of CPR and outcome were compared for patients who progressed to a shockable rhythm and patients who remained in non-shockable rhythms. Of 753 cases with initial non-shockable rhythms 517 (69%) had asystole and 236 (31%) PEA. Ninety-eight (13%) patients progressed to a shockable rhythm, while 653 (87%) remained non-shockable during the entire resuscitation effort (two unknown). Hands-off ratio was higher in the shockable than the non-shockable group, 0.21+/-0.12 vs. 0.16+/-0.10 (p=0.000) with no significant difference in compression and ventilation rates. Ov...Continue Reading

  • References24
  • Citations21

References

  • References24
  • Citations21

Citations

Mentioned in this Paper

Ventricular Fibrillation
Emergency Medicine (Field)
Emergency Care
Shock
Etiology
Anterior Thoracic Region
Chest
Cardiopulmonary
Ventilation, Function (Observable Entity)
Electroversion Therapy

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