Epidemiology and survival outcomes of out-of-hospital cardiac arrest following volatile substance use in Queensland, Australia

被引:1
|
作者
Schultz, Brendan V. [1 ,9 ]
Rolley, Adam [1 ,2 ,3 ]
Doan, Tan N. [1 ,4 ]
Bodnar, Daniel [1 ,5 ,6 ]
Isoardi, Katherine [7 ,8 ]
机构
[1] Queensland Ambulance Serv, Dept Hlth, Brisbane, Qld, Australia
[2] Royal Brisbane & Womens Hosp, Metro North Hosp & Hlth Serv, Jamieson Trauma Inst, Brisbane, Qld, Australia
[3] Queensland Univ Technol, Sch Clin Sci, Brisbane, Qld, Australia
[4] Univ Melbourne, Dept Med, Royal Melbourne Hosp, Melbourne, Vic, Australia
[5] Royal Brisbane & Womens Hosp, Emergency & Trauma Ctr, Brisbane, Qld, Australia
[6] Queensland Childrens Hosp, Emergency Dept, Brisbane, Qld, Australia
[7] Princess Alexandra Hosp, Clin Toxicol Unit, Brisbane, Qld, Australia
[8] Univ Queensland, Fac Med, Brisbane, Qld, Australia
[9] Queensland Ambulance Serv, 125 Kedron Pk Rd, Kedron, Qld 4031, Australia
关键词
Out-of-hospital cardiac arrest (OHCA); volatile substance use; toxicology; cardiopulmonary resuscitation; MISUSE; RESUSCITATION; ABUSE; DEATH; TIME;
D O I
10.1080/15563650.2023.2267172
中图分类号
R99 [毒物学(毒理学)];
学科分类号
100405 ;
摘要
Introduction The deliberate inhalation of volatile substances for their psychotropic properties is a recognised public health issue that can precipitate sudden death. This study aimed to describe the epidemiological characteristics and survival outcomes of patients with out-of-hospital cardiac arrests following volatile substance use.Methods We conducted a retrospective cohort analysis of all out-of-hospital cardiac arrest attended by the Queensland Ambulance Service over a ten-year period (2012-2021). Incidents were extracted from the Queensland Ambulance Service cardiac arrest registry, which collects clinical information using the Utstein-style guidelines and linked hospital data.Results During the study period, 52,102 out-of-hospital cardiac arrests were attended, with 22 (0.04%) occurring following volatile substance use. The incidence rate was 0.04 per 100,000 population, with no temporal trends identified. The most commonly used product was deodorant cans (19/22), followed by butane canisters (2/22), and nitrous oxide canisters (1/22). The median age of patients was 15 years (interquartile range 13-23), with 14/22 male and 8/22 Indigenous Australians. Overall, 16/22 patients received a resuscitation attempt by paramedics. Of these, 12/16 were bystander witnessed, 10/16 presented in an initial shockable rhythm, and 9/16 received bystander chest compressions. The rates of event survival, survival to hospital discharge, and survival with good neurological outcome (Cerebral Performance Category 1-2) were 69% (11/16, 95% CI 41-89%), 38% (6/16, 95% CI 15-65%) and 31% (5/16, 11-59%), respectively. Eight patients in the paramedic-treated cohort that used hydrocarbon-based products were administered epinephrine during resuscitation. Of these, none subsequently survived to hospital discharge. In contrast, all six patients that did not receive epinephrine survived to hospital discharge, with 5/6 having a good neurological outcome.Conclusion Out-of-hospital cardiac arrest following volatile substance use is rare and associated with relatively favourable survival rates. Patients were predominately aged in their adolescence with Indigenous Australians disproportionately represented.
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页码:649 / 655
页数:7
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