Increased survival after EMS witnessed cardiac arrest. Observations from the Resuscitation Outcomes Consortium (ROC) Epistry-Cardiac arrest

被引：61

作者：

Hostler, David ^{[1
]}

Thomas, Elizabeth G. ^{[2
]}

Emerson, Scott S. ^{[2
]}

Christenson, James ^{[3
]}

Stiell, Ian G. ^{[4
]}

Rittenberger, Jon C. ^{[1
]}

Gorman, Kyle R.

Bigham, Blair L. ^{[5
]}

Callaway, Clifton W. ^{[1
]}

Vilke, Gary M. ^{[6
]}

Beaudoin, Tammy ^{[4
]}

Cheskes, Sheldon ^{[7
]}

Craig, Alan ^{[8
]}

Davis, Daniel P. ^{[6
]}

Reed, Andrew ^{[9
]}

Idris, Ahamed ^{[10
]}

Nichol, Graham ^{[2
,11
]}

机构：

[1] Univ Pittsburgh, Dept Emergency Med, Pittsburgh, PA 15261 USA

[2] Univ Washington, Clin Trial Ctr, Seattle, WA 98195 USA

[3] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada

[4] Univ Ottawa, Dept Emergency Med, Ottawa, ON, Canada

[5] Univ Toronto, Toronto, ON, Canada

[6] Univ Calif San Diego, San Diego, CA 92103 USA

[7] Sunnybrook Osler Ctr Prehosp Care, Etobicoke, ON, Canada

[8] Toronto Emergency Med Serv, Toronto, ON, Canada

[9] Queens Univ, Dept Emergency Med, Kingston, ON K7L 2V7, Canada

[10] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA

[11] Univ Washington, Harborview Ctr Prehosp Emergency Care, Seattle, WA 98195 USA

来源：

RESUSCITATION | 2010年 / 81卷 / 07期

基金：

加拿大健康研究院;

关键词：

Prehospital; CPR; Bystander; Return of spontaneous circulation; ROSC; CARDIOPULMONARY-RESUSCITATION; BYSTANDER CPR; INTERVENTIONS; COLLAPSE; SYSTEM; IMPACT; OPALS;

D O I：

10.1016/j.resuscitation.2010.02.005

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Out of hospital cardiac arrest (OHCA) is common and lethal. It has been suggested that OHCA witnessed by EMS providers is a predictor of survival because advanced help is immediately available. We examined EMS witnessed OHCA from the Resuscitation Outcomes Consortium (ROC) to determine the effect of EMS witnessed vs. bystander witnessed and unwitnessed OHCA. Methods: Data were analyzed from a prospective, population-based cohort study in 10 U.S. and Canadian ROC sites. Individuals with non-traumatic OHCA treated 04/01/06-03/31/07 by EMS providers with defibrillation or chest compressions were included. Cases were grouped into EMS-witnessed, bystander witnessed, and unwitnessed and further stratified for bystander CPR. Multiple logistic regressions evaluated the odds ratio (OR) for survival to discharge relative to the EMS-witnessed group after adjusting for age, sex, public/private location of collapse, ROC site, and initial ECG rhythm. Of 9991 OHCA, 1022 (10.2%) of EMS-witnessed, 3369 (33.7%) bystander witnessed, and 5600 (56.1%) unwitnessed. Results: The most common initial rhythm in the EMS-witnessed group was PEA which was higher than in the bystander- and unwitnessed groups (p < 0.001). The adjusted OR (95% CI) of survival compared to the EMS-witnessed group was 0.41, (0.36, 0.46) in bystander witnessed with bystander CPR, 0.37 (0.33, 0.43) in bystander witnessed without bystander CPR, 0.17 (0.14, 0.20) in unwitnessed with bystander CPR and 0.21 (0.18, 0.24) in unwitnessed cases without bystander CPR. Conclusions: Immediate application of prehospital care for OHCA may improve survival. Efforts should be made to educate patients to access 9-1-1 for prodromal symptoms. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

引用

页码：826 / 830

页数：5

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