Cardiac arrest in private locations: different strategies are needed to improve outcome
Background: A tremendous amount of public resources are focused on improving cardiac arrest (OHCA) survival in public places, yet most OHCAs occur in private residences. Methods and results: A prospective, observational study of patients transported to seven urban and suburban hospitals and the indi...
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| Veröffentlicht in: | Resuscitation 2003-08, Vol.58 (2), p.171-176 |
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| creator | Swor, Robert A. Jackson, R.E. Compton, S. Domeier, R. Zalenski, R. Honeycutt, L. Kuhn, G.J. Frederiksen, S. Pascual, R.G. |
| description | Background: A tremendous amount of public resources are focused on improving cardiac arrest (OHCA) survival in public places, yet most OHCAs occur in private residences.
Methods and results: A prospective, observational study of patients transported to seven urban and suburban hospitals and the individuals who called 911 at the time of a cardiac arrest (bystander) was performed. Bystanders (
N=543) were interviewed via telephone beginning 2 weeks after the incident to obtain data regarding patient and bystander demographics, including cardiopulmonary resuscitation (CPR) training. Of all arrests 80.2% were in homes. Pateints who arrested in public places were significantly younger (63.2 vs. 67.2,
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| doi_str_mv | 10.1016/S0300-9572(03)00118-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73538362</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0300957203001187</els_id><sourcerecordid>73538362</sourcerecordid><originalsourceid>FETCH-LOGICAL-c457t-664e44a5bd74a5c340695f654c3866adb88696ba3d1d6b259c869b440d69fe0f3</originalsourceid><addsrcrecordid>eNqFkE2LFDEQhoMo7jj6E5RcFD30Wul8dfYiMui6sOBBxWNIJ9US6e6sSWbAf292Z3CPe0kI9bypqoeQlwzOGTD1_htwgM5I3b8F_g6AsaHTj8iGDZp3TGp4TDb_kTPyrJTfAMCl0U_JGesNGK7NhvzcuRyi89TljKXSuNKbHA-uIp2TdzWmtVzQEKcJM66Vlppb7VfE0hJIV8SAgdZE43KT0wFp2lefFnxOnkxuLvjidG_Jj8-fvu--dNdfL692H687L6SunVIChXByDLqdngtQRk5KCs8HpVwYh0EZNToeWFBjL41v71EICMpMCBPfkjfHf1v3P_u2gV1i8TjPbsW0L1ZzyQeu-gbKI-hzKiXjZNuei8t_LQN7a9TeGbW3uixwe2e0xbfk1anBflww3KdOChvw-gS44t08Zbf6WO45Cb0WYmjchyOHTcchYrbFR1w9hpjRVxtSfGCUfw0lkq4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73538362</pqid></control><display><type>article</type><title>Cardiac arrest in private locations: different strategies are needed to improve outcome</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Swor, Robert A. ; Jackson, R.E. ; Compton, S. ; Domeier, R. ; Zalenski, R. ; Honeycutt, L. ; Kuhn, G.J. ; Frederiksen, S. ; Pascual, R.G.</creator><creatorcontrib>Swor, Robert A. ; Jackson, R.E. ; Compton, S. ; Domeier, R. ; Zalenski, R. ; Honeycutt, L. ; Kuhn, G.J. ; Frederiksen, S. ; Pascual, R.G.</creatorcontrib><description><![CDATA[Background: A tremendous amount of public resources are focused on improving cardiac arrest (OHCA) survival in public places, yet most OHCAs occur in private residences.
Methods and results: A prospective, observational study of patients transported to seven urban and suburban hospitals and the individuals who called 911 at the time of a cardiac arrest (bystander) was performed. Bystanders (
N=543) were interviewed via telephone beginning 2 weeks after the incident to obtain data regarding patient and bystander demographics, including cardiopulmonary resuscitation (CPR) training. Of all arrests 80.2% were in homes. Pateints who arrested in public places were significantly younger (63.2 vs. 67.2,
P<0.02), more often had an initial rhythm of VF (63.0 vs. 37.7%,
P<0.001), were seen or heard to have collapsed by a bystander (74.8 vs. 48.1%,
P<0.001), received bystander CPR (60.2 vs. 28.6%,
P<0.001), and survived to DC (17.5 vs. 5.5%,
P<0.001). Patients who arrested at home were older and had an older bystander (55.4 vs. 41.3,
P<0.001). The bystander was less likely to be CPR trained (65.0 vs. 47.4%,
P<0.001), less likely to be trained within the last 5 years (49.2 vs. 17.9,
P<0.001), and less likely to perform CPR if trained (64.2 vs. 30.0%,
P<0.001). Collapse to shock intervals for public versus home VF patients were not different.
Conclusions: Many important characteristics of cardiac arrest patients and the bystander differ in public versus private locations. Fundamentally different strategies are needed to improve survival from these events.
Contexto: Uma tremenda quantidade de recursos públicos estão orientados para a melhoria da sobrevida da paragem cardı́aca em locais públicos, no entanto a maioria das paragens ocorre em residências privadas.
Métodos e Resultados: Foi efectuado um estudo observacional, prospectivo, de doentes transportados para sete hospitais urbanos e suburbanos e dos indivı́duos que activaram o sistema de emergência e testemunharam a paragem cardı́aca. Estas testemunhas (
N=543) foram entrevistadas via telefone a partir de duas semanas após o incidente para obter dados demográficos sobre o doente e a testemunha, incluindo treino em reanimação cardio-respiratória. De todas as paragens, 80.2% ocorreram em casa. Os doentes que sofreram paragem em locais públicos eram significativamente mais novos (63.2 vs. 67.2,
P<0.02), tiveram mais vezes um ritmo inicial de fibrilhação ventricular (63.0 vs. 37.7%,
P<0.001), foram presenciados ou relatados por uma testemunha (74.8 vs. 48.1%,
P<0.001), foram reanimados por uma testemunha (60.2 vs. 28.6%,
P<0.001) e sobreviveram à desfibrilhação (17.5 vs. 5.5%,
P<0.001). Doentes que sofreram paragem em casa eram mais velhos e foram assistidos por alguém mais velho (55.4 vs. 41.3,
P<0.001). A testemunha tinha menor probabilidade de ter treino em reanimação cardio-pulmonar (65.0 vs. 47.4%,
P<0.001), menor probabilidade de ter recebido treino nos últimos 5 anos (49.2 vs. 17.9,
P<0.001) e menor probabilidade de iniciar reanimação mesmo que treinada (64.2 vs 30.0%,
P<0.001). Os intervalos do colapso até ao choque não foram diferentes para os doentes em fibrilhação em locais públicos versus em casa.
Conclusões: Muitas das caracterı́sticas importantes dos doentes com paragem cardı́aca e das testemunhas diferem nos locais públicos versus privados. São necessárias estratégias fundamentalmente diferentes para melhorar a sobrevida destes eventos.
Antecedentes: Una gran cantidad de recursos públicos ha sido enfocado a mejorar la sobrevida del paro cardı́aco(OHCA) en lugares públicos, pero la mayorı́a de los OHCAs ocurren en residencias privadas.
Métodos y resultados: Se realizó un estudio prospectivo de observación de los pacientes transportados a siete hospitales suburbanos y de los individuos que llamaron al 911 al momento de un paro cardı́aco (testigo lego). Los testigos (
n=543) fueron interrogados vı́a telefónica empezando dos semanas después del incidente para obtener datos demográficos acerca de los pacientes y testigos reanimadores, incluyendo entrenamiento en reanimación cardiopulmonar(RCP). De todos los paros cardı́acos, el 80.2% ocurrió en hogares. Los pacientes que sufrieron el paro en sitios públicos fueron significativamente mas jóvenes (63.2 vs.67.2,
P <0.02), tenı́an mas frecuentemente un ritmo inicial de fibrilación ventricular (VF) (63.0 vs. 37.7%,
P<0.001), fueron vistos o escuchados por un testigo al colapsarse( 74.8 vs. 48.1%,
P<0.001), recibieron RCP por testigos (60.2 vs. 28.6%,
P<0.001), y sobrevivieron al alta (17.5 vs.5.5%,
P<0.001). Los pacientes que presentaron el paro en su hogar eran mas viejos y sus testigos eran también mas viejos (55.4 vs. 41.3,
P<0.001). El testigo era menos probablemente entrenado en RCP (65.0 vs 47.4%,
P<0.001), con menor probabilidad de haber sido entrenado en los últimos 5 años (49.2 vs 17.9,
P<0.001), y si estaba entrenado con menos probabilidad de realizar RCP (64.2 vs. 30.0%,
P<0.001). Los intervalos entre el colapso y la entrega de la descarga no fueron diferentes entre las VF ocurridas en sitios públicos o privados.
Conclusiones: Muchas caracterı́sticas importantes de los pacientes de paro cardı́aco y de sus testigos son distintas según ocurran en localizaciones privadas o públicas. Son necesarias estrategias fundamentalmente diferentes para mejorar la sobrevida en estos eventos.]]></description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/S0300-9572(03)00118-7</identifier><identifier>PMID: 12909379</identifier><identifier>CODEN: RSUSBS</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiopulmonary resuscitation ; Cardiopulmonary Resuscitation - education ; Cardiopulmonary Resuscitation - statistics & numerical data ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Emergency Medical Service Communication Systems ; Heart arrest ; Heart Arrest - epidemiology ; Heart Arrest - mortality ; Humans ; Intensive care medicine ; Medical sciences ; Morte súbita ; Muerte súbita ; Observation ; Paragem cardı́aca ; Paro cardı́aco ; Prospective Studies ; Reanimación cardiopulmonar ; Ressuscitação cardiopulmonar ; Sudden death ; Survival Rate ; Time Factors</subject><ispartof>Resuscitation, 2003-08, Vol.58 (2), p.171-176</ispartof><rights>2003 Elsevier Ireland Ltd</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-664e44a5bd74a5c340695f654c3866adb88696ba3d1d6b259c869b440d69fe0f3</citedby><cites>FETCH-LOGICAL-c457t-664e44a5bd74a5c340695f654c3866adb88696ba3d1d6b259c869b440d69fe0f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0300957203001187$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15027448$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12909379$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Swor, Robert A.</creatorcontrib><creatorcontrib>Jackson, R.E.</creatorcontrib><creatorcontrib>Compton, S.</creatorcontrib><creatorcontrib>Domeier, R.</creatorcontrib><creatorcontrib>Zalenski, R.</creatorcontrib><creatorcontrib>Honeycutt, L.</creatorcontrib><creatorcontrib>Kuhn, G.J.</creatorcontrib><creatorcontrib>Frederiksen, S.</creatorcontrib><creatorcontrib>Pascual, R.G.</creatorcontrib><title>Cardiac arrest in private locations: different strategies are needed to improve outcome</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description><![CDATA[Background: A tremendous amount of public resources are focused on improving cardiac arrest (OHCA) survival in public places, yet most OHCAs occur in private residences.
Methods and results: A prospective, observational study of patients transported to seven urban and suburban hospitals and the individuals who called 911 at the time of a cardiac arrest (bystander) was performed. Bystanders (
N=543) were interviewed via telephone beginning 2 weeks after the incident to obtain data regarding patient and bystander demographics, including cardiopulmonary resuscitation (CPR) training. Of all arrests 80.2% were in homes. Pateints who arrested in public places were significantly younger (63.2 vs. 67.2,
P<0.02), more often had an initial rhythm of VF (63.0 vs. 37.7%,
P<0.001), were seen or heard to have collapsed by a bystander (74.8 vs. 48.1%,
P<0.001), received bystander CPR (60.2 vs. 28.6%,
P<0.001), and survived to DC (17.5 vs. 5.5%,
P<0.001). Patients who arrested at home were older and had an older bystander (55.4 vs. 41.3,
P<0.001). The bystander was less likely to be CPR trained (65.0 vs. 47.4%,
P<0.001), less likely to be trained within the last 5 years (49.2 vs. 17.9,
P<0.001), and less likely to perform CPR if trained (64.2 vs. 30.0%,
P<0.001). Collapse to shock intervals for public versus home VF patients were not different.
Conclusions: Many important characteristics of cardiac arrest patients and the bystander differ in public versus private locations. Fundamentally different strategies are needed to improve survival from these events.
Contexto: Uma tremenda quantidade de recursos públicos estão orientados para a melhoria da sobrevida da paragem cardı́aca em locais públicos, no entanto a maioria das paragens ocorre em residências privadas.
Métodos e Resultados: Foi efectuado um estudo observacional, prospectivo, de doentes transportados para sete hospitais urbanos e suburbanos e dos indivı́duos que activaram o sistema de emergência e testemunharam a paragem cardı́aca. Estas testemunhas (
N=543) foram entrevistadas via telefone a partir de duas semanas após o incidente para obter dados demográficos sobre o doente e a testemunha, incluindo treino em reanimação cardio-respiratória. De todas as paragens, 80.2% ocorreram em casa. Os doentes que sofreram paragem em locais públicos eram significativamente mais novos (63.2 vs. 67.2,
P<0.02), tiveram mais vezes um ritmo inicial de fibrilhação ventricular (63.0 vs. 37.7%,
P<0.001), foram presenciados ou relatados por uma testemunha (74.8 vs. 48.1%,
P<0.001), foram reanimados por uma testemunha (60.2 vs. 28.6%,
P<0.001) e sobreviveram à desfibrilhação (17.5 vs. 5.5%,
P<0.001). Doentes que sofreram paragem em casa eram mais velhos e foram assistidos por alguém mais velho (55.4 vs. 41.3,
P<0.001). A testemunha tinha menor probabilidade de ter treino em reanimação cardio-pulmonar (65.0 vs. 47.4%,
P<0.001), menor probabilidade de ter recebido treino nos últimos 5 anos (49.2 vs. 17.9,
P<0.001) e menor probabilidade de iniciar reanimação mesmo que treinada (64.2 vs 30.0%,
P<0.001). Os intervalos do colapso até ao choque não foram diferentes para os doentes em fibrilhação em locais públicos versus em casa.
Conclusões: Muitas das caracterı́sticas importantes dos doentes com paragem cardı́aca e das testemunhas diferem nos locais públicos versus privados. São necessárias estratégias fundamentalmente diferentes para melhorar a sobrevida destes eventos.
Antecedentes: Una gran cantidad de recursos públicos ha sido enfocado a mejorar la sobrevida del paro cardı́aco(OHCA) en lugares públicos, pero la mayorı́a de los OHCAs ocurren en residencias privadas.
Métodos y resultados: Se realizó un estudio prospectivo de observación de los pacientes transportados a siete hospitales suburbanos y de los individuos que llamaron al 911 al momento de un paro cardı́aco (testigo lego). Los testigos (
n=543) fueron interrogados vı́a telefónica empezando dos semanas después del incidente para obtener datos demográficos acerca de los pacientes y testigos reanimadores, incluyendo entrenamiento en reanimación cardiopulmonar(RCP). De todos los paros cardı́acos, el 80.2% ocurrió en hogares. Los pacientes que sufrieron el paro en sitios públicos fueron significativamente mas jóvenes (63.2 vs.67.2,
P <0.02), tenı́an mas frecuentemente un ritmo inicial de fibrilación ventricular (VF) (63.0 vs. 37.7%,
P<0.001), fueron vistos o escuchados por un testigo al colapsarse( 74.8 vs. 48.1%,
P<0.001), recibieron RCP por testigos (60.2 vs. 28.6%,
P<0.001), y sobrevivieron al alta (17.5 vs.5.5%,
P<0.001). Los pacientes que presentaron el paro en su hogar eran mas viejos y sus testigos eran también mas viejos (55.4 vs. 41.3,
P<0.001). El testigo era menos probablemente entrenado en RCP (65.0 vs 47.4%,
P<0.001), con menor probabilidad de haber sido entrenado en los últimos 5 años (49.2 vs 17.9,
P<0.001), y si estaba entrenado con menos probabilidad de realizar RCP (64.2 vs. 30.0%,
P<0.001). Los intervalos entre el colapso y la entrega de la descarga no fueron diferentes entre las VF ocurridas en sitios públicos o privados.
Conclusiones: Muchas caracterı́sticas importantes de los pacientes de paro cardı́aco y de sus testigos son distintas según ocurran en localizaciones privadas o públicas. Son necesarias estrategias fundamentalmente diferentes para mejorar la sobrevida en estos eventos.]]></description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiopulmonary Resuscitation - education</subject><subject>Cardiopulmonary Resuscitation - statistics & numerical data</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Emergency Medical Service Communication Systems</subject><subject>Heart arrest</subject><subject>Heart Arrest - epidemiology</subject><subject>Heart Arrest - mortality</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>Morte súbita</subject><subject>Muerte súbita</subject><subject>Observation</subject><subject>Paragem cardı́aca</subject><subject>Paro cardı́aco</subject><subject>Prospective Studies</subject><subject>Reanimación cardiopulmonar</subject><subject>Ressuscitação cardiopulmonar</subject><subject>Sudden death</subject><subject>Survival Rate</subject><subject>Time Factors</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE2LFDEQhoMo7jj6E5RcFD30Wul8dfYiMui6sOBBxWNIJ9US6e6sSWbAf292Z3CPe0kI9bypqoeQlwzOGTD1_htwgM5I3b8F_g6AsaHTj8iGDZp3TGp4TDb_kTPyrJTfAMCl0U_JGesNGK7NhvzcuRyi89TljKXSuNKbHA-uIp2TdzWmtVzQEKcJM66Vlppb7VfE0hJIV8SAgdZE43KT0wFp2lefFnxOnkxuLvjidG_Jj8-fvu--dNdfL692H687L6SunVIChXByDLqdngtQRk5KCs8HpVwYh0EZNToeWFBjL41v71EICMpMCBPfkjfHf1v3P_u2gV1i8TjPbsW0L1ZzyQeu-gbKI-hzKiXjZNuei8t_LQN7a9TeGbW3uixwe2e0xbfk1anBflww3KdOChvw-gS44t08Zbf6WO45Cb0WYmjchyOHTcchYrbFR1w9hpjRVxtSfGCUfw0lkq4</recordid><startdate>20030801</startdate><enddate>20030801</enddate><creator>Swor, Robert A.</creator><creator>Jackson, R.E.</creator><creator>Compton, S.</creator><creator>Domeier, R.</creator><creator>Zalenski, R.</creator><creator>Honeycutt, L.</creator><creator>Kuhn, G.J.</creator><creator>Frederiksen, S.</creator><creator>Pascual, R.G.</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030801</creationdate><title>Cardiac arrest in private locations: different strategies are needed to improve outcome</title><author>Swor, Robert A. ; Jackson, R.E. ; Compton, S. ; Domeier, R. ; Zalenski, R. ; Honeycutt, L. ; Kuhn, G.J. ; Frederiksen, S. ; Pascual, R.G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c457t-664e44a5bd74a5c340695f654c3866adb88696ba3d1d6b259c869b440d69fe0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiopulmonary resuscitation</topic><topic>Cardiopulmonary Resuscitation - education</topic><topic>Cardiopulmonary Resuscitation - statistics & numerical data</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Emergency Medical Service Communication Systems</topic><topic>Heart arrest</topic><topic>Heart Arrest - epidemiology</topic><topic>Heart Arrest - mortality</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>Morte súbita</topic><topic>Muerte súbita</topic><topic>Observation</topic><topic>Paragem cardı́aca</topic><topic>Paro cardı́aco</topic><topic>Prospective Studies</topic><topic>Reanimación cardiopulmonar</topic><topic>Ressuscitação cardiopulmonar</topic><topic>Sudden death</topic><topic>Survival Rate</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Swor, Robert A.</creatorcontrib><creatorcontrib>Jackson, R.E.</creatorcontrib><creatorcontrib>Compton, S.</creatorcontrib><creatorcontrib>Domeier, R.</creatorcontrib><creatorcontrib>Zalenski, R.</creatorcontrib><creatorcontrib>Honeycutt, L.</creatorcontrib><creatorcontrib>Kuhn, G.J.</creatorcontrib><creatorcontrib>Frederiksen, S.</creatorcontrib><creatorcontrib>Pascual, R.G.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Swor, Robert A.</au><au>Jackson, R.E.</au><au>Compton, S.</au><au>Domeier, R.</au><au>Zalenski, R.</au><au>Honeycutt, L.</au><au>Kuhn, G.J.</au><au>Frederiksen, S.</au><au>Pascual, R.G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiac arrest in private locations: different strategies are needed to improve outcome</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2003-08-01</date><risdate>2003</risdate><volume>58</volume><issue>2</issue><spage>171</spage><epage>176</epage><pages>171-176</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><coden>RSUSBS</coden><abstract><![CDATA[Background: A tremendous amount of public resources are focused on improving cardiac arrest (OHCA) survival in public places, yet most OHCAs occur in private residences.
Methods and results: A prospective, observational study of patients transported to seven urban and suburban hospitals and the individuals who called 911 at the time of a cardiac arrest (bystander) was performed. Bystanders (
N=543) were interviewed via telephone beginning 2 weeks after the incident to obtain data regarding patient and bystander demographics, including cardiopulmonary resuscitation (CPR) training. Of all arrests 80.2% were in homes. Pateints who arrested in public places were significantly younger (63.2 vs. 67.2,
P<0.02), more often had an initial rhythm of VF (63.0 vs. 37.7%,
P<0.001), were seen or heard to have collapsed by a bystander (74.8 vs. 48.1%,
P<0.001), received bystander CPR (60.2 vs. 28.6%,
P<0.001), and survived to DC (17.5 vs. 5.5%,
P<0.001). Patients who arrested at home were older and had an older bystander (55.4 vs. 41.3,
P<0.001). The bystander was less likely to be CPR trained (65.0 vs. 47.4%,
P<0.001), less likely to be trained within the last 5 years (49.2 vs. 17.9,
P<0.001), and less likely to perform CPR if trained (64.2 vs. 30.0%,
P<0.001). Collapse to shock intervals for public versus home VF patients were not different.
Conclusions: Many important characteristics of cardiac arrest patients and the bystander differ in public versus private locations. Fundamentally different strategies are needed to improve survival from these events.
Contexto: Uma tremenda quantidade de recursos públicos estão orientados para a melhoria da sobrevida da paragem cardı́aca em locais públicos, no entanto a maioria das paragens ocorre em residências privadas.
Métodos e Resultados: Foi efectuado um estudo observacional, prospectivo, de doentes transportados para sete hospitais urbanos e suburbanos e dos indivı́duos que activaram o sistema de emergência e testemunharam a paragem cardı́aca. Estas testemunhas (
N=543) foram entrevistadas via telefone a partir de duas semanas após o incidente para obter dados demográficos sobre o doente e a testemunha, incluindo treino em reanimação cardio-respiratória. De todas as paragens, 80.2% ocorreram em casa. Os doentes que sofreram paragem em locais públicos eram significativamente mais novos (63.2 vs. 67.2,
P<0.02), tiveram mais vezes um ritmo inicial de fibrilhação ventricular (63.0 vs. 37.7%,
P<0.001), foram presenciados ou relatados por uma testemunha (74.8 vs. 48.1%,
P<0.001), foram reanimados por uma testemunha (60.2 vs. 28.6%,
P<0.001) e sobreviveram à desfibrilhação (17.5 vs. 5.5%,
P<0.001). Doentes que sofreram paragem em casa eram mais velhos e foram assistidos por alguém mais velho (55.4 vs. 41.3,
P<0.001). A testemunha tinha menor probabilidade de ter treino em reanimação cardio-pulmonar (65.0 vs. 47.4%,
P<0.001), menor probabilidade de ter recebido treino nos últimos 5 anos (49.2 vs. 17.9,
P<0.001) e menor probabilidade de iniciar reanimação mesmo que treinada (64.2 vs 30.0%,
P<0.001). Os intervalos do colapso até ao choque não foram diferentes para os doentes em fibrilhação em locais públicos versus em casa.
Conclusões: Muitas das caracterı́sticas importantes dos doentes com paragem cardı́aca e das testemunhas diferem nos locais públicos versus privados. São necessárias estratégias fundamentalmente diferentes para melhorar a sobrevida destes eventos.
Antecedentes: Una gran cantidad de recursos públicos ha sido enfocado a mejorar la sobrevida del paro cardı́aco(OHCA) en lugares públicos, pero la mayorı́a de los OHCAs ocurren en residencias privadas.
Métodos y resultados: Se realizó un estudio prospectivo de observación de los pacientes transportados a siete hospitales suburbanos y de los individuos que llamaron al 911 al momento de un paro cardı́aco (testigo lego). Los testigos (
n=543) fueron interrogados vı́a telefónica empezando dos semanas después del incidente para obtener datos demográficos acerca de los pacientes y testigos reanimadores, incluyendo entrenamiento en reanimación cardiopulmonar(RCP). De todos los paros cardı́acos, el 80.2% ocurrió en hogares. Los pacientes que sufrieron el paro en sitios públicos fueron significativamente mas jóvenes (63.2 vs.67.2,
P <0.02), tenı́an mas frecuentemente un ritmo inicial de fibrilación ventricular (VF) (63.0 vs. 37.7%,
P<0.001), fueron vistos o escuchados por un testigo al colapsarse( 74.8 vs. 48.1%,
P<0.001), recibieron RCP por testigos (60.2 vs. 28.6%,
P<0.001), y sobrevivieron al alta (17.5 vs.5.5%,
P<0.001). Los pacientes que presentaron el paro en su hogar eran mas viejos y sus testigos eran también mas viejos (55.4 vs. 41.3,
P<0.001). El testigo era menos probablemente entrenado en RCP (65.0 vs 47.4%,
P<0.001), con menor probabilidad de haber sido entrenado en los últimos 5 años (49.2 vs 17.9,
P<0.001), y si estaba entrenado con menos probabilidad de realizar RCP (64.2 vs. 30.0%,
P<0.001). Los intervalos entre el colapso y la entrega de la descarga no fueron diferentes entre las VF ocurridas en sitios públicos o privados.
Conclusiones: Muchas caracterı́sticas importantes de los pacientes de paro cardı́aco y de sus testigos son distintas según ocurran en localizaciones privadas o públicas. Son necesarias estrategias fundamentalmente diferentes para mejorar la sobrevida en estos eventos.]]></abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>12909379</pmid><doi>10.1016/S0300-9572(03)00118-7</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0300-9572 |
| ispartof | Resuscitation, 2003-08, Vol.58 (2), p.171-176 |
| issn | 0300-9572 1873-1570 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_73538362 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiopulmonary resuscitation Cardiopulmonary Resuscitation - education Cardiopulmonary Resuscitation - statistics & numerical data Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Emergency Medical Service Communication Systems Heart arrest Heart Arrest - epidemiology Heart Arrest - mortality Humans Intensive care medicine Medical sciences Morte súbita Muerte súbita Observation Paragem cardı́aca Paro cardı́aco Prospective Studies Reanimación cardiopulmonar Ressuscitação cardiopulmonar Sudden death Survival Rate Time Factors |
| title | Cardiac arrest in private locations: different strategies are needed to improve outcome |
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