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Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study.

Yates, E J and Schmidbauer, S and Smyth, A M and Ward, M and Dorrian, S and Siriwardena, A N and Friberg, H and Perkins, G D (2018) Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study. Resuscitation, 130. pp. 21-27. ISSN 1873-1570. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

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Official URL: https://www.resuscitationjournal.com/article/S0300...

Abstract

INTRODUCTION

Termination of resuscitation guidelines for out-of-hospital cardiac arrest can identify patients in whom continuing resuscitation has little chance of success. This study examined the outcomes of patients transferred to hospital with ongoing CPR. It assessed outcomes for those who would have met the universal prehospital termination of resuscitation criteria (no shocks administered, unwitnessed by emergency medical services, no return of spontaneous circulation).

METHODS

A retrospective cohort study of consecutive adult patients who were transported to hospital with ongoing CPR was conducted at three hospitals in the West Midlands, UK between September 2016 and November 2017. Patient characteristics, interventions and response to treatment (ROSC, survival to discharge) were identified.

RESULTS

227 (median age 69 years, 67.8% male) patients were identified. 89 (39.2%) met the universal prehospital termination of resuscitation criteria. Seven (3.1%) were identified with a potentially reversible cause of cardiac arrest. After hospital arrival, patients received few specialist interventions that were not available in the prehospital setting. Most (n = 210, 92.5%) died in the emergency department. 17 were admitted (14 to intensive care), of which 3 (1.3%) survived to hospital discharge. There were no survivors (0%) in those who met the criteria for universal prehospital termination of resuscitation.

CONCLUSION

Overall survival amongst patients transported to hospital with ongoing CPR was very poor. Application of the universal prehospital termination of resuscitation rule, in patients without obvious reversible causes of cardiac arrest, would have allowed resuscitation to have been discontinued at the scene for 39.2% of patients who did not survive.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WG Cardiovascular system. Cardiology
Divisions: Clinical Support > Critical Care
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Depositing User: Mrs Yolande Brookes
Date Deposited: 06 Jul 2018 14:14
Last Modified: 06 Jul 2018 14:14
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1694

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