Impact of the Level on the Resuscitation of Prehospital Cardiac Arrest Patients

Kim, Se Jin; Cho, Suk Jin; Lee, Sang Lae; Ryu, Seok Yong; Kim, Hong Yong; Kim, Sung Jun

Abstract

PURPOSE
The purpose of this research is to compare between teams in the same hospital the results of cardiopulmonary resuscitation on prehospital cardiac arrest patients.
METHODS
We studied retrospectively 21 victims of prehospital cardiac arrest from June 20 to November 30, 2000, (group 1) and 155 victims of prehospital cardiac arrest from December 2000 to December 2003 (group 2). The results of resuscitation were estimated by using the number of ROSCs (return of spontaneous circulation), the 24-hour survival rate, and the alive discharge rate.
RESULTS
In group 1, 13 of 21 patients (61.9%) had no ROSC, 4 patients (19.0%) had a transient ROSC, and no one was discharged alive. In group 2, 84 of 155 patients (54.2%) had no ROSC, 37 (23.9%) had a transient ROSC, and 11 patients (7.1%) were discharged alive. There were no statistical differences in ROSC rates, 24-hour survival rates, and alive discharge rates between the two groups, but group 2 had relatively good ROSC and survival rates. Among those discharged, 9 had visited our emergency department for cardiac causes and 2 for non-cardiac causes. The initial EKG findings were VF in 8 and PEA and Bradycardia in 3. In all discharged survival cases, the cardiac arrest had been witnessed.
CONCLUSION
We failed to find significant outcome differences based on ACLS team skill. The result might have been made due to the fact that 119 transport time exceeded the threshold time (>10minutes) for good prehospital cardiac resuscitation and the absence of early cardiopulmonary resuscitation.