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- Hessulf, Fredrik, 1986, et al.
(författare)
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Adherence to Guidelines is Associated With Improved Survival Following In-hospital Cardiac Arrest in Sweden
- 2020
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Ingår i: Resuscitation. - : Lippincott Williams & Wilkins. - 0300-9572 .- 1873-1570. ; 155, s. -21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most resuscitation guidelines have recommendations regarding maximum delay times from collapse to calling for the rescue team and initiation of treatment following cardiac arrest. The aim of the study was to investigate the association between adherence to guidelines for cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest (IHCA) and survival with a focus on delay to treatment.Methods: We used the Swedish Registry for CPR to study 3212 patients with a shockable rhythm and 9113 patients with non-shockable rhythm from January 1, 2008 to December 31, 2017. Adult patients older than or equal to 18 years with a witnessed IHCA where resuscitation was initiated were included. We assessed trends in adherence to guidelines and their associations with 30-day survival and neurological function. Adherence to guidelines was defined as follows: time from collapse to calling for the rescue team and CPR within 1 min for non-shockable rhythms. For shockable rhythms, adherence was defined as the time from collapse to calling for the rescue team and CPR within 1 min and defibrillation within 3 min.Results: In patients with a shockable rhythm, the 30-day survival for those treated according to guidelines was 66.1%, as compared to 46.5% among those not treated according to guidelines on one or more parameters, adjusted odds ratio 1.84 (95% CI 1.52-2.22). Among patients with a non-shockable rhythm the 30-day survival for those treated according to guidelines was 22.8%, as compared to 16.0% among those not treated according to guidelines on one or more parameters, adjusted odds ratio 1.43 (95% CI 1.24-1.65). Neurological function (cerebral performance category 1-2) among survivors was better among patients treated in accordance with guidelines for both shockable (95.7% vs 91.1%, <0.001) and non-shockable rhythms (91.0% vs 85.5%, p < 0.008). Adherence to the Swedish guidelines for CPR increased slightly 2008-2017.Conclusions: Adherence to guidelines was associated with increased probability of survival and improved neurological function in patients with a shockable and non-shockable rhythm, respectively. Increased adherence to guidelines could increase cardiac arrest survival.
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| 3. |
- Källestedt, Marie-Louise Södersved, et al.
(författare)
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Occupational affiliation does not influence practical skills in cardiopulmonary resuscitation for in-hospital healthcare professionals
- 2011
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 19, s. 3-
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Tidskriftsartikel (refereegranskat)abstract
- Background: D-CPR (Defibrillator Cardiopulmonary Resuscitation) is a technique for optimal basic life support during cardiopulmonary resuscitation (CPR). Guidelines recommend that healthcare professionals can perform CPR with competence. How CPR training and provision is organized varies between hospitals, and it is our impression that in Sweden this has generally improved during the last 15-20 years. However, some hospitals still do not have any AED (Automated External Defibrillators). The aim was to investigate potential differences in practical skills between different healthcare professions before and after training in D-CPR. Methods: Seventy-four healthcare professionals were video recorded and evaluated for adherence to a modified Cardiff Score. A Laerdal Resusci Anne manikin in connection to PC Skill reporting System was used to evaluate CPR quality. A simulated CPR situation was accomplished during a 5-10 min scenario of ventricular fibrillation. Paired and unpaired statistical methods were used to examine differences within and between occupations with respect to the intervention. Results: There were no differences in skills among the different healthcare professions, except for compressions per minute. In total, the number of compression per minute and depth improved for all groups (P < 0.001). In total, 41% of the participants used AED before and 96% of the participants used AED after the intervention (P < 0.001). Before intervention, it took a median time of 120 seconds until the AED was used; after the intervention, it took 82 seconds. Conclusion: Nearly all healthcare professionals learned to use the AED. There were no differences in CPR skill performances among the different healthcare professionals.
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| 4. |
- Strömsöe, Anneli, 1969-, et al.
(författare)
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Improvements in logistics could increase survival after out-of-hospital cardiac arrest in Sweden
- 2013
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 273:6, s. 622-627
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. In a review based on estimations and assumptions, to report the estimated number of survivors after out-of-hospital cardiac arrest (OHCA) in whom cardiopulmonary resuscitation (CPR) was started and to speculate about possible future improvements in Sweden.Design. An observational study. Setting All ambulance organisations in Sweden. Subjects Patients included in the Swedish Cardiac Arrest Registry who suffered an OHCA between January 1, 2008 and December 31, 2010. Approximately 80% of OHCA cases in Sweden in which CPR was started are included. Interventions NoneResults. In 11005 patients, the 1-month survival rate was 9.4%. There are approximately 5000 OHCA cases annually in which CPR is started and 30-day survival is achieved in up to 500 patients yearly (6 per 100000 inhabitants). Based on findings on survival in relation to the time to calling for the Emergency Medical Service (EMS) and the start of CPR and defibrillation, it was estimated that, if the delay from collapse to (i) calling EMS, (ii) the start of CPR, and (iii) the time to defibrillation were reduced to <2min, <2min, and <8min, respectively, 300400 additional lives could be saved.Conclusion. Based on findings relating to the delay to calling for the EMS and the start of CPR and defibrillation, we speculate that 300400 additional OHCA patients yearly (4 per 100000 inhabitants) could be saved in Sweden.
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| 5. |
- Södersved Källestedt, Marie-Louise, et al.
(författare)
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Hospital employees' theoretical knowledge on what to do in an in-hospital cardiac arrest
- 2010
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central (BMC). - 1757-7241. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background:Guidelines recommend that all health care professionals should be able to perform cardiopulmonary resuscitation (CPR), including the use of an automated external defibrillator. Theoretical knowledge of CPR is then necessary. The aim of this study was to investigate how much theoretical knowledge in CPR would increase among all categories of health care professionals lacking training in CPR, in an intervention hospital, after a systematic standardised training. Their results were compared with the staff at a control hospital with an ongoing annual CPR training programme.Methods:Health care professionals at two hospitals, with a total of 3144 employees, answered a multiple-choice questionnaire before and after training in CPR. Bootstrapped chi-square tests and Fisher's exact test were used for the statistical analyses.Results:In the intervention hospital, physicians had the highest knowledge pre-test, but other health care professionals including nurses and assistant nurses reached a relatively high level post-test. Improvement was inversely related to the level of previous knowledge and was thus most marked among other health care professionals and least marked among physicians. The staff at the control hospital had a significantly higher level of knowledge pre-test than the intervention hospital, whereas the opposite was found post-test.Conclusions: Overall theoretical knowledge increased after systematic standardised training in CPR. The increase was more pronounced for those without previous training and for those staff categories with the least medical education.
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| 6. |
- Södersved Källestedt, Marie-Louise, 1976-, et al.
(författare)
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In-hospital cardiac arrest characteristics and outcome after defibrillator implementation and education : from 1 single hospital in Sweden.
- 2012
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Ingår i: American Journal of Emergency Medicine. - : W.B. Saunders Co.. - 0735-6757 .- 1532-8171. ; 30:9, s. 1712-1718
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Survival after in-hospital cardiac arrest (CA) has been reported to be surprisingly low without any major improvement during the last decade. AIMS: The aim of this study is to evaluate the clinical impact (delay to defibrillation and survival after CA) of an intervention within 1 single hospital (Västerås, Sweden), including (1) a systematic education of all health care professionals in cardiopulmonary resuscitation and (2) the implementation of 18 automated external defibrillators. METHODS: Information was retrieved from the Swedish National Register of Cardiopulmonary Resuscitation. The differences between the 2 calendar periods were evaluated by χ(2) and Fisher exact tests. Logistic regression was used to control for potential confounders. RESULTS: In total, there were 73 in-hospital CAs before (12 months) and 133 after (18 months) the intervention. The overall delay to defibrillation was not reduced after the intervention, and the proportion of survivors to hospital discharge was 26% before and 32% after the intervention (P =.51). Cerebral function, however, was improved after the intervention (as judged by the cerebral performance categories score; P < .001). Thus, the proportion of survivors among all CA patients discharged with a cerebral performance scale score of 1 or 2 (good or acceptable cerebral function) increased from 20% to 32%. CONCLUSION: An intervention within 1 single hospital (systematic training of all health care professionals in cardiopulmonary resuscitation and implementation of automated external defibrillators) did not reduce treatment delay or increase overall survival. Our results, however, suggest indirect signs of an improved cerebral function among survivors.
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