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- Ekström, L, et al.
(author)
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Survival after cardiac arrest outside hospital over a 12-year period in Göteborg
- 1994
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In: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 27:3, s. 181-187
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Journal article (peer-reviewed)abstract
- Background: A two-tiered ambulance system with a mobile coronary care unit and standard ambulance has operated in Gothenburg (population 434 000) since 1980. Mass education in cardiopulmonary resuscitation (CPR) commenced in 1985 and in 1988 semiautomatic defibrillators were introduced. Aim: To describe early and late survival after cardiac arrest outside hospital over a 12-year period. Target population: All patients with prehospital cardiac arrest in Gothenburg reached by mobile coronary care unit or standard ambulance between 1980 and 1992. Results: The number of patients with cardiac arrest remained fairly steady over time. Among patients with witnessed ventricular fibrillation, the time to defibrillation decreased over time. The proportion of patients in whom bystander initiated CPR was increased only moderately over time. The proportion of patients given medication such as lignocaine and adrenaline successively increased. The number of patients with cardiac arrest who were discharged from hospital per year remained steady between 1981 and 1990 (20 per year), but increased during 1991 and 1992 to 41 and 31 respectively. Conclusions: Improvements in the emergency medical service in Gothenburg over a 12-year period have lead to: (1) a shortened delay time between cardiac arrest and first defibrillation and (2) an improved survival of patients with cardiac arrest outside hospital probably explained by this shortened delay time.
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- Herlitz, Johan, et al.
(author)
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Predictors of early and late survival after out of hospital cardiac arrest in which asystole was the first recorded arrhythmia on scene
- 1994
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In: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 28:1, s. 27-36
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Journal article (peer-reviewed)abstract
- Background: A large proportion of patients who suffer out-of-hospital cardiac arrest have asystole as the initial recorded arrhythmia. Since they have a poor prognosis, less attention has been paid to this group of patients. Aim: To describe a consecutive population of patients with out-of-hospital cardiac arrest with asystole as the first recorded arrhythmia and to try to define indicators for an increased chance of survival in this population. Setting: The community of Gothenburg. Patients: All patients who suffered out-of-hospital cardiac arrest during 1981 to 1992 and were reached by our emergency medical service (EMS) system and where cardiopulmonary resuscitation (CPR) was attempted. Results: In all there were 3434 cardiac arrests of which 1222 (35%) showed asystole as the first recorded arrhythmia. They differed from patients with ventricular fibrillation by being younger, including more women and having a longer interval between collapse and arrival of the first ambulance. In all 90 patients (7%) were hospitalized alive and 20 (2%) could be discharged from hospital. Independent predictors for an increased chance of survival were: (a) a short interval between the collapse and arrival of the first ambulance (P < 0.001) and the time the collapse occurred (P < 0.05). Initial treatment given in some cases with adrenaline, atropine and tribonate were not associated with an increased survival. Conclusions: Of all the patients with out-of-hospital cardiac arrest, 35% were found in asystole. Of these, 7% were hospitalized alive and 2% could be discharged from hospital. Efforts should be made to improve still further the interval between collapse and arrival of the first ambulance.
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