Abstract 14: Japanese Emergency Medical System Achieves Good Result in Resuscitation of Out-of-Hospital Cardiac Arrest without Drug Administration. A Population Based Analysis, Sapporo Japan.
Introduction This report is the first official analyses from Sapporo to use the ‘Utstein template’ to report outcomes of out-of-hospital cardiac arrest (OHCA).
Method We investigated prospectively and inclusively the prognosis of OHCA patients from January 2002 to June 2005, and compare with data from other districts. Cases were identified prospectively using Emergency Medical System dispatch records.
Results A total of 3372 attempted resuscitations were reported during the 42 months; 535 per million population per year. 622 out of 3372 were witnessed cardiogenic OHCS. The initial rhythms assessed by Emergency Medical Technician (EMT) are as follows. 29.1% were ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), 42.1% were Asystolic, and the rest were other rhythm as Pulseless electrical activity. The ratio of return of spontaneous circulation (ROSC) is 41.3% and the survivor discharge is 16.9%. These outcomes rise up to 68.0% in ROSC, 38.1% in survivor discharge in the victims whose initial rhythm was VF/Pulseless VT.
Discussion In our survey, the rate of ROSC and discharge alive is not inferior to other districts, though the rate of VF or Pulseless VT which is expected better results, as an initial rhythm, is low. We argue that the favorable outcome depends on the unique EMT supervising and training system called “Sapporo method” and therapeutic hypothermia subsequent to early induction of percutaneous cardiopulmonary bypass.
Conclusion These data compare favorably in outcome with other international reports.