Abstract 1774: Establishing a Statewide Cardiac Arrest Reporting and Educational Network: The Arizona Experience
BACKGROUND: A few large cities have published their out-of-hospital cardiac arrest (OOHCA) survival statistics using the Utstein reporting method. To date there has been no published data of OOHCA for a state.
OBJECTIVE: Determine the survival rates for OOHCA victims in Arizona and create a functional statewide network for disseminating resuscitation information to prehospital care providers.
METHOD: Arizona’s Bureau of Emergency Medical Services (EMS) initiated a statewide, prospective observational cohort review of all non-traumatic arrests upon whom resuscitation was attempted in the field. EMS first care reports voluntarily submitted by 30 EMS agencies covering approximately 3.6 of the 5.8 million (62.1%) Arizona residents were analyzed. Entry criteria included time intervals and nodal events conforming to the Utstein template recommendations. Outcome was determined by neurological intact hospital discharge.
RESULTS: Total OOHCA reported statewide were 1,296. There were (41.9%) bystander witnessed arrests. Witnessed arrest provided an odds ratio of 9.1 for survival [95% CI 3.8–21.7]. Bystander initiated CPR was provided in (37.3 %) of all arrests. Bystander CPR provided an odds ratio of 2.2 for survival [95% CI 1.2– 4.1]. Initial rhythm of ventricular fibrillation (VF) was (27.3%), PEA was (22.6%), and asystole was (49.5%). Arrests occurred in residential locations in 67%, extended care or medical facilities in 18%, and public locations in 15%. Outcomes were obtained in 1066, with 31 outcomes still pending. Three (3%) of the 1066 victims survived to hospital discharge. Seven (7%) of VF victims survived to hospital discharge. Each EMS agency received their OOHCA statistics for QI and educational purposes.
CONCLUSION: It is feasible for a public health agency to implement a voluntary, statewide database to determine survival from OOHCA. Such a database serves EMS and public health agencies as a baseline for quality improvement and assessment of new OOHCA protocols. Current overall survival from OOHCA in a statewide database is dismal.