Abstract P38: Re-arrest is Rare During Air Ambulance Transport of Post-Cardiac Arrest Patients
Background: Patients successfully resuscitated from cardiac arrest (CA) can benefit from integrated multidisciplinary care. This care may be volume and resource-dependent. Short transfer delays from scene to tertiary care hospitals have not been shown to adversely affect outcome following CA. Our objectives were to determine the rate of re-arrest and the rate of other critical events during air ambulance transport of resuscitated CA patients.
Methods: Retrospective chart review of CA patients transported via air ambulance to a single tertiary care facility between 1–1–2001 and 10 –23–2008. Data abstracted included demographics, presumed etiology, arrest rhythm, re-arrest, in-flight critical events and medications, hospital interventions, and outcome. Critical events were classified as hypotension (SBP<90mmHg), hypoxia (SpO2<90%), both hypotension and hypoxia, or none. The primary outcome was the rate of re-arrest in flight. Secondary outcomes were the rates of critical events in flight. Data were analyzed using descriptive statistics.
Results: We reviewed 206 charts; 59 were excluded for trauma. Of the remaining 147 patients, the average age was 61±15 years and 97 (65%) were male. VF/VT was the most common rhythm (54%); 73% of patients were comatose (GCS ≤8). Transport infusions included vasopressors (53%), anti-arrhythmics (42%), heparin (42%) and nitroglycerin (15%). Eight patients (5%) re-arrested in flight; however, three of these patients had good outcomes. Forty-one (28%) experienced a critical event. Cardiac interventions were common: 84 (59%) patients received coronary catheterization, 51 (36%) received a stent, and 21 (15%) received AICD. Hypothermia was administered to 24 patients (17%). Seventy-one patients (49%) survived and 59 (41%) had a good outcome.
Conclusion: Critical events during transfer of CA patients to specialty care are common, including a 5% incidence of re-arrests. Rapid transport using air ambulance capable of in-transport critical care may optimize patient safety.