Abstract 16762: Predictors of Neurologic Outcomes after Ventricular Fibrillation with Out-Of-Hospital Cardiac Arrest Witnessed by Emergency Medical Service Personnel
Background: In Japan, advanced interventions that can be performed by emergency medical service (EMS) personnel in patients with out-of-hospital cardiac arrest (OHCA) are defibrillation, advanced airway management, intravenous access, and administration of epinephrine. It is unclear whether these interventions performed by EMS can improve neurologic outcomes.
Objective: To evaluate predictors of favorable neurologic outcomes in patients with ventricular fibrillation (VF) and OHCA witnessed by EMS personnel.
Methods: An observational study was performed in 352,172 patients who had OHCA in Japan and received cardiopulmonary resuscitation (CPR) between January 1, 2008 and December 31, 2010. We studied 1,089 of these patients in whom age was 18 to 74 years, the scene of OHCA was witnessed by EMS personnel, CPR was performed, OHCA was cardiogenic, initial rhythm was VF, and defibrillation was performed. A multivariate logistic-regression analysis was conducted to assess factors associated with favorable neurologic outcomes (defined as Cerebral Performance Category 1 or 2) 1 month after cardiac arrest.
Results: The median time from collapse to hospital arrival was 16 minutes. The rate of return of spontaneous circulation before hospital arrival was 48%, and the rate of favorable neurologic outcomes after 1 month was 41%. Early defibrillation was associated with favorable neurologic outcomes, whereas advanced airway management, administration of epinephrine, and increasing shock times were not.
Conclusions: In patients with VF witnessed by EMS personnel, resuscitation attempts should simply focus on basic CPR with a bag-valve mask and early defibrillation.
- © 2012 by American Heart Association, Inc.