Abstract 225: Healthcare Provider Perspectives on Resuscitation of Drug-Related Out-of-Hospital Cardiac Arrest
Introduction: Out-of-hospital cardiac arrest from drug overdose (OD-OHCA) caused over 38,000 deaths in 2010. A preliminary study in Pittsburgh found that OD-OHCA patients differed demographically and in the resuscitation treatments they received, despite identical American Heart Association (AHA) resuscitation guidelines. We hypothesized that physician and non-physician healthcare provider perceptions affect decision-making in the treatment of OD-OHCA versus non-OD OHCA.
Methods: A handwritten survey was administered at the National Association of EMS Physicians 2013 Scientific Assembly between January 9 and 12, 2013. Participants were asked about their affiliated EMS agencies, perceptions of OD-OHCA incidence and abused drugs, and perspectives on and knowledge of the treatment of OD-OHCA during resuscitation. Participants were instructed to complete only one survey.
Results: In sum, 193 respondents participated in this survey: 144 (75%) were physicians and 49 (25%) were non-physician healthcare providers. Of the physicians, 79% identified current status as a medical director and 76% of non-physicians identified as a paramedic. Eighty-three percent of physicians and 65% of non-physicians indicated that OD-OHCA patients had different demographics than non-OD OHCA; 64% all respondents felt that OD-OHCA patients should be treated differently. Of those respondents who believed that OD-OHCA patients should be treated differently, 47% believed there were differences in the AHA guidelines, while only 27% of those respondents who believed that OD-OHCA patients should not be treated differently believed that AHA guidelines recommended differential treatment. Fifty-four percent of all respondents reported that they or their paramedics make different decisions when treating OD-OHCA patients, regardless of protocol. Seventy-eight percent of respondents indicated the use of naloxone during OD-OHCA resuscitation while 12% reported administering naloxone during non-OD OHCA resuscitations.
Conclusions: Physicians and non-physicians report perceiving OD-OHCA patients differently than non-OD and making different treatment decisions based on these perceptions. This may result in etiology-oriented resuscitation for OD-OHCA.
- © 2013 by American Heart Association, Inc.