Abstract 18: The Outcomes of Traumatic or Injured Out-of-Hospital Cardiac Arrest and Ventricular Fibrillation: Implications for Use Automated External Defibrillator Use
Objectives: Ventricular fibrillation (VF) may not be often for traumatic or injured OHCA, the outcomes of traumatic or injured OHCA presenting with VF and the role of automated external defibrillator (AED) has not been clearly defined.
Methods: A prospective three-year observational database of adult OHCA patients collected from a web-based electronic OHCA registry in an urban EMS system was studied. All EMS ambulance teams were capable with advanced airway, intravenous fluid skills, basic traumatic life support techniques and AED treatments. AED protocol was applied to all EMS OHCA patients. Outcomes included 2-hour sustained return of spontaneous circulation (2hr ROSC), survival to discharge, and cerebral performance category scale (CPC) at discharge.
Results: Among a total of 9,005 OHCA patients, 764 were traumatic and 514 of them were actively resuscitated and transported. In 411 transported cases the initial cardiac rhythms upon EMS arrival were recorded. For 24 patients (5.8%) presenting with VF and receiving EMS defibrillation therapy, thirteen (54.2%) reached 2hr ROSC, nine (37.5%) reached survival to discharge, and six (25%) reached CPC 1-2. (Table 1) For a total of nine electrical injuries, eight presented with VF and three of them (37.5%, 95% CI: 13.7-69.4%) reached CPC 1. The adjusted odds ratios of VF patient versus non-VF for outcomes were 4.4 (95% CI: 1.8-10.3) for 2hr ROSC, 25.2 (95% CI: 8.8-72.6) for survival to discharge, and 18.1 (95% CI: 5.5-59.3) for CPC 1-2, and VF was the only significant predictor for survival to discharge and CPC 1-2.
Conclusion: Though traumatic or injured OHCA may not often present with shockable rhythm upon EMS arrival, those presenting with VF may still have fair chance to reach good neurological outcome, especially for those with electrical injury. Traumatic and injured OHCA with VF may have significantly better survivals compared with the non-VF, which may imply the proper use of AED on this occasion.
- Cardiac arrest
- Ventricular fibrillation
- Emergency medical services (EMS)
- Automated external defibrillator (AED)
Author Disclosures: Y. Chen: None. J. Chen: None. K. Chong: None. M. Cheng: None. T. Lu: None. W. Chiang: None. M. Ma: None. P. Ko: None.
- © 2014 by American Heart Association, Inc.