Abstract 63: Early Epinephrine Administration Within 15 Minutes After EMS Call Led to Favorable Neurological Outcome
Introduction: Effectiveness of epinephrine administration on OHCA patients has been extensively explored, but there is no definitive evidence to improving improve favorable neurological outcome.
Hypothesis: We hypothesized if we have successfully given epinephrine early stage of cardiac arrest, it may improve the neurological outcome.
Methods: A total 925288 OHCA patients registered between January 2005 and December 2012 on Japan’s nationwide registry database. Among these, 100338 patients aged 15-89 with witnessed cardiac arrest due to cardiac cause origin were eligible for our analyses. We excluded all of SGA device applied and Tracheal Intubated case to neglect for their effects, outer timeline data, and ROSC before epinephrine administration. In fact, 6099 patients received prehospital epinephrine administration with Bag Valve Mask (as BVM) ventilation by Emergency lifesaving technician (as Epi group;12.5%) divided into following time span (as t), 9≦t<15min (Early-Epi groups; n=575) and t≦15min (Late-Epi groups; n=5524), respectively. A 42768 patients received non-epinephrine administration with BVM ventilation (as Non-Epi group;87.5%). Favorable neurological outcome at one month after collapse(CPC-1/2) was compared among the groups. Statistical analysis were used logistic regression analysistherefore, we have used just simply compared the time duration effect within epinephrine administer groups
Results: In patients with the early Epi- group had a significantly higher CPC-1/2 rate compared with the non-Epi group (12.2% vs.8.0% unadjusted odds ratio 1.59, CI 1.23-2.05) and Also, Early Epi groups indicates significantly higher CPC-1/2 rate than that of the Late-Epi groups (12.1% vs.3.4% unadjusted odds ratio3.98, CI 2.98-5.33).
Conclusions: We conclude that early epinephrine administration within 15 minute after EMS call, Emergency lifesaving technician could have chance to improves the long term neurological outcome in patients with witness cardiogenic OHCA. Epinephrine for OHCA should be given within 15 minutes after EMS call. In order to carry it out, it prefer to local EMS protocol and re-training curriculum change. Further investigation of effectiveness of early epinephrine administration must be warrant.
Author Disclosures: T. Hidhearu: None. H. Takyu: None. T. Nakagawa: None. S. Toru: None. S. Gotoh: None. E. Hasegawa: None. T. Kinoshi: None. H. Takahashi: None. E. Sone: None. S. Shimazaki: None.
- © 2014 by American Heart Association, Inc.