Abstract 18049: Improved Survival in Out of Hospital Cardiac Arrest: Withholding Positive Pressure Ventilation
Hypothesis: The withholding/delay of positive pressure ventilation can improve out of hospital adult primary cardiac arrest survival.
Methods: All adult primary cardiac arrest victims in a single municipal (Sate of Florida) Fire/Rescue service in whom resuscitation attempts were made were initially given chest compressions only. Positive pressure ventilation was withheld until the first of either 10 minutes or return of spontaneous circulation (ROSC). Continuous uninterrupted chest compressions were an integral part of the protocol. Primary cardiac arrest was defined as an arrest not felt to be due to hypoxia. The Florida State EMSTARS (EMS Tracking and Reporting System) database provided the information for statewide average ROSC.
Results: Over a two-year period the ROSC and neurologically intact recovery rate was dramatically improved over Florida State average controls. The 2013 total ROSC rate was 40% (18/45) compared to a Florida State average ROSC of 16.7%. The 2014 primary cardiac arrest ROSC rate was 51.5% (17/33) with 29.4% of the ROSC patients or 15.2% of the total achieving neurologically intact survival. This compares to the 2014 Florida State average ROSC of 17.9%.
Conclusion: Delayed positive pressure ventilation seems to be associated with both improved ROSC and neurologically intact survival in adult out of hospital primary cardiac arrest. Further study is warranted to determine the extent of this association.
Author Disclosures: K. Scheppke: Employment; Significant; Medical Director of EMS. J. Ippolito: Employment; Significant; Chief of Emergency Medical Services. K. Breyer: Employment; Significant; Deputy Chief of Operations. R. Chait: None.
- © 2015 by American Heart Association, Inc.