- Email: [email protected]
Does emergency call placed before cardiac arrests improve the survival from out-of-hospital cardiac arrests (OHCAs)?
Abstracts / Resuscitation 85S (2014) S15–S121
S35
Basic Life Support
AP041
AP040
Children capability to perform CPR, is useful to teach them so young?
Does emergency call placed before cardiac arrests improve the survival from out-of-hospital cardiac arrests (OHCAs)? Yutaka Takei 1,∗ , Yoshio Tanaka 5 , Taiki Nishi 5 , Hiroyuki Wato 2 , Minoru Kubo 3 , Satoru Sakagami 4 , Hideo Inaba 5 1
Department of Medical Science and Technology, Hiroshima International University, Higashi-Hiroshima, Hiroshima, Japan 2 Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan 3 Department of Pediatrics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan 4 Department of Internal Medicine, Kanazawa Medical Centre, Kanazawa, Ishikawa, Japan 5 Department of Emergency Medical Science, Kanazawa, Ishikawa, Japan Aim: To evaluate the efficacy of emergency call before cardiac arrest in survival from OHCAs witnessed by bystanders and emergency medical technicians (EMTs). Methods: Data for 210,134 bystander-witnessed and 49,654 EMT-witnessed OHCAs having complete dataset for analysis but no involvement of physician were extracted from the nationwide database of 588,742 OHCAs collected prospectively between 2005 and 2011. Of 259,788 cases in total, 255,386 cases having usual time intervals (0.5–99.5% values) were divided into the three groups and analysed for one-month neurologically favourable survival; Emergency call before arrest (Interval between arrest witness and emergency call ranged from −48 to −5 min, N = 63,674), standard emergency call (−4 to 4 min, N = 134,923) and delayed emergency call (5–60 min, N = 56,789). Results: The rate of one-month neurologically favourable survival was 6.2, 4.5 and 1.8% for before-arrest group, standard group and delayed group, respectively; odds ratio (95% CI) with beforearrest group as reference, 0.71 (0.68–0.74) vs. standard group, 0.27 (0.25–0.29) vs. delayed group. The proportion of EMT-witnessed cases was 74.6%, 0.3% and 0%, respectively. When analysed only for bystander-witnessed cases, the rate of survival was 3.2%, 4.5% and 1.8%, respectively; 1.39 (1.28–1.53) vs. standard, 0.53 (0.48–0.59) vs. delayed. The rate of dispatcher-assisted CPR (DA-CPR) and success of DA-CPR to induce bystander CPR in these cases was the lowest (24.8% and 57.6%, respectively) in before-arrest group and highest (45.1% and 64.4%, respectively) in delayed group. After adjustment for patient age, arrest witness, aetiology of arrest, initial rhythm and response time, adjusted odds ratio (95% CI) for survival with before-arrest group as reference were 0.87 (0.79–0.95) vs. standard group and 0.45 (0.40–0.50) vs. delayed group. Conclusions: Emergency call placed before cardiac arrest was efficient in survival from witnessed OHCAs. However, this favourable effect was invalidated when the patients descending into cardiac arrest before EMT arrival. http://dx.doi.org/10.1016/j.resuscitation.2014.03.089
Xavier Jimenez-Fabrega ∗ , Francesc Carmona-Jimenez, Xavier Escalada-Roig, Angels Mora-Vives, Marisa Rubio-Moron, Marta Trayner-Guixens, Anna Puig-Mari, Pilar Palma-Padro Sistema d’Emergències Mèdiques (SEM), Barcelona, Spain Objective: To assess the children capability for performing CPR at different ages, and evaluate how this capability improve at older ages. Methods: Cross-sectional study performed during November 2013. 244 children of different school years were asked to perform hands-only CPR until exhaustion perception on a mannequin, after teaching them the chest compression (CC) technique. Quality data were gathered from Laerdal® Skill Reporter Software and transferred to a data base. Quality data was described as percents and quantitative data as mean and standard deviation (SD). Groups were compared by simple linear regression. IBM-SPSS 19.0 software was used for the analysis. Results: 244 children between 8 and 14 years participated in the study. 50.4% were male. The mean depth and frequency of CC and exhaustion time are described in Table 1. Table 1 Age
n
Mean depth compression
SD
Mean frequency
SD
Mean Exhaustion time (mm:ss)
SD
8 9 10 11 12 13 14 Total
3 25 44 56 69 45 2 244
18.33 mm 24.48 mm 27.70 mm 29.80 mm 33.54 mm 38.38 mm 41.50 mm 31.47 mm
4.5 5.2 7.6 8.1 7.6 5.7 3.5 8.4
120.0pm 130.4pm 128.3pm 130.5pm 121.7pm 131.6pm 125.5pm 127.7pm
24.6 33.7 15.4 25.1 24.5 25.3 0.7 24.6
01:24 00:42 00:30 00:49 00:50 00:44 01:00 00:45
0:11 0:18 0:16 0:36 0:20 0:10 0:25 0:24
In a simple regression model, every year older was associated with an increase in 3,5 mm of CC depth (p < 0.001). No significant or clinical association was observed between age and frequency or exhaustion time. Conclusions: Even when children are able to perform CPR at the recommended frequency, they get exhausted too soon and even older children can’t achieve recommended depth. Under our point of view, is not useful to teach young children in hands-only CPR, but this not means they don’t must to know the first chain survival link. http://dx.doi.org/10.1016/j.resuscitation.2014.03.090
S35
Basic Life Support
AP041
AP040
Children capability to perform CPR, is useful to teach them so young?
Does emergency call placed before cardiac arrests improve the survival from out-of-hospital cardiac arrests (OHCAs)? Yutaka Takei 1,∗ , Yoshio Tanaka 5 , Taiki Nishi 5 , Hiroyuki Wato 2 , Minoru Kubo 3 , Satoru Sakagami 4 , Hideo Inaba 5 1
Department of Medical Science and Technology, Hiroshima International University, Higashi-Hiroshima, Hiroshima, Japan 2 Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan 3 Department of Pediatrics, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan 4 Department of Internal Medicine, Kanazawa Medical Centre, Kanazawa, Ishikawa, Japan 5 Department of Emergency Medical Science, Kanazawa, Ishikawa, Japan Aim: To evaluate the efficacy of emergency call before cardiac arrest in survival from OHCAs witnessed by bystanders and emergency medical technicians (EMTs). Methods: Data for 210,134 bystander-witnessed and 49,654 EMT-witnessed OHCAs having complete dataset for analysis but no involvement of physician were extracted from the nationwide database of 588,742 OHCAs collected prospectively between 2005 and 2011. Of 259,788 cases in total, 255,386 cases having usual time intervals (0.5–99.5% values) were divided into the three groups and analysed for one-month neurologically favourable survival; Emergency call before arrest (Interval between arrest witness and emergency call ranged from −48 to −5 min, N = 63,674), standard emergency call (−4 to 4 min, N = 134,923) and delayed emergency call (5–60 min, N = 56,789). Results: The rate of one-month neurologically favourable survival was 6.2, 4.5 and 1.8% for before-arrest group, standard group and delayed group, respectively; odds ratio (95% CI) with beforearrest group as reference, 0.71 (0.68–0.74) vs. standard group, 0.27 (0.25–0.29) vs. delayed group. The proportion of EMT-witnessed cases was 74.6%, 0.3% and 0%, respectively. When analysed only for bystander-witnessed cases, the rate of survival was 3.2%, 4.5% and 1.8%, respectively; 1.39 (1.28–1.53) vs. standard, 0.53 (0.48–0.59) vs. delayed. The rate of dispatcher-assisted CPR (DA-CPR) and success of DA-CPR to induce bystander CPR in these cases was the lowest (24.8% and 57.6%, respectively) in before-arrest group and highest (45.1% and 64.4%, respectively) in delayed group. After adjustment for patient age, arrest witness, aetiology of arrest, initial rhythm and response time, adjusted odds ratio (95% CI) for survival with before-arrest group as reference were 0.87 (0.79–0.95) vs. standard group and 0.45 (0.40–0.50) vs. delayed group. Conclusions: Emergency call placed before cardiac arrest was efficient in survival from witnessed OHCAs. However, this favourable effect was invalidated when the patients descending into cardiac arrest before EMT arrival. http://dx.doi.org/10.1016/j.resuscitation.2014.03.089
Xavier Jimenez-Fabrega ∗ , Francesc Carmona-Jimenez, Xavier Escalada-Roig, Angels Mora-Vives, Marisa Rubio-Moron, Marta Trayner-Guixens, Anna Puig-Mari, Pilar Palma-Padro Sistema d’Emergències Mèdiques (SEM), Barcelona, Spain Objective: To assess the children capability for performing CPR at different ages, and evaluate how this capability improve at older ages. Methods: Cross-sectional study performed during November 2013. 244 children of different school years were asked to perform hands-only CPR until exhaustion perception on a mannequin, after teaching them the chest compression (CC) technique. Quality data were gathered from Laerdal® Skill Reporter Software and transferred to a data base. Quality data was described as percents and quantitative data as mean and standard deviation (SD). Groups were compared by simple linear regression. IBM-SPSS 19.0 software was used for the analysis. Results: 244 children between 8 and 14 years participated in the study. 50.4% were male. The mean depth and frequency of CC and exhaustion time are described in Table 1. Table 1 Age
n
Mean depth compression
SD
Mean frequency
SD
Mean Exhaustion time (mm:ss)
SD
8 9 10 11 12 13 14 Total
3 25 44 56 69 45 2 244
18.33 mm 24.48 mm 27.70 mm 29.80 mm 33.54 mm 38.38 mm 41.50 mm 31.47 mm
4.5 5.2 7.6 8.1 7.6 5.7 3.5 8.4
120.0pm 130.4pm 128.3pm 130.5pm 121.7pm 131.6pm 125.5pm 127.7pm
24.6 33.7 15.4 25.1 24.5 25.3 0.7 24.6
01:24 00:42 00:30 00:49 00:50 00:44 01:00 00:45
0:11 0:18 0:16 0:36 0:20 0:10 0:25 0:24
In a simple regression model, every year older was associated with an increase in 3,5 mm of CC depth (p < 0.001). No significant or clinical association was observed between age and frequency or exhaustion time. Conclusions: Even when children are able to perform CPR at the recommended frequency, they get exhausted too soon and even older children can’t achieve recommended depth. Under our point of view, is not useful to teach young children in hands-only CPR, but this not means they don’t must to know the first chain survival link. http://dx.doi.org/10.1016/j.resuscitation.2014.03.090