TY - JOUR
T1 - Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest is hampered by interruptions in chest compressions-A nationwide prospective feasibility study
AU - Krarup, Niels Henrik
AU - Terkelsen, Christian Juhl
AU - Johnsen, Søren Paaske
AU - Clemmensen, Peter
AU - Olivecrona, Göran K.
AU - Hansen, Troels Martin
AU - Trautner, Sven
AU - Lassen, Jens Flensted
PY - 2011/3/1
Y1 - 2011/3/1
N2 - Aim of the study: Quality of cardiopulmonary resuscitation (CPR) is a critical determinant of outcome following out-of-hospital cardiac arrest. The aim of our study was to evaluate the quality of CPR provided by emergency medical service providers (Basic Life Support (BLS) capability) and emergency medical service providers assisted by paramedics, nurse anesthetists or physician-manned ambulances (Advanced Life Support (ALS) capability) in a nationwide, unselected cohort of out-of-hospital cardiac arrest cases. Methods: We conducted a prospective, observational study of out-of-hospital cardiac arrest with non-traumatic etiology (>18 years of age) occurring from the 1st to the 31st of January 2009 and treated by the primary Danish emergency medical service operator, covering approximately 85% of the population. One hundred and ninety-one cases were eligible for analysis. Follow-up was up to one year or death. Quality of CPR was evaluated using measurements of transthoracic impedance. Results: The majority of patients were treated by ambulances with ALS capability (54%). Interruptions in CPR related to loading of the patient into the emergency medical service vehicle were substantial, but independent of whether patients were managed by ALS or BLS capable units (222. s versus 224. s, P = 0.76) as were duration of interruptions during rhythm analysis alone (20. s versus 22. s, P = 0.33) and defibrillation (24. s versus 26. s, P = 0.07). Conclusions: Nationwide, routine monitoring of transthoracic impedance is feasible. CPR is hampered by extended interruptions, particularly during loading of the patient into the emergency medical service vehicle, rhythm analysis and defibrillation.
AB - Aim of the study: Quality of cardiopulmonary resuscitation (CPR) is a critical determinant of outcome following out-of-hospital cardiac arrest. The aim of our study was to evaluate the quality of CPR provided by emergency medical service providers (Basic Life Support (BLS) capability) and emergency medical service providers assisted by paramedics, nurse anesthetists or physician-manned ambulances (Advanced Life Support (ALS) capability) in a nationwide, unselected cohort of out-of-hospital cardiac arrest cases. Methods: We conducted a prospective, observational study of out-of-hospital cardiac arrest with non-traumatic etiology (>18 years of age) occurring from the 1st to the 31st of January 2009 and treated by the primary Danish emergency medical service operator, covering approximately 85% of the population. One hundred and ninety-one cases were eligible for analysis. Follow-up was up to one year or death. Quality of CPR was evaluated using measurements of transthoracic impedance. Results: The majority of patients were treated by ambulances with ALS capability (54%). Interruptions in CPR related to loading of the patient into the emergency medical service vehicle were substantial, but independent of whether patients were managed by ALS or BLS capable units (222. s versus 224. s, P = 0.76) as were duration of interruptions during rhythm analysis alone (20. s versus 22. s, P = 0.33) and defibrillation (24. s versus 26. s, P = 0.07). Conclusions: Nationwide, routine monitoring of transthoracic impedance is feasible. CPR is hampered by extended interruptions, particularly during loading of the patient into the emergency medical service vehicle, rhythm analysis and defibrillation.
KW - Cardiopulmonary resuscitation
KW - Heart arrest
KW - Resuscitation
UR - http://www.scopus.com/inward/record.url?scp=79751524955&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2010.11.003
DO - 10.1016/j.resuscitation.2010.11.003
M3 - Article
C2 - 21146913
AN - SCOPUS:79751524955
SN - 0300-9572
VL - 82
SP - 263
EP - 269
JO - Resuscitation
JF - Resuscitation
IS - 3
ER -