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Clinical Articles, News & Views

Swift ambulance response reduces mortality

Survival to discharge after out-of-hospital cardiac arrest (OOHCA) improves dramatically with a reduction in ambulance response times, according to a study1 published recently in Europace.

Researchers from Dublin and Boston, Massachusetts, assessed mean and median emergency medical services (EMS) response times to OOHCA calls across a total of 962 OOHCAs occurring in Dublin from 1 January 2003 until 31 December 2008, following the introduction of several improvements in pre-hospital emergency medical care.

During this period the adjusted incidence of OOHCA for the catchment population declined from 109.4 to 88.2 per 100,000.  Overall survival to hospital discharge improved significantly from 2.6 to 11.3% (p=0.001). Survival from ventricular fibrillation (VF) to hospital admission, rose from 28.6 to 86.3% (p=0.001).  Survival to hospital discharge from VF improved from 21.4 to 33% (p=0.007). Mean EMS response times to the scene of arrest decreased from 9.18 to 8.34 min. Emergency medical services scene time, reflecting acute pre-hospital medical care, rose from 14.46 to 18.12 min.

Bystander cardiopulmonary resuscitation (CPR) was in progress when emergency services arrived in 11% of the cases. 19% had a known prior cardiac history or chest pain prior to circulatory collapse.  The authors speculate that reduction in ambulance response time, resulting in earlier initiation of basic and advanced life support and earlier defibrillation, led to an increase in the proportion of victims found in VF rather than asystole and likely accounted for most of the improvement. Further improvements in response times and public education to improve bystander CPR rates should remain a priority, they add.

References

1 Margey R, Browne L, Murphy E, et al. The Dublin cardiac arrest registry: temporal improvement in survival from out-of-hospital cardiac arrest reflects improved pre-hospital emergency care. Europace 2011;13:1157–65.  doi: 10.1093/europace/eur092.

Published on: December 1, 2011

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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