The Scene Time Interval and Basic Life Support Termination of Resuscitation Rule in Adult Out-of-Hospital Cardiac Arrest.
10.3346/jkms.2015.30.1.104
- Author:
Tae Han KIM
1
;
Sang Do SHIN
;
Yu Jin KIM
;
Chu Hyun KIM
;
Jeong Eun KIM
Author Information
1. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Out-of-Hospital Cardiac Arrest;
Cardiopulmonary Resuscitation;
Decision Support Technique
- MeSH:
Adult;
Advanced Cardiac Life Support/*mortality;
Cardiopulmonary Resuscitation/*mortality;
Critical Care/statistics & numerical data;
Decision Support Techniques;
Electric Countershock/*mortality;
Emergency Medical Services;
Female;
Hospital Mortality;
Humans;
Male;
Out-of-Hospital Cardiac Arrest/*epidemiology/*mortality/therapy;
Refusal to Treat;
Republic of Korea/epidemiology;
Retrospective Studies;
Survival Rate;
Time Factors;
Time-to-Treatment;
Treatment Outcome
- From:Journal of Korean Medical Science
2015;30(1):104-109
- CountryRepublic of Korea
- Language:English
-
Abstract:
We validated the basic life support termination of resuscitation (BLS TOR) rule retrospectively using Out-of-Hospital Cardiac Arrest (OHCA) data of metropolitan emergency medical service (EMS) in Korea. We also tested it by investigating the scene time interval for supplementing the BLS TOR rule. OHCA database of Seoul (January 2011 to December 2012) was used, which is composed of ambulance data and hospital medical record review. EMS-treated OHCA and 19 yr or older victims were enrolled, after excluding cases occurred in the ambulance and with incomplete information. The primary and secondary outcomes were hospital mortality and poor neurologic outcome. After calculating the sensitivity (SS), specificity (SP), and the positive and negative predictive values (PPV and NPV), tested the rule according to the scene time interval group for sensitivity analysis. Of total 4,835 analyzed patients, 3,361 (69.5%) cases met all 3 criteria of the BLS TOR rule. Of these, 3,224 (95.9%) were dead at discharge (SS,73.5%; SP,69.6%; PPV,95.9%; NPV, 21.3%) and 3,342 (99.4%) showed poor neurologic outcome at discharge (SS, 75.2%; SP, 89.9%; PPV, 99.4%; NPV, 11.5%). The cut-off scene time intervals for 100% SS and PPV were more than 20 min for survival to discharge and more than 14 min for good neurological recovery. The BLS TOR rule showed relatively lower SS and PPV in OHCA data in Seoul, Korea.
