Humans ; Out-of-Hospital Cardiac Arrest/etiology*

Humans ; Out-of-Hospital Cardiac Arrest/therapy* ; China/epidemiology*

Cardiopulmonary Resuscitation ; Humans ; Out-of-Hospital Cardiac Arrest/therapy* ; Singapore/epidemiology*

Early defibrillation with an automated external defibrillator (AED) is crucial to survival success in sudden cardiac arrest. Dissemination of public-access AEDs have increased the frequency of early defibrillations and contributed to improved outcomes after out-of-hospital cardiac arrests (OHCAs). However, public-access AEDs are not yet widely-disseminated in Korea. We report the first survival case of an OHCA patient who received shocks from a public-access AED in Korea.
Death, Sudden, Cardiac ; Defibrillators ; Heart Arrest ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest ; Shock

PURPOSE: The purpose of this study is to evaluate relevance of postanoxic seizure with prognosis in cases of out-of hospital cardiac arrest (OHCA) patients treated with TH and to research the prognostic role of portable electroencephalography (EEG). METHODS: A total of 180 OHCA patients arrived during July of 2008 and June of 2011, and 144 patients who had been treated with therapeutic hypothermia were included in this study. Portable EEG was taken 24 hours after induction of TH and classified by the attending neurologist. As an outcome variable, overall mortality and neurological outcome after six months from discharge were evaluated (Good neurological outcome; Cerebral performance category (CPC) scale 1, 2, Poor neurological outcome; CPC scale 3~5). RESULTS: Among 144 patients, 93 patients (63.9%) were male, and mean age was 51. Eighty two patients (56.9%) survived and almost 30% (43/144) of patients had a good neurological outcome. Sixty five patients (45.1%) had seizures, and, among this group, 19 patients (29.2%) were discharged with a good neurological outcome. No statistical difference was observed between the seizure group and the non-seizure group. Initial rhythm, APACHI II score, and time from basic life support to return of spontaneous circulation (OR, 2.169; 95% CI, 1.158~4.063, OR 1.107; 95% CI 1.064~1.152, OR 1.014; 95% CI 1.006~1.022, respectively) showed statistical importance, however, the seizure group (OR, 0.67, 95% CI, 0.356~1.032, p=0.065) had no statistical relevance with mortality. Grading of EEG by the neurologist showed a positive association with neurological outcomes (p<0.001). Factors associated with good neurological outcome were VF/VT initial rhythm (p=0.005), cardiac cause of arrest (p=0.001), high initial body temperature (p<0.001), low APACHI II score (p=0.010), and shorter time interval between arrest from basic life support (p=0.005). CONCLUSION: In our study, the seizure group showed no relevance with mortality and prognosis. In hope of achieving a better outcome, careful treatment should be provided in cases of OHCA patients with seizure. Conduct of larger, prospective studies is needed.
Body Temperature ; Dinucleoside Phosphates ; Electroencephalography ; Heart Arrest ; Humans ; Hypothermia ; Male ; Out-of-Hospital Cardiac Arrest ; Prognosis ; Seizures

PURPOSE: Our goal was to compare resuscitation outcomes, 24 hour survival, and survival discharge between patients resuscitated with an AutoPulse compression device vs. those resuscitated using manual compression in adult, out-of-hospital non-traumatic cardiac arrest patients. METHODS:We retrospectively reviewed cases of out-of-hospital cardiac arrest that occurred between July 2005 and June 2008. We included, 267 non-traumatic patients who had. We compared characteristics between 93 patients who had AutoPulse compression and 174 patients who had manual compression. Characteristics included resuscitation outcomes (return of spontaneous circulation [ROSC], 24 hour survival and resuscitation outcomes according to the initial ECG. RESULTS: The rate of ROSC was 43.1% for AutoPulse compression and 50.57% for manual compression; the difference was not significant (p=0.294). Survival rates at 24 hours were, respectively, 33.3% and 31.6% (p=0.88). Survival discharge proportions were, 8.6% and 11.5%, respectively (p=0.599). CONCLUSION: There are no statistically significant differences in resuscitation outcomes between AutoPulse and manual compression in adult, out-of-hospital, non-traumatic, cardiac arrest patients.
Adult ; Cardiopulmonary Resuscitation ; Electrocardiography ; Heart Arrest ; Humans ; Out-of-Hospital Cardiac Arrest ; Resuscitation ; Retrospective Studies ; Survival Rate

It is unclear whether specific agent groups are associated with outcomes in cases of poisoning-induced out-of-hospital cardiac arrest (P-OHCA). The study population comprised cases of confirmed P-OHCA drawn from the national out-of-hospital cardiac arrest (OHCA) registry (2008–2013). Exposures were categorized into five groups according to the International Classification of Disease, 10th version: group 1, prescribed drugs; group 2, vapors and gases; group 3, pesticides; group 4, alcohol and organic solvents; and group 5, other poisons. The outcome was survival to discharge and good neurological recovery. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated to test the association between specific groups and outcomes. A total of 2,083 patients were analyzed; group 1 (10.3%), group 2 (23.6%), group 3 (52.9%), group 4 (1.4%), and group 5 (13.2%). The survival to discharge and good neurological recovery rates were 3.3%/1.3% for all patients, 10.3%/5.6% (group 1), 6.9%/3.4% (group 2), 2.4%/0.4% (group 3), 2.2%/1.0% (group 4), and 3.3%/2.4% (group 5) (all P < 0.001). The aORs (95% CIs) of groups 2–5 compared with group 1 for survival to discharge were 0.47 (0.09–2.51), 0.34 (0.17–0.68), 0.33 (0.14–0.77), and 0.31 (0.13–0.77), respectively. The odds ratios (95% CIs) for good neurological recovery were significant only in group 1, the pesticides group (0.07 [0.02–0.26]) and were not significant in the other groups. P-OHCA outcomes differed significantly among the poisoning agent groups. The pesticides group showed the worst outcomes, followed by the group of vapors or gases.
Classification ; Gases ; Heart Arrest ; Humans ; Odds Ratio ; Out-of-Hospital Cardiac Arrest* ; Pesticides ; Poisoning ; Poisons ; Solvents

Cardiac Arrest victims are increasing but EMS is not ready for them, in Korea. At this time, we need to know the exact status about the chain of survival of CPR and the outcome after out-of-hospital arrest. More than 90% of out-of-hospital arrest was witnessed, and about a half at home, but bystander CPR was done in only about 10%. EMS is activated by the unified phone number (119), but in only 1%, EMS was dispatched for CPR, nationwide. EMS responders were not educated and organized specific for CPR situation. BLS and equipped AED were not always utilized to whom needed. Pre-hospital ACLS were exceptionally done by first responder. Initial ECG findings, most of which were recorded at Hospital ED(more than 20 minutes after collapse), were VF/Pulseless VT(11-12%), Asystole(63-64%), and PEA(24-26%). Initial ROSC rate was 44-45%, and final Discharge Alive rate was 5-10%. The outcome of out-of-hospital arrest was dependent on bystander CPR and initial ECG finding. Most of lay-person are aware to CPR, but not adequately educated to do CPR when needed. We should organize the efforts to improve the quality of EMS and build up the education system of CPR nationwide, at now.
Cardiopulmonary Resuscitation* ; Education ; Electrocardiography ; Heart Arrest ; Korea* ; Out-of-Hospital Cardiac Arrest

PURPOSE: The purpose of this study was to provide an appropriate direction for cardiopulmonary resuscitation (CPR) education for laypersons by analyzing the status of CPR training, bystander CPR, and the prognosis of patients with out-of-hospital cardiac arrest (OHCA). METHODS: Data were obtained prospectively by interviews of bystanders who arrived with an OHCA patient between Jan 1, 2009 and Mar 31, 2010. Variables analyzed included CPR education, bystander CPR, and prognosis of OHCA patients. Multivariate logistic regression analysis was performed to identify independent factors for bystander CPR. RESULTS: Nineteen (33.9%) of 56 bystanders (male: 48.2%, age: 48.98+/-16.87) conducted CPR on an individual having an OHCA. Fourteen (25.0%) of the 56 had CPR education. Of the 14, 8 (57.1%) performed CPR. Among those who did not have any CPR training (p<0.05) 11 (26.2%) conducted it. In a multivariate regression analysis, younger age was a significant predictor for bystander CPR. Previous CPR training and male also appeared to be potential factors although their predictive value was not statistically significant. CONCLUSION: The rates of CPR training experience and bystander CPR were relatively low in this study. Younger age, male and previous CPR training were associated with the rate of bystander CPR, which is known as a critical factor influencing survival of OHCA patients. In order to increase survival of OHCA patients by raising the bystander CPR rate, systemic CPR education for laypersons should be established.
Cardiopulmonary Resuscitation ; Heart Arrest ; Humans ; Logistic Models ; Male ; Out-of-Hospital Cardiac Arrest ; Prognosis ; Prospective Studies

BACKGROUND: In cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program. METHODS: Data from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention. RESULTS: Of 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1–3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3–2.9 [1.6%]; 1.4–1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes. CONCLUSION: The nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.
Cardiopulmonary Resuscitation* ; Emergencies ; Heart Arrest ; Humans ; Male ; Odds Ratio ; Out-of-Hospital Cardiac Arrest* ; Survival Rate ; Telephone*