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

Out-of-hospital Cardiac Arrest ; Heart Arrest ; Policy ; Covid-19 ; Pandemics

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

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

INTRODUCTION

Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7 – 10%. It is crucial that CPR be initiated within 4 – 6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes.

This descriptive study was done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-ofhospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics was used to summarize the demographic and clinical characteristics of the patients.

Forty-three subjects were male patients, comprising the majority at 73.02%. Hypertension was identified as the top comorbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received prehospital intervention before ER arrival, comprising only hands-on CPR. Twenty-three of these were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to
ER arrival is 20 minutes.

Overall survival of OHCA in our local setting remains dismal, as the return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

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: 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

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

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