1.Study on the factors related to not attempting resuscitation for out-of-hospital cardiac arrest
Nan HU ; Sijia TIAN ; Luxi ZHANG ; Shengmei NIU ; Xuqin KANG ; Huixin LIAN ; Jing LOU ; Jinjun ZHANG
Chinese Journal of Emergency Medicine 2023;32(9):1195-1199
Objective:To explore the epidemiological factors of patients with OHCA who did not attempt CPR, and analyze the reasons and clinical features of non resuscitation.Methods:Data from OHCA patients who did not undergo CPR were collected from January 2020 to December 2020 at Beijing Emergency Medical Center. The registration form was designed according to the Utstein model, and the data were analyzed retrospectively by the chi-square test.Results:A total of 5 977 patients were enrolled and divided into two groups according to age: 2 349 patients aged ≤ 80 years old and 3 628 patients aged ≥ 81 years old. Compared with the younger group, the proportion of patients in the older group who did not undergo CPR due to disease (97.0%) and family desertion (99.4%) were higher, and the difference was statistically significant (both P<0.01). Conclusions:Elderly people over 80 years old with underlying diseases have a high probability of developing OHCA at home. Most of the witnesses at the scene were family members and could not implement CPR in time. After the emergency personnel arrived at the scene, they found that the patient had been in cardiac arrest for too long and had apparently died. Family members would choose to give up treatment.
2.Epidemiology and clinical characteristics of poisoning induced cardiac arrest in Beijing
Qingkai MENG ; Sijia TIAN ; Xuqin KANG ; Luqian ZHANG ; Shengmei NIU ; Huixin LIAN ; Jinjun ZHANG
Chinese Journal of Emergency Medicine 2023;32(11):1486-1489
Objective:To analyze the clinical characteristics of patients with cardiac arrest caused by poisoning, explore the differences in the corresponding emergency measures and emergency effects under different causes of poisoning, and improve the success rate of out-of-hospital cardiac arrest rescue.Methods:All out-of-hospital toxic cardiac arrest patients admitted to Beijing Emergency Medical Center from January 2021 to December 2021 were retrospectively included.Results:A total of 38 patients with a median age of 43 years, including 26(68.4%) were male. There were 20 cases of acute alcoholism (52.6%), and 9 (23.7%) cases of carbon monoxide and drug poisoning respectively. In 38 cases, only 2 cases achieved return of spontaneous circulation, and no cases survived more than 24 hours.Conclusions:Poisoning induced cardiac arrest is one of the non-cardiac causes of out-of-hospital cardiac arrest, responsible for 1.7%. Alcoholism is the main poisoning cause of noncardiac out-of-hospital cardiac arrest in Beijing, prevent the poisoning and quickly identify the cause of the poisoning and give the correct rescue measures is very important for cardiac arrest.
3.Comparative study on clinical characteristics of cardiogenic and non-cardiogenic cardiac arrest patients out-of-hospital based on Utstein style
Wei ZHANG ; Sijia TIAN ; Luxi ZHANG ; Xuqin KANG ; Shengmei NIU ; Yang LIU ; Jinjun ZHANG
Chinese Journal of Emergency Medicine 2024;33(1):28-32
Objective:To analyze the causes of out-of-hospital cardiac arrest (OHCA) and the differences in outcomes of pre-hospital first-aid measures and cardiopulmonary resuscitation for different etiologies, improved the success rate of rescue.Methods:A retrospective study was conducted on OHCA patients admitted to Beijing Emergency Medical Centre from January to December 2021. The pre-hospital emergency medical records and rescue results within medical institutions were collected. Compared the basic situation between patients with cardiogenic and non-cardiogenic cardiac arrest, the differences of rescue measures and CPR outcomes between the groups were compared by non-parametric test and χ 2 test. Results:A total of 7 517 patients were included in this study. Cardiogenic arrest patients were older, more underlying diseases (84.2%), and cardiac arrest mainly occurred at home. The cause of non-cardiogenic arrest included disease (85.1%), trauma (2.9%), suicide (5.0%), traffic accidents (1.7%), poisoning (1.1%), and so on. In terms of first-aid measures, after the emergency doctor arrived at the scene, the proportion of first-aid measures used for cardiogenic patients was high (22.3%), and the first aid measures include cardiopulmonary resuscitation, tracheal intubation, defibrillation, oxygen inhalation, injection of adrenaline and use of other drugs. All the proportions of first-aid measures for cardiogenic patients were significantly higher than non-cardiogenic patients (all P<0.001). In terms of clinical outcomes, there were no statistical differences in return of spontaneous circulation ( P=0.072) and 24-hour survival ( P=0.093) between cardiogenic and non-cardiogenic patients. Conclusions:Cardiogenic cardiac arrest was the main cause of OHCA. Cardiogenic arrest patients were more underlying diseases, and older in age, the main clinical feature was onset at home. The comprehensive treatment measures for pre-hospital first-aid cardiac arrest should continue to be strengthened to improve the success rate of rescue for OHCA.