Document Detail


Interruptions of chest compressions during emergency medical systems resuscitation.
MedLine Citation:
PMID:  16116053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Survival after nontraumatic out-of-hospital (OOH) cardiac arrest in Tucson, Arizona, has been flat at 6% (121/2177) for the decade 1992 to 2001. We hypothesized that interruptions of chest compressions occur commonly and for substantial periods during treatment of OOH cardiac arrest and could be contributing to the lack of improvement in resuscitation outcome. METHODS AND RESULTS: Sixty-one adult OOH cardiac arrest patients treated by automated external defibrillator (AED)-equipped Tucson Fire Department first responders from November 2001 through November 2002 were retrospectively reviewed. Reviews were performed according to the code arrest record and verified with the AED printout. Validation of the methodology for determining the performance of chest compressions was done post hoc. The median time from "9-1-1" call receipt to arrival at the patient's side was 6 minutes, 27 seconds (interquartile range [IQR, 25% to 75%], 5 minutes, 24 seconds, to 7 minutes, 34 seconds). An additional 54 seconds (IQR, 38 to 74 seconds) was noted between arrival and the first defibrillation attempt. Initial defibrillation shocks never restored a perfusing rhythm (0/21). Chest compressions were performed only 43% of the time during the resuscitation effort. Although attempting to follow the 2000 guidelines for cardiopulmonary resuscitation, chest compressions were delayed or interrupted repeatedly throughout the resuscitation effort. Survival to hospital discharge was 7%, not different from that of our historical control (4/61 versus 121/2177; P=0.74). CONCLUSIONS: Frequent interruption of chest compressions results in no circulatory support during more than half of resuscitation efforts. Such interruptions could be a major contributing factor to the continued poor outcome seen with OOH cardiac arrest.
Authors:
Terence D Valenzuela; Karl B Kern; Lani L Clark; Robert A Berg; Marc D Berg; David D Berg; Ronald W Hilwig; Charles W Otto; Daniel Newburn; Gordon A Ewy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-08-22
Journal Detail:
Title:  Circulation     Volume:  112     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-30     Completed Date:  2006-02-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1259-65     Citation Subset:  AIM; IM    
Affiliation:
Emergency Medicine Research Center, University of Arizona, Tucson, AZ, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiopulmonary Resuscitation*
Defibrillators*
Female
Heart Arrest / mortality
Humans
Male
Middle Aged
Retrospective Studies
Time Factors
Ventricular Fibrillation / therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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