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Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest is hampered by interruptions in chest compressions-A nationwide prospective feasibility study

Krarup, Niels Henrik; Terkelsen, Christian Juhl; Johnsen, Soren Paaske; Clemmensen, Peter; Olivecrona, Göran LU ; Hansen, Troels Martin; Trautner, Sven and Lassen, Jens Flensted (2011) In Resuscitation 82(3). p.263-269
Abstract
Aim of the study: Quality of cardiopulmonary resuscitation (CPR) is a critical determinant of outcome following out-of-hospital cardiac arrest. The aim of our study was to evaluate the quality of CPR provided by emergency medical service providers (Basic Life Support (BLS) capability) and emergency medical service providers assisted by paramedics, nurse anesthetists or physician-manned ambulances (Advanced Life Support (ALS) capability) in a nationwide, unselected cohort of out-of-hospital cardiac arrest cases. Methods: We conducted a prospective, observational study of out-of-hospital cardiac arrest with non-traumatic etiology (>18 years of age) occurring from the 1st to the 31st of January 2009 and treated by the primary Danish... (More)
Aim of the study: Quality of cardiopulmonary resuscitation (CPR) is a critical determinant of outcome following out-of-hospital cardiac arrest. The aim of our study was to evaluate the quality of CPR provided by emergency medical service providers (Basic Life Support (BLS) capability) and emergency medical service providers assisted by paramedics, nurse anesthetists or physician-manned ambulances (Advanced Life Support (ALS) capability) in a nationwide, unselected cohort of out-of-hospital cardiac arrest cases. Methods: We conducted a prospective, observational study of out-of-hospital cardiac arrest with non-traumatic etiology (>18 years of age) occurring from the 1st to the 31st of January 2009 and treated by the primary Danish emergency medical service operator, covering approximately 85% of the population. One hundred and ninety-one cases were eligible for analysis. Follow-up was up to one year or death. Quality of CPR was evaluated using measurements of transthoracic impedance. Results: The majority of patients were treated by ambulances with ALS capability (54%). Interruptions in CPR related to loading of the patient into the emergency medical service vehicle were substantial, but independent of whether patients were managed by ALS or BLS capable units (222s versus 224s, P=0.76) as were duration of interruptions during rhythm analysis alone (20s versus 22s, P=0.33) and defibrillation (24s versus 26s, P=0.07). Conclusions: Nationwide, routine monitoring of transthoracic impedance is feasible. CPR is hampered by extended interruptions, particularly during loading of the patient into the emergency medical service vehicle, rhythm analysis and defibrillation. (C) 2010 Elsevier Ireland Ltd. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Resuscitation, Heart arrest, Cardiopulmonary resuscitation
in
Resuscitation
volume
82
issue
3
pages
263 - 269
publisher
Elsevier
external identifiers
  • wos:000288417600006
  • scopus:79751524955
ISSN
1873-1570
DOI
10.1016/j.resuscitation.2010.11.003
language
English
LU publication?
yes
id
dd59dc1c-1cee-42c1-8484-4e3c1e24fd87 (old id 1926420)
date added to LUP
2011-05-02 08:19:33
date last changed
2017-09-03 03:08:14
@article{dd59dc1c-1cee-42c1-8484-4e3c1e24fd87,
  abstract     = {Aim of the study: Quality of cardiopulmonary resuscitation (CPR) is a critical determinant of outcome following out-of-hospital cardiac arrest. The aim of our study was to evaluate the quality of CPR provided by emergency medical service providers (Basic Life Support (BLS) capability) and emergency medical service providers assisted by paramedics, nurse anesthetists or physician-manned ambulances (Advanced Life Support (ALS) capability) in a nationwide, unselected cohort of out-of-hospital cardiac arrest cases. Methods: We conducted a prospective, observational study of out-of-hospital cardiac arrest with non-traumatic etiology (>18 years of age) occurring from the 1st to the 31st of January 2009 and treated by the primary Danish emergency medical service operator, covering approximately 85% of the population. One hundred and ninety-one cases were eligible for analysis. Follow-up was up to one year or death. Quality of CPR was evaluated using measurements of transthoracic impedance. Results: The majority of patients were treated by ambulances with ALS capability (54%). Interruptions in CPR related to loading of the patient into the emergency medical service vehicle were substantial, but independent of whether patients were managed by ALS or BLS capable units (222s versus 224s, P=0.76) as were duration of interruptions during rhythm analysis alone (20s versus 22s, P=0.33) and defibrillation (24s versus 26s, P=0.07). Conclusions: Nationwide, routine monitoring of transthoracic impedance is feasible. CPR is hampered by extended interruptions, particularly during loading of the patient into the emergency medical service vehicle, rhythm analysis and defibrillation. (C) 2010 Elsevier Ireland Ltd. All rights reserved.},
  author       = {Krarup, Niels Henrik and Terkelsen, Christian Juhl and Johnsen, Soren Paaske and Clemmensen, Peter and Olivecrona, Göran and Hansen, Troels Martin and Trautner, Sven and Lassen, Jens Flensted},
  issn         = {1873-1570},
  keyword      = {Resuscitation,Heart arrest,Cardiopulmonary resuscitation},
  language     = {eng},
  number       = {3},
  pages        = {263--269},
  publisher    = {Elsevier},
  series       = {Resuscitation},
  title        = {Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest is hampered by interruptions in chest compressions-A nationwide prospective feasibility study},
  url          = {http://dx.doi.org/10.1016/j.resuscitation.2010.11.003},
  volume       = {82},
  year         = {2011},
}