Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia

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Abstract

Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8 ) occurring in a RACF. A shockable rhythm was present in 179 (7.6 ) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66 ); 173 (97 ) received an EMS attempted resuscitation. ROSC was achieved in 71 (41 ) patients and 15 (8.7 ) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92 ) of whom 804 (37 ) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22 ) and 10 patients (1.2 ) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8 vs. 4.7 , p = 0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95 CI 2.4a??3.7) and the presence of bystander CPR (OR 4.6, 95 CI 3.7a??5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.
Original languageEnglish
Pages (from-to)58 - 62
Number of pages5
JournalResuscitation
Volume83
Issue number1
DOIs
Publication statusPublished - 2012

Cite this

@article{04517eb67dda40b6bd0c0682518d4b22,
title = "Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia",
abstract = "Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8 ) occurring in a RACF. A shockable rhythm was present in 179 (7.6 ) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66 ); 173 (97 ) received an EMS attempted resuscitation. ROSC was achieved in 71 (41 ) patients and 15 (8.7 ) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92 ) of whom 804 (37 ) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22 ) and 10 patients (1.2 ) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8 vs. 4.7 , p = 0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95 CI 2.4a??3.7) and the presence of bystander CPR (OR 4.6, 95 CI 3.7a??5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.",
author = "Conor Deasy and Janet Bray and Smith, {Karen Louise} and Linton Harriss and Stephen Bernard and Patricia Davidson and Peter Cameron",
year = "2012",
doi = "10.1016/j.resuscitation.2011.06.030",
language = "English",
volume = "83",
pages = "58 -- 62",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia

AU - Deasy, Conor

AU - Bray, Janet

AU - Smith, Karen Louise

AU - Harriss, Linton

AU - Bernard, Stephen

AU - Davidson, Patricia

AU - Cameron, Peter

PY - 2012

Y1 - 2012

N2 - Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8 ) occurring in a RACF. A shockable rhythm was present in 179 (7.6 ) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66 ); 173 (97 ) received an EMS attempted resuscitation. ROSC was achieved in 71 (41 ) patients and 15 (8.7 ) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92 ) of whom 804 (37 ) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22 ) and 10 patients (1.2 ) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8 vs. 4.7 , p = 0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95 CI 2.4a??3.7) and the presence of bystander CPR (OR 4.6, 95 CI 3.7a??5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.

AB - Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8 ) occurring in a RACF. A shockable rhythm was present in 179 (7.6 ) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66 ); 173 (97 ) received an EMS attempted resuscitation. ROSC was achieved in 71 (41 ) patients and 15 (8.7 ) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92 ) of whom 804 (37 ) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22 ) and 10 patients (1.2 ) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8 vs. 4.7 , p = 0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95 CI 2.4a??3.7) and the presence of bystander CPR (OR 4.6, 95 CI 3.7a??5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.

UR - http://www.ncbi.nlm.nih.gov/pubmed/21756967

U2 - 10.1016/j.resuscitation.2011.06.030

DO - 10.1016/j.resuscitation.2011.06.030

M3 - Article

VL - 83

SP - 58

EP - 62

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

IS - 1

ER -