The significance of pre-arrest factors in out-of-hospital cardiac arrests witnessed by emergency medical services: a report from the Victorian Ambulance Cardiac Arrest Registry

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Abstract

Background The significance of pre-arrest factors in out-of-hospital cardiac arrests (OHCA) witnessed by emergency medical services (EMS) is not well established. The purpose of this study was to assess the association between prodromal symptoms and pre-arrest clinical observations on the arresting rhythm and survival in EMS witnessed OHCA. Methods Between 1st January 2003 and 31st December 2011, 1056 adult EMS witnessed arrests of a presumed cardiac aetiology were identified from the Victorian Ambulance Cardiac Arrest Registry. Pre-arrest prodromal features and clinical characteristics were extracted from the patient care record. Backward elimination logistic regression was used to identify pre-arrest factors associated with an initial shockable rhythm and survival to hospital discharge. Results The median age was 73.0 years, 690 (65.3 ) were male, and the rhythm of arrest was shockable in 465 (44.0 ) cases. The most commonly reported prodromal symptoms prior to arrest were chest pain (48.8 ), dyspnoea (41.8 ) and altered consciousness (37.8 ). An unrecordable systolic blood pressure was observed in 34.4 , a respiratory rate 24 min-1 was present in 43.1 , and 45.5 had a Glasgow coma score
Original languageEnglish
Pages (from-to)35 - 42
Number of pages8
JournalResuscitation
Volume88
DOIs
Publication statusPublished - 2015

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