Traumatic out-of-hospital cardiac arrests in Melbourne, Australia
Introduction: Many consider attempted resuscitation for traumatic out-of-hospital cardiac arrest (OHCA) futile. This study aims to describe the characteristics and profile of adult traumatic OHCA. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all trauma relate...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
2012
|
| Online Access: | http://hdl.handle.net/20.500.11937/26695 |
| _version_ | 1848752059651719168 |
|---|---|
| author | Deasy, C. Bray, Janet Smith, K. Harriss, L. Morrison, C. Bernard, S. Cameron, P. |
| author_facet | Deasy, C. Bray, Janet Smith, K. Harriss, L. Morrison, C. Bernard, S. Cameron, P. |
| author_sort | Deasy, C. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Introduction: Many consider attempted resuscitation for traumatic out-of-hospital cardiac arrest (OHCA) futile. This study aims to describe the characteristics and profile of adult traumatic OHCA. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all trauma related cases of OHCA in patients aged =16 years. Results: Between 2000 and 2009, EMS attended 33,178 OHCAs of which 2187 (6.6%) had a traumatic aetiology. The median age (IQR) of traumatic OHCA cases was 36 (25-55) years and 1612 were male (77.5%). Bystander CPR was performed in 201 cases (10.2%) with median (IQR) EMS response time 8 (6-11). min. The first recorded rhythm by EMS was asystole seen in 1650 (75.4%), PEA in 294 (13.4%) cases and VF in 35 cases (1.6%). Cardiac output was present in 208 (9.5%) cases who subsequently had an EMS witnessed OHCA. EMS attempted resuscitation in 545 (24.9%) patients of whom 84 (15.4%) achieved ROSC and were transported, and 27 (5.1%) survived to hospital discharge; 107 were transported with CPR of whom 8 (7.4%) survived to hospital discharge. Where EMS attempted resuscitation in traumatic OHCAs, survival for VF was 11.8% (n= 4), PEA 5.1% (n= 10) and asystole 2.4% (n= 3). In EMS witnessed traumatic OHCA, resuscitation was attempted in 175 cases (84.1%), 35 (16.8%) patients achieved sustained ROSC before transport of whom 5 (14%) survived to leave hospital and 60 (28.8%) were transported with CPR of whom 6 (10%) survived to leave hospital. Compared to OHCA cases with 'presumed cardiac' aetiology traumatic OHCAs were younger [median years (IQR): 36 (25-55) vs 74 (61-82)], had resuscitation attempted less (25% vs 48%), were less likely to have a shockable rhythm (1.6% vs 17.1%), were more likely to be witnessed (62.8% vs 38.1%) and were less likely to receive bystander CPR (10.2% vs 25.5%) (p< 0.001, respectively). Multivariate logistic regression identified factors associated with EMS decision to attempt resuscitation. The odds ratio [OR (95% CI)] for 'presence of bystander CPR' was 5.94 (4.11-8.58) and for 'witnessed arrest' was 2.60 (1.86-3.63). Conclusion: In this paramedic delivered EMS attempted resuscitation was not always futile in traumatic OHCA with a survival of 5.1%. The quality of survival needs further study. © 2011 Elsevier Ireland Ltd. |
| first_indexed | 2025-11-14T08:02:36Z |
| format | Journal Article |
| id | curtin-20.500.11937-26695 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T08:02:36Z |
| publishDate | 2012 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-266952017-09-13T15:28:49Z Traumatic out-of-hospital cardiac arrests in Melbourne, Australia Deasy, C. Bray, Janet Smith, K. Harriss, L. Morrison, C. Bernard, S. Cameron, P. Introduction: Many consider attempted resuscitation for traumatic out-of-hospital cardiac arrest (OHCA) futile. This study aims to describe the characteristics and profile of adult traumatic OHCA. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all trauma related cases of OHCA in patients aged =16 years. Results: Between 2000 and 2009, EMS attended 33,178 OHCAs of which 2187 (6.6%) had a traumatic aetiology. The median age (IQR) of traumatic OHCA cases was 36 (25-55) years and 1612 were male (77.5%). Bystander CPR was performed in 201 cases (10.2%) with median (IQR) EMS response time 8 (6-11). min. The first recorded rhythm by EMS was asystole seen in 1650 (75.4%), PEA in 294 (13.4%) cases and VF in 35 cases (1.6%). Cardiac output was present in 208 (9.5%) cases who subsequently had an EMS witnessed OHCA. EMS attempted resuscitation in 545 (24.9%) patients of whom 84 (15.4%) achieved ROSC and were transported, and 27 (5.1%) survived to hospital discharge; 107 were transported with CPR of whom 8 (7.4%) survived to hospital discharge. Where EMS attempted resuscitation in traumatic OHCAs, survival for VF was 11.8% (n= 4), PEA 5.1% (n= 10) and asystole 2.4% (n= 3). In EMS witnessed traumatic OHCA, resuscitation was attempted in 175 cases (84.1%), 35 (16.8%) patients achieved sustained ROSC before transport of whom 5 (14%) survived to leave hospital and 60 (28.8%) were transported with CPR of whom 6 (10%) survived to leave hospital. Compared to OHCA cases with 'presumed cardiac' aetiology traumatic OHCAs were younger [median years (IQR): 36 (25-55) vs 74 (61-82)], had resuscitation attempted less (25% vs 48%), were less likely to have a shockable rhythm (1.6% vs 17.1%), were more likely to be witnessed (62.8% vs 38.1%) and were less likely to receive bystander CPR (10.2% vs 25.5%) (p< 0.001, respectively). Multivariate logistic regression identified factors associated with EMS decision to attempt resuscitation. The odds ratio [OR (95% CI)] for 'presence of bystander CPR' was 5.94 (4.11-8.58) and for 'witnessed arrest' was 2.60 (1.86-3.63). Conclusion: In this paramedic delivered EMS attempted resuscitation was not always futile in traumatic OHCA with a survival of 5.1%. The quality of survival needs further study. © 2011 Elsevier Ireland Ltd. 2012 Journal Article http://hdl.handle.net/20.500.11937/26695 10.1016/j.resuscitation.2011.09.025 restricted |
| spellingShingle | Deasy, C. Bray, Janet Smith, K. Harriss, L. Morrison, C. Bernard, S. Cameron, P. Traumatic out-of-hospital cardiac arrests in Melbourne, Australia |
| title | Traumatic out-of-hospital cardiac arrests in Melbourne, Australia |
| title_full | Traumatic out-of-hospital cardiac arrests in Melbourne, Australia |
| title_fullStr | Traumatic out-of-hospital cardiac arrests in Melbourne, Australia |
| title_full_unstemmed | Traumatic out-of-hospital cardiac arrests in Melbourne, Australia |
| title_short | Traumatic out-of-hospital cardiac arrests in Melbourne, Australia |
| title_sort | traumatic out-of-hospital cardiac arrests in melbourne, australia |
| url | http://hdl.handle.net/20.500.11937/26695 |