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Resuscitation. 2017 Apr;113:90-95. doi: 10.1016/j.resuscitation.2017.01.029. Epub 2017 Feb 13.

Out-of-hospital cardiac arrest (OHCA) attended by mobile emergency teams with a physician on board. Results of the Spanish OHCA Registry (OSHCAR).

Author information

1
Empresa Pública de Emergencias Sanitarias, Almería, Andalucía, Spain. Electronic address: frosell@al.epes.es.
2
Sistema Emergencies Mediques, Catalunya, Spain.
3
Hospital Virgen del Rocío, Sevilla, Andalucía, Spain.
4
Fundación Pública Urxencias Sanitarias 061, Galicia, Spain.
5
SUMMA112, Madrid, Spain.
6
Servicio de urgencias extrahospitalarias de Navarra, Navarra, Spain.
7
SAMU, Emergencias Sanitarias, Comunidad Valenciana, Spain.
8
SAMU 061 Baleares, Islas Baleares, Spain.
9
Servicio de Urgencias y Emergencias 061, La Rioja, Spain.
10
Emergentziak-Emergencias, Osakidetza, Euzkadi, Spain.
11
Emergencias Sanitarias, Castilla y León, Spain.
12
Servicio de Emergencias 061 Cantabria, Cantabria, Spain.
13
Servicio de Urgencias Canario, Islas Canarias, Spain.
14
SAMU-Asturias, Asturias, Spain.
15
061 e Instituto de Ciencias de la Salud, Aragón, Spain.
16
Emergencias sanitarias de Extremadura, Extremadura, Spain.
17
SAMUR Protección Civil, Madrid, Spain.
18
Servicio de Bomberos de Zaragoza, Aragón, Spain.
19
Servicio de Urgencias y Emergencias, Castilla La Mancha, Spain.
20
Servicio de Emergencias 061, Murcia, Spain.
21
Unidad de Cuidados Intensivos, Hospital Río Carrión, Palencia, Spain.
22
Empresa Pública de Emergencias Sanitarias, Andalucía, Spain.
23
Hospital el Toyo, Almería, Spain.

Abstract

Most survival outcomes in out-of-hospital cardiac arrest (OHCA) are provided by emergency medical services (EMS) without a doctor on board. Our objective was to determine such outcomes in a whole country with public physician-led EMS.

METHODS:

We analyzed data from a nationwide prospective registry of OHCA cases attended by 19 public EMS in Spain, covering the period from 1-October 2013 to 30-October 2014.

RESULTS:

Advanced life support (ALS) was initiated in 9347 cases (incidence 18.6 cases/105 inhabitants per year). Resuscitation was considered futile in 558 cases (5.9%), and ALS was continued in 8789 cases (94.1%); mean age 63.5±17 years, 72.1% men. Initial rhythm was shockable in 22.1% of cases. Basic life support (BLS) was provided by bystanders in 1602 (24%) cases (635 of them with telephone assistance from the dispatch center). Of 8789 patients receiving ALS, 72.1% men, 2669 (30.4%) patients had return of spontaneous circulation on hospital arrival, 50.6% when the initial rhythm was shockable. Hospital discharge with good neurological status (CPC1-2) was found in 11.1% of the study population and in 27.6% when considering the Utstein comparator group of patients. A total of 216 (2.5%) patients arrived at the hospital with ongoing resuscitation, of whom only one survived with CPC1-2, and 165 (1.9%) patients were included in non-heart-beating donation programs.

CONCLUSIONS:

In Spain with physician-led EMS, OHCA survival with CPC1-2 reached a reasonable percentage despite only a modest contribution of bystander BLS. Ongoing resuscitation strategy seems to be futile except when considering non-heart beating donation programs.

KEYWORDS:

Emergency medical services; Out-of-hospital cardiac arrest; Physician on board; Survival

[Indexed for MEDLINE]

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