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

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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; Hansen, Troels Martin; Trautner, Sven; Lassen, Jens Flensted.

I: Resuscitation, Vol. 82, Nr. 3, 2011, s. 263-269.

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Krarup, Niels Henrik ; Terkelsen, Christian Juhl ; Johnsen, Soren Paaske ; Clemmensen, Peter ; Olivecrona, Göran ; Hansen, Troels Martin ; Trautner, Sven ; Lassen, Jens Flensted. / Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest is hampered by interruptions in chest compressions-A nationwide prospective feasibility study. I: Resuscitation. 2011 ; Vol. 82, Nr. 3. s. 263-269.

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TY - JOUR

T1 - Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest is hampered by interruptions in chest compressions-A nationwide prospective feasibility study

AU - Krarup, Niels Henrik

AU - Terkelsen, Christian Juhl

AU - Johnsen, Soren Paaske

AU - Clemmensen, Peter

AU - Olivecrona, Göran

AU - Hansen, Troels Martin

AU - Trautner, Sven

AU - Lassen, Jens Flensted

PY - 2011

Y1 - 2011

N2 - 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.

AB - 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.

KW - Resuscitation

KW - Heart arrest

KW - Cardiopulmonary resuscitation

U2 - 10.1016/j.resuscitation.2010.11.003

DO - 10.1016/j.resuscitation.2010.11.003

M3 - Article

VL - 82

SP - 263

EP - 269

JO - Resuscitation

JF - Resuscitation

SN - 1873-1570

IS - 3

ER -