Original Article

Results of Out-of-Hospital Cardiopulmonary Arrest Cases with Intervention by Lay Rescuers and Emergency Health Workers

10.5152/eajem.2016.79058

  • Mehmet Murat Oktay
  • Behçet Al
  • Suat Zengin
  • Şener Cindoruk
  • Mustafa Sabak
  • Mustafa Boğan
  • Cuma Yıldırım

Received Date: 22.12.2015 Accepted Date: 19.02.2016 Eurasian J Emerg Med 2016;15(1):7-14

Aim:

In this study, all interventions made by lay rescuers and health professionals and the shortcomings for cardiopulmonary arrest management outside the hospital were examined.

Materials and Methods:

The study was conducted between December 2012 and May 2014 in the Emergency Department of Gaziantep University. To ensure orderly and standardized records, a study form was prepared that consisted of 31 questions. The time and location of the cardiac arrest, information regarding the lay rescuers and professional health workers, and the practices followed during transport and at the emergency service were examined. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) for Windows software version 22.0, and p<0.05 was accepted as statistically significant.

Results:

Of the 205 cardiac arrests, 69.8% were male and 30.2% were female. The mean age in all of the cases was 58.34±19.1 years. The cardiac arrests mostly occurred in the home environment (62.4%) and happened between 13.00 and 20.00 hours (43.4%). The most frequent conditions that caused a worsening of the cases were syncope (unresponsiveness) (35.6%). The people who identified the cardiac arrest case and called for help by informing emergency health personnel (EHP) were mostly family members (50.7%). The activation time was 14.27±20.30 min. The time to arrive at the scene was 8.4±6.4 (1–35) min. Lay rescuers performed resuscitation in 19.5% of cases. The most frequent rhythms on the arrival of the EHP were asystole (74.1%). EHP evaluated the glaskow coma scale (GCS) of 88.3% of the cases as ≤7 at the scene. EHP performed basic life support (BLS) on all cases (100%) and endo-tracheal intubation (ETI) on 29.3% of the cases at the scene. The on-scene time and transport time to ED were 8.09±8.82 and 9.02±7.92 (1-50) min, respectively. The average duration of CPR at ED was 35.15±16.9 min. Of all the cases, 7.8% were discharged from intensive care unit (ICU) to homes. Of all the cases, 77.6% died at the ED, and 14.6% died in ICU.

Conclusion:

The intervention rate by lay rescuers was far less than the international rates. The survival rates were generally below the internationally reported rates. There is no adequate public awareness in our area for identifying cardiac arrest in patients and for initiating early chest compressions.

Keywords: Out-of-hospital cardiopulmonary arrest, lay rescuer, emergency health staff, emergency department, survive, mortality