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186 Absiracts
POSTER PRESENTATIONS
PRE-HOSPITAL CARDIAC ARRESTS A TWO YEAR EXPERIENCE
Km!@ca@ntandDrRichanlRuasell Gmmwieh District Ho@al, Greawieh, Londnn, UK
Mark Whitbread - Resuscitation Service, The Royal London Hospital, London, ENGLAND.
[email protected]~thas beUlrhowninsurvivrlillthapprt15~dCspitCiflteXaalioaal guid&aandextalalvetrabdagin&mucedlifcsupport.wepreaalt thedatac&ctadoverr12nnmthpuiodiarbusyhospimlwith2fidl tilllC~tl8il&gof&CZsMdoW1OOALsprovidas. Mathabzovcr1ycafdatawaspmspeuivclyc&ctedusiagaudit fcmlr. Dltawasaltedofltos dathse@I Info V.5). Dab3 was slrplyadot3survivp1Lnnls1)Rehunofcirculption,2)sunivplpt24 holmalld3)sluvivaltodiachprge. RCUYI: 338 evmts were studied of which 255 were true cardiac amats.nlerewasnoslgniflcmtdifferalceinsluvivalheIweathe suea. llwe was comlatiof~ between age and outcome, youoger patiam surviving melt oh to discharge. Length of reauscitatioo (LOR) was invanely &ted to outcome. Mean LOR for survival to dischqe was 2.3mins. Analysis by location of aneat revealed that thUK!wUPSlUViVdXlWUlt3gCtOdiSChiUgCftWllClitiCdUlCSZt?a.%. Aaalysisforauvivalbyplescntingarrhythmia~ealedthat unmonitcred arrests and VIVPVT arrests have a significantly better cutannethaftdtherEMDoriisyst4liearmts.Outcofneatcardiac arrc3t was aig&iemtIy better if a rEalsAtation offleer was plxsent. condplbn: This study amtinns prevlow deaaiptive work on in
hospital czudiac aneat. It pmvidcs fwther insight into mechanism of arrest and lntuventlmts that are mlly life saving. This study suggests Ihat early defibrillation sod effeclive CPR are viral for good outcome in cardiac meat. For sun&d to discharge msuscitativa effort must be brief sod efficpciou. We discuss the need for further prospective chical trlds into intava~tionr at cardiac anest. Further data and analysis is forthcoming.
la aal, Icsll8 rrrlly naltb authority lmtb U.K.
The Royal London Hospital is situated in the East End of London and serves s population of approximately 250,000, which is largely made up of the residents of Tower Hamlets.
The Hospital deals with some 700 cardiac arrests annually. 25% of these calls a~ to the Accident & Emergency Department to deal with conllnned pm-hospital cardiac arrests.
Traditionally the management of pre-hospital cardii arrests sre dealt with by the Emergency Medical Services. In Tower Hamlets this is provided by the. London Ambulance Service. The total number of wnfhmed cardiac arrests reported on horn the 1st of January 1995 until the3lstofDecember19%was371,ofwhich267wezemaIesnd104 female. Data was collected using the Utstein template for x-porting confirmed pre-hospital cardiac arrests. The presenting ECG rhytbm io 213 was asystole, of which there were no survivors. Of the patients who presented in ventricular fibrillation, there were 4 survivors to discharge home.
We need to seek ways of improving the pre-hospital maoagement of cardiac arrest, with the major focus being on the wider distribution of defibrillators. This way increasing the number of neurologically intact long-term patients, while avoiding distress to patients and their relatives.
c!0bfP.4msoN OF m- 6mlNoEs AND -MlNuEls- IN CPR
