Evaluating the quality of prehospital cardiopulmonary resuscitation by reviewing automated external defibrillator records and survival for out-of-hospital witnessed arrests

Patrick Chow In Ko, Wen Jone Chen, Chih Hao Lin, Matthew Huei Ming Ma, Fang Yue Lin

研究成果: Article同行評審

62 引文 斯高帕斯(Scopus)

摘要

Without an easy method to monitor the performance of prehospital cardiopulmonary resuscitation (CPR), earlier studies have not been able to assess the quality of CPR. In this study, we have used a new approach to evaluate prehospital CPR performance and the impact on outcome using data retrieved from the automatic external defibrillators (AED). Electrocardiography (ECG) and voice records from AED data cards from 633 out-of-hospital cardiac arrests (OHCA) were reviewed. Fifty-two witnessed cardiac arrests in ventricular fibrillation (VF) requiring post-shock CPR underwent an independent, structured review by two physicians. The adequacy of prehospital CPR was defined on the basis of noticeable deflection of the ECG with chest compressions, the actual number of chest compressions delivered per minute, and the continuity of prehospital CPR at the scene and during transport. Outcome measures included return of spontaneous circulation (ROSC) and survival to hospital admission and discharge. The quality of prehospital CPR was judged as adequate in 15 (29%, 95%; CI: 18-42%) and inadequate in 37 (71%, 95%; CI: 58-82%) of the consensus. Adequate CPR performance resulted in a higher rate of ROSC at the scene (53% versus 8%, 95% CI of the difference 14-76%), and survival to hospital discharge (53% versus 8%, 95% CI of the difference 14-76%). Two reviewers agreed on whether CPR was adequate in 92.3% of cases, with a kappa of 0.82. The quality of prehospital CPR is associated with a greater likelihood of survival in witnessed VF arrests in need of post-shock CPR. The potential of widely available electrocardiography and voice records in AEDs in providing a convenient and real-time evaluation of prehospital CPR should be explored further.

原文English
頁(從 - 到)163-169
頁數7
期刊Resuscitation
64
發行號2
DOIs
出版狀態Published - 2005 二月

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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