ATLANTA -- Ask anyone who ran Monday's AJC Peachtree Road Race: it was a scorcher.
The hot weather meant Grady Hospital EMT's transporting more than twice as many patients as usual from the race. The scariest case? A man that had cardiac arrest just short of the finish line.
On the corner of 10th and Piedmont, one of the more active corners of an always-active course track, a middle-aged man collapsed on the street at 10:30 in the morning.
"The bike medic was there within a minute," said Michael Colman, operations manager for Grady EMS.
The bike medics are a group of Grady Hospital EMTs who volunteer to help during the race. They carry all the necessary emergency equipment and, in a packed race like the Peachtree, often get to spots faster than an ambulance.
Said Colman, "It really helps us to be able to basically get a mini-ambulance to the patient."
This patient was having cardiac arrest. Within minutes, medics brought out a defibrillator and attempted to revive him.
It worked.
"The entire crowd started cheering," said runner Ryan Watton, who witnessed the whole thing. "He was put on the stretcher; he raised his arms just to let everyone know, 'I'm OK'."
At 11Alive News we received numerous responses from eyewitnesses and concerned residents who wanted to know if the man who collapsed was still OK. Good news: he is. According to race officials, he was undergoing tests early Tuesday but was "doing fine."
When you see a cardiac arrest, your brain fights you - "No, this isn't really happening" - and the circumstances fight you - "Dang! in CPR class the manikin didn't weigh very much and wasn't sitting in a deep chair. This blog deals with practical details and presents reports of "saves." Let me have your questions and comments - they will steer the course of this blog. This blog is brought to you by the volunteers at www.slicc.org
Tuesday, July 5, 2011
Friday, July 1, 2011
When this sort of thing stops being NEWS, we will be where we need to be!
Lifeguards save boy in Quincy pool
E-mail| Print | Comments (0) July 1, 2011 8:38 PM
By Neal J. Riley, Globe Correspondent
A Quincy boy who stopped breathing while at his swim class today was revived by lifeguards who pulled him from the water and performed CPR, town officials said.
The boy, who police said was 13, was in the highest-level swim class at the Lincoln-Hancock Community School in Quincy when he lost consciousness in the water at about 1 p.m., according to Christopher Walker, spokesman for Quincy Mayor Thomas Koch.
About 45-50 youths were in the pool at the time, watched by 14 lifeguards, Walker said.
It appears that the near-drowning of the boy, who was taken to Children’s Hospital Boston, was the result of a medical condition, Quincy Recreation Director Barry Welch said. The unidentified boy apparently tried to stand up in the shallow end and fell backward onto another swimmer, Welch said.
Lifeguard Joseph Benoit, 20, said in a telephone interview that the class was wrapping up when some of the students, who range from 10 to 15 years old, alerted him that the boy was bleeding from the mouth and sinking under the water near the side of the pool. He and another lifeguard pulled the boy out and immediately began CPR with lifeguard Julie Kisielius, 21.
“I’ve done it hundreds and hundreds of times on the dummies but this is the first time I’ve done it on a human,” said Benoit, a junior studying civil engineering at the University of Massachusetts Lowell.
Benoit said he did not initially detect a pulse from the boy and estimated that two minutes went by before he was revived, a situation that had everyone “a little scared.”
“As far as the nerves, the nerves are still real,” Benoit said tonight.
The pool’s on-site supervisor, Benoit said he had just been recertified in CPR two weeks ago. He has been a lifeguard at the pool for five summers.
“The proper training helped out with everything and made it go smoothly,” he said.
About 750 children take lessons at the pool during the summer, Welch said.
“They were as cool as can be, it was textbook,” Welch said of the lifeguards, who are all trained by the American Red Cross. “All the training that you put into these situations, it’s nice to see that the young people respond as they’re trained to do.”
“I think it’s fair to say that they saved this kid’s life,” Walker said. “At the very least they prevented a tragedy.”
Benoit said he was just happy that the boy was OK.
“Hopefully we’ll see him again for future lessons,” he said.
E-mail| Print | Comments (0) July 1, 2011 8:38 PM
By Neal J. Riley, Globe Correspondent
A Quincy boy who stopped breathing while at his swim class today was revived by lifeguards who pulled him from the water and performed CPR, town officials said.
The boy, who police said was 13, was in the highest-level swim class at the Lincoln-Hancock Community School in Quincy when he lost consciousness in the water at about 1 p.m., according to Christopher Walker, spokesman for Quincy Mayor Thomas Koch.
About 45-50 youths were in the pool at the time, watched by 14 lifeguards, Walker said.
It appears that the near-drowning of the boy, who was taken to Children’s Hospital Boston, was the result of a medical condition, Quincy Recreation Director Barry Welch said. The unidentified boy apparently tried to stand up in the shallow end and fell backward onto another swimmer, Welch said.
Lifeguard Joseph Benoit, 20, said in a telephone interview that the class was wrapping up when some of the students, who range from 10 to 15 years old, alerted him that the boy was bleeding from the mouth and sinking under the water near the side of the pool. He and another lifeguard pulled the boy out and immediately began CPR with lifeguard Julie Kisielius, 21.
“I’ve done it hundreds and hundreds of times on the dummies but this is the first time I’ve done it on a human,” said Benoit, a junior studying civil engineering at the University of Massachusetts Lowell.
Benoit said he did not initially detect a pulse from the boy and estimated that two minutes went by before he was revived, a situation that had everyone “a little scared.”
“As far as the nerves, the nerves are still real,” Benoit said tonight.
The pool’s on-site supervisor, Benoit said he had just been recertified in CPR two weeks ago. He has been a lifeguard at the pool for five summers.
“The proper training helped out with everything and made it go smoothly,” he said.
About 750 children take lessons at the pool during the summer, Welch said.
“They were as cool as can be, it was textbook,” Welch said of the lifeguards, who are all trained by the American Red Cross. “All the training that you put into these situations, it’s nice to see that the young people respond as they’re trained to do.”
“I think it’s fair to say that they saved this kid’s life,” Walker said. “At the very least they prevented a tragedy.”
Benoit said he was just happy that the boy was OK.
“Hopefully we’ll see him again for future lessons,” he said.
Warrington man thanks police, firemen for saving his life
Posted: Friday, July 1, 2011 2:27 pm | Updated: 3:20 pm, Fri Jul 1, 2011.
By Rich Pietras Staff Writer | 0 comments
Warrington police and fire personnel were recognized this week at the board of supervisors meeting - and by the man they helped saved - after responding to a call on the evening of April 29.
After 59-year-old Pine Code Road resident Chris Opdyke went into cardiac arrest, his wife Pat called 911. After Pat started CPR, police and firemen arrived and used an automated external defibrillators (AED) machine before Medics from Central Bucks Ambulance arrived.
By Rich Pietras Staff Writer | 0 comments
Warrington police and fire personnel were recognized this week at the board of supervisors meeting - and by the man they helped saved - after responding to a call on the evening of April 29.
After 59-year-old Pine Code Road resident Chris Opdyke went into cardiac arrest, his wife Pat called 911. After Pat started CPR, police and firemen arrived and used an automated external defibrillators (AED) machine before Medics from Central Bucks Ambulance arrived.
Good Guys 1, Commotio Cordis 0
Two honored as destiny leads to a life saved
HEROES — Rome Free Academy lacrosse coaches Guy Calandra, left, and Jeremy Roberts, were honored by the Board of Education Wednesday night for helping save the life of a lacrosse player in Onondaga County on June 15. (Sentinel photo by Lindsay A. Mogle)
Rome Free Academy varsity lacrosse coach Jeremy Roberts believes his entire life may have been leading to the day he was able to use all of his training and skills to help save the life of one of his players.
"As I look back at it, God has a plan and he puts people in places for certain reasons," said Roberts, age 36. "He took 20 years to get me ready for that one day, in my opinion."
Roberts and fellow RFA coach Guy Calandra used their CPR training to help keep Jamesville-DeWitt sophomore Daniel Cochran alive after he took a hard ball to the chest on June 15 in Onondaga County. The two coaches kept pumping and breathing until a defibrillator was carried out onto the field and shocked the teen back to life.
Roberts said he first learned CPR as a life guard at age 16, and then leaned how to deal with crisis situations when he served in the Marines. He also became a certified CPR trainer with the Red Cross a few years ago, and has to know first aid as a coach.
"I was put on that field on that day," Roberts said. God "put me there to save Danny’s life."
Roberts and Calandra were honored for their life-saving efforts by the Rome Board of Education Wednesday night. But both men said they don’t deserve all the credit.
"Everybody did things right on cue, nobody panicked. A lot of people did everything right," said Calandra. "It’s pretty traumatic, thinking back; what he looked like, what could have happened."
Cochran was one of 55 players trying out for the Nike Upstate Rising lacrosse competition on June 15 at the Fayetteville-Manlius High School in Onondaga County. Roberts and Calandra had been chosen in October to coach the sophomore Upstate Rising team. Calandra said he was about five feet away when Cochran, playing defense, turned into a shot from one of the offensive players. The ball hit Cochran in the left side of his chest, just below his padding.
"He yelled and he took a few steps and he fell face first," Calandra said. He knelt down to check on Cochran, but was getting no response. So he yelled across the field for Roberts.
"The first time he yelled to me, I thought he was just trying to get my attention," Roberts stated. "He yelled again and I could tell from the pitch of his voice...that something was seriously wrong."
Roberts joined Calandra at Cochran’s side, and as they checked the boy they determined he wasn’t breathing and didn’t have a pulse.
"We just looked at each other and we knew within seconds that he didn’t have a pulse, so we started CPR," Calandra said. He started chest compressions and Roberts started breathing. Calandra said they went through two cycles of CPR before a registered nurse came to the field and took over.
Calandra said he called Cochran’s parents and called 9-1-1 as athletic director Cyndi Kelder came to the field with the defibrillator and shock paddles. One use of the defibrillator put Cochran’s heart back into rhythm and started him breathing again.
"Within 15 seconds, I had everything again. It was phenomenal what happened in that minute after the shock," Roberts said. "I kept encouraging him, telling him to hang in there."
Cochran was rushed to University Hospital in Syracuse and eventually made a full recovery. He returned to school before the end of the year and is expected to return for the next round of lacrosse try-outs on July 13. Both coaches said they look forward to seeing Cochran again.
Calandra and Roberts were saluted at the Board of Education meeting Wednesday night with formal commendations plus separate praise from Rome school district representatives.
The efforts by Calandra and Roberts on June 15 "reflected the best" in the district’s coaches and teams, said district Superintendent Jeffrey P. Simons. Their "quick actions" in responding to Cochran’s emergency needs "reflected very well on our entire community" in what he described as "what a remarkable event."
Athletic Director Michael Stamboly said Calandra and Roberts "absolutely rose to the occasion." He added, "to save somebody’s life" has to be "the highest honor anybody can achieve." They have "two different approaches...two different styles," he observed, but "they work as a team" which was evident in what they did for Cochran. He remarked, "God knows what would have happened" if not for them, commenting "you guys did a great job."
Athletic Trainer Kelly Hoke said "our athletic department is a family," and Calandra and Roberts are "so representative of what we try to do....How we care about the kids...." She noted how proud their own families were, and added, "we’re so proud of them" as well.
Simons concluded the remarks by telling Calandra and Roberts, "thank you for your actions" and "the high quality with which you represented the district."
The two coaches received plaques with the framed text of their commendations from the board, said Simons, along with commemorative desk clocks that include a facing inscription recognizing their accomplishments on June 15.
HEROES — Rome Free Academy lacrosse coaches Guy Calandra, left, and Jeremy Roberts, were honored by the Board of Education Wednesday night for helping save the life of a lacrosse player in Onondaga County on June 15. (Sentinel photo by Lindsay A. Mogle)
Rome Free Academy varsity lacrosse coach Jeremy Roberts believes his entire life may have been leading to the day he was able to use all of his training and skills to help save the life of one of his players.
"As I look back at it, God has a plan and he puts people in places for certain reasons," said Roberts, age 36. "He took 20 years to get me ready for that one day, in my opinion."
Roberts and fellow RFA coach Guy Calandra used their CPR training to help keep Jamesville-DeWitt sophomore Daniel Cochran alive after he took a hard ball to the chest on June 15 in Onondaga County. The two coaches kept pumping and breathing until a defibrillator was carried out onto the field and shocked the teen back to life.
Roberts said he first learned CPR as a life guard at age 16, and then leaned how to deal with crisis situations when he served in the Marines. He also became a certified CPR trainer with the Red Cross a few years ago, and has to know first aid as a coach.
"I was put on that field on that day," Roberts said. God "put me there to save Danny’s life."
Roberts and Calandra were honored for their life-saving efforts by the Rome Board of Education Wednesday night. But both men said they don’t deserve all the credit.
"Everybody did things right on cue, nobody panicked. A lot of people did everything right," said Calandra. "It’s pretty traumatic, thinking back; what he looked like, what could have happened."
Cochran was one of 55 players trying out for the Nike Upstate Rising lacrosse competition on June 15 at the Fayetteville-Manlius High School in Onondaga County. Roberts and Calandra had been chosen in October to coach the sophomore Upstate Rising team. Calandra said he was about five feet away when Cochran, playing defense, turned into a shot from one of the offensive players. The ball hit Cochran in the left side of his chest, just below his padding.
"He yelled and he took a few steps and he fell face first," Calandra said. He knelt down to check on Cochran, but was getting no response. So he yelled across the field for Roberts.
"The first time he yelled to me, I thought he was just trying to get my attention," Roberts stated. "He yelled again and I could tell from the pitch of his voice...that something was seriously wrong."
Roberts joined Calandra at Cochran’s side, and as they checked the boy they determined he wasn’t breathing and didn’t have a pulse.
"We just looked at each other and we knew within seconds that he didn’t have a pulse, so we started CPR," Calandra said. He started chest compressions and Roberts started breathing. Calandra said they went through two cycles of CPR before a registered nurse came to the field and took over.
Calandra said he called Cochran’s parents and called 9-1-1 as athletic director Cyndi Kelder came to the field with the defibrillator and shock paddles. One use of the defibrillator put Cochran’s heart back into rhythm and started him breathing again.
"Within 15 seconds, I had everything again. It was phenomenal what happened in that minute after the shock," Roberts said. "I kept encouraging him, telling him to hang in there."
Cochran was rushed to University Hospital in Syracuse and eventually made a full recovery. He returned to school before the end of the year and is expected to return for the next round of lacrosse try-outs on July 13. Both coaches said they look forward to seeing Cochran again.
Calandra and Roberts were saluted at the Board of Education meeting Wednesday night with formal commendations plus separate praise from Rome school district representatives.
The efforts by Calandra and Roberts on June 15 "reflected the best" in the district’s coaches and teams, said district Superintendent Jeffrey P. Simons. Their "quick actions" in responding to Cochran’s emergency needs "reflected very well on our entire community" in what he described as "what a remarkable event."
Athletic Director Michael Stamboly said Calandra and Roberts "absolutely rose to the occasion." He added, "to save somebody’s life" has to be "the highest honor anybody can achieve." They have "two different approaches...two different styles," he observed, but "they work as a team" which was evident in what they did for Cochran. He remarked, "God knows what would have happened" if not for them, commenting "you guys did a great job."
Athletic Trainer Kelly Hoke said "our athletic department is a family," and Calandra and Roberts are "so representative of what we try to do....How we care about the kids...." She noted how proud their own families were, and added, "we’re so proud of them" as well.
Simons concluded the remarks by telling Calandra and Roberts, "thank you for your actions" and "the high quality with which you represented the district."
The two coaches received plaques with the framed text of their commendations from the board, said Simons, along with commemorative desk clocks that include a facing inscription recognizing their accomplishments on June 15.
Thursday, June 30, 2011
Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates
From our buddies down under...
Abstract
Background
To examine the impact of changing dispatcher CPR instructions (400 compressions: 2 breaths, followed by 100:2 ratio) on rates of bystander CPR and survival in adults with presumed cardiac out-of-hospital arrest (OHCA) in Melbourne, Australia.
Methods
The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for OHCA where Emergency Medical Services (EMS) attempted CPR between August 2006 and August 2009. OHCA included were: 1) patients aged ≥18 years old; 2) presumed cardiac etiology; and 3) not witnessed by EMS.
Results
For the pre- and post- study periods, 1021 and 2101 OHCAs met inclusion criteria, respectively. Rates of bystander CPR increased overall (45% to 55%, p<0.001) and by initial rhythm (shockable 55% to 70%, p<0.001 and non-shockable 40% to 46%, p=0.01). In VF/VT OHCA, there were improvements in the number of patients arriving at hospital with a return of spontaneous circulation (ROSC) (48% to 56%, p=0.02) and in survival to hospital discharge (21% to 29%, p=0.002), with improved outcomes restricted to patients receiving bystander CPR. After adjusting for factors associated with survival, the period of time following the change in CPR instructions was a significant predictor of survival to hospital discharge in VF/VT patients (OR 1.57, 95%CI: 1.15 to 2.20, p=0.005).
Conclusion
Following changes to dispatcher CPR instructions, significant increases were seen in rates of bystander CPR and improvements were seen in survival in VF/VT patients who received bystander CPR, after adjusting for factors associated with survival.
Abstract
Background
To examine the impact of changing dispatcher CPR instructions (400 compressions: 2 breaths, followed by 100:2 ratio) on rates of bystander CPR and survival in adults with presumed cardiac out-of-hospital arrest (OHCA) in Melbourne, Australia.
Methods
The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for OHCA where Emergency Medical Services (EMS) attempted CPR between August 2006 and August 2009. OHCA included were: 1) patients aged ≥18 years old; 2) presumed cardiac etiology; and 3) not witnessed by EMS.
Results
For the pre- and post- study periods, 1021 and 2101 OHCAs met inclusion criteria, respectively. Rates of bystander CPR increased overall (45% to 55%, p<0.001) and by initial rhythm (shockable 55% to 70%, p<0.001 and non-shockable 40% to 46%, p=0.01). In VF/VT OHCA, there were improvements in the number of patients arriving at hospital with a return of spontaneous circulation (ROSC) (48% to 56%, p=0.02) and in survival to hospital discharge (21% to 29%, p=0.002), with improved outcomes restricted to patients receiving bystander CPR. After adjusting for factors associated with survival, the period of time following the change in CPR instructions was a significant predictor of survival to hospital discharge in VF/VT patients (OR 1.57, 95%CI: 1.15 to 2.20, p=0.005).
Conclusion
Following changes to dispatcher CPR instructions, significant increases were seen in rates of bystander CPR and improvements were seen in survival in VF/VT patients who received bystander CPR, after adjusting for factors associated with survival.
Wednesday, June 29, 2011
It had to happen sometime...
Heart lecture interrupted by heart attack
By Daniel Hartill, Sun Journal
Posted June 29, 2011, at 9:29 a.m.
Last modified June 29, 2011, at 6:21 p.m.
Russ Dillingham | Sun Journal
LEWISTON, Maine — Dr. William Phillips figured he was being kidded when a lecture on coronary heart disease was interrupted by a man complaining of chest pain.
A moment later, the cardiologist and nearby nurses saved the man’s life.
“I can’t tell you how I was hoping that guy was going to open his eyes, because, I thought, nothing could be worse if he dies right here,” Phillips said Tuesday.
As Phillips and the nurses began CPR, more than 100 people, many with histories of heart problems, watched.
“What I’m hoping is that they got the lesson about calling 911,” he said. “They got to see firsthand the importance of immediate response.”
The lecture had begun in the usual way.
Folks gathered Monday evening in a conference room at 12 High St. beside Central Maine Medical Center. The topic was a comparison of bypass surgery versus stenting for heart patients.
“We were talking about angina and this man raised his hand and said, ‘I’m having it right now,’” Phillips said. “I said, ‘Are you kidding?’
“And he said, ‘No.’”
That’s when Phillips got serious.
“I said to one of the nurses, ‘Could you get a wheelchair and take him over to the emergency room?’” Phillips said.
There wasn’t time, though. The man collapsed and Phillips ran to his side.
“In the meantime, he had completely arrested,” the doctor said. “He had no pulse. He wasn’t breathing. We started CPR and everybody’s standing around.”
Three cardiac rehab nurses — Brenda Robitaille, Nicola Adams and Heidi Langois — were there, too.
“It wasn’t just me,” Phillips said. “If I had been alone, it would have been terrible.”
One of the nurses brought in an automated external defibrillator, a portable electronic device that diagnoses a sudden, life-threatening heart problem and shocks the heart back into rhythm.
“The AED saved his life,” Phillips said.
“Then, (paramedics) came in the door,” he said. “They started an IV. They gave him an EKG and took the patient over to the emergency room.”
Later, Phillips checked in on the man.
“I went over to the emergency room, and he was sitting up in the bed, talking with his wife and waiting for test results,” the doctor said. Central Maine Medical Center declined to identify the patient, citing confidentiality laws.
But before Phillips checked on the man, he had a lecture to finish.
“After we had taken a breather, everybody wanted to continue on with the talk,” he said. “It was a pretty impressive event. I think the people there will remember the lecture for that.”
Phillips hopes the attendees will remember the importance of rapid response to heart problems.
“What if the man had been driving himself to the hospital?” Phillips said. The incident also highlighted the use of AEDs.
A West Paris man used one to save his father on June 12. The devices are becoming more common in local institutions such as schools.
“This is the second time in as many weeks that a local (AED) has saved a life,” Phillips said.
To see more of the Sun Journal, visit sunjournal.com.
By Daniel Hartill, Sun Journal
Posted June 29, 2011, at 9:29 a.m.
Last modified June 29, 2011, at 6:21 p.m.
Russ Dillingham | Sun Journal
LEWISTON, Maine — Dr. William Phillips figured he was being kidded when a lecture on coronary heart disease was interrupted by a man complaining of chest pain.
A moment later, the cardiologist and nearby nurses saved the man’s life.
“I can’t tell you how I was hoping that guy was going to open his eyes, because, I thought, nothing could be worse if he dies right here,” Phillips said Tuesday.
As Phillips and the nurses began CPR, more than 100 people, many with histories of heart problems, watched.
“What I’m hoping is that they got the lesson about calling 911,” he said. “They got to see firsthand the importance of immediate response.”
The lecture had begun in the usual way.
Folks gathered Monday evening in a conference room at 12 High St. beside Central Maine Medical Center. The topic was a comparison of bypass surgery versus stenting for heart patients.
“We were talking about angina and this man raised his hand and said, ‘I’m having it right now,’” Phillips said. “I said, ‘Are you kidding?’
“And he said, ‘No.’”
That’s when Phillips got serious.
“I said to one of the nurses, ‘Could you get a wheelchair and take him over to the emergency room?’” Phillips said.
There wasn’t time, though. The man collapsed and Phillips ran to his side.
“In the meantime, he had completely arrested,” the doctor said. “He had no pulse. He wasn’t breathing. We started CPR and everybody’s standing around.”
Three cardiac rehab nurses — Brenda Robitaille, Nicola Adams and Heidi Langois — were there, too.
“It wasn’t just me,” Phillips said. “If I had been alone, it would have been terrible.”
One of the nurses brought in an automated external defibrillator, a portable electronic device that diagnoses a sudden, life-threatening heart problem and shocks the heart back into rhythm.
“The AED saved his life,” Phillips said.
“Then, (paramedics) came in the door,” he said. “They started an IV. They gave him an EKG and took the patient over to the emergency room.”
Later, Phillips checked in on the man.
“I went over to the emergency room, and he was sitting up in the bed, talking with his wife and waiting for test results,” the doctor said. Central Maine Medical Center declined to identify the patient, citing confidentiality laws.
But before Phillips checked on the man, he had a lecture to finish.
“After we had taken a breather, everybody wanted to continue on with the talk,” he said. “It was a pretty impressive event. I think the people there will remember the lecture for that.”
Phillips hopes the attendees will remember the importance of rapid response to heart problems.
“What if the man had been driving himself to the hospital?” Phillips said. The incident also highlighted the use of AEDs.
A West Paris man used one to save his father on June 12. The devices are becoming more common in local institutions such as schools.
“This is the second time in as many weeks that a local (AED) has saved a life,” Phillips said.
To see more of the Sun Journal, visit sunjournal.com.
Good News From Sweeden
Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia: bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective
Anna Adielsson1, Jacob Hollenberg2, Thomas Karlsson3, Jonny Lindqvist3, Stefan Lundin1, Johan Silfverstolpe4, Leif Svensson4, Johan Herlitz3,5
+ Author Affiliations
1Department of Anaesthesia and Intensive Care Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
2Stockholm Pre-hospital Centre, South Hospital, Stockholm, Sweden
3Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
4Emergency Medical Services, KAMBER, Regionhuset, Lund, Sweden
5The Centre for Pre-hospital Research in Western Sweden, University College of Borås, Borås, Sweden
Correspondence to
Johan Herlitz, Institution of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg SE-413 45, Sweden; johan.herlitz@gu.se
Accepted 5 May 2011
Published Online First 29 June 2011
Abstract
Objectives In a national perspective, to describe survival among patients found in ventricular fibrillation or pulseless ventricular tachycardia witnessed by a bystander and with a presumed cardiac aetiology and answer two principal questions: (1) what are the changes over time? and (2) which are the factors of importance?
Design Observational register study.
Setting Sweden.
Patients All patients included in the Swedish Out of Hospital Cardiac Arrest Register between 1 January 1990 and 31 December 2009 who were found in bystander-witnessed ventricular fibrillation with a presumed cardiac aetiology.
Interventions Bystander cardiopulmonary resuscitation (CPR) and defibrillation.
Main outcome measures Survival to 1 month.
Results In all, 7187 patients fulfilled the set criteria. Age, place of out-of-hospital cardiac arrest (OHCA) and gender did not change. Bystander CPR increased from 46% to 73%; 95% CI for OR 1.060 to 1.081 per year. The median delay from collapse to defibrillation increased from 12 min to 14 min (p for trend 0.0004). Early survival increased from 28% to 45% (95% CI 1.044 to 1.065) and survival to 1 month increased from 12% to 23% (95% CI 1.058 to 1.086). Strong predictors of early and late survival were a short interval from collapse to defibrillation, bystander CPR, female gender and OHCA outside the home.
Conclusion In a long-term perspective in Sweden, survival to 1 month after ventricular fibrillation almost doubled. This was associated with a marked increase in bystander CPR. Strong predictors of outcome were a short delay to defibrillation, bystander CPR, female gender and place of collapse.
Anna Adielsson1, Jacob Hollenberg2, Thomas Karlsson3, Jonny Lindqvist3, Stefan Lundin1, Johan Silfverstolpe4, Leif Svensson4, Johan Herlitz3,5
+ Author Affiliations
1Department of Anaesthesia and Intensive Care Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
2Stockholm Pre-hospital Centre, South Hospital, Stockholm, Sweden
3Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
4Emergency Medical Services, KAMBER, Regionhuset, Lund, Sweden
5The Centre for Pre-hospital Research in Western Sweden, University College of Borås, Borås, Sweden
Correspondence to
Johan Herlitz, Institution of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg SE-413 45, Sweden; johan.herlitz@gu.se
Accepted 5 May 2011
Published Online First 29 June 2011
Abstract
Objectives In a national perspective, to describe survival among patients found in ventricular fibrillation or pulseless ventricular tachycardia witnessed by a bystander and with a presumed cardiac aetiology and answer two principal questions: (1) what are the changes over time? and (2) which are the factors of importance?
Design Observational register study.
Setting Sweden.
Patients All patients included in the Swedish Out of Hospital Cardiac Arrest Register between 1 January 1990 and 31 December 2009 who were found in bystander-witnessed ventricular fibrillation with a presumed cardiac aetiology.
Interventions Bystander cardiopulmonary resuscitation (CPR) and defibrillation.
Main outcome measures Survival to 1 month.
Results In all, 7187 patients fulfilled the set criteria. Age, place of out-of-hospital cardiac arrest (OHCA) and gender did not change. Bystander CPR increased from 46% to 73%; 95% CI for OR 1.060 to 1.081 per year. The median delay from collapse to defibrillation increased from 12 min to 14 min (p for trend 0.0004). Early survival increased from 28% to 45% (95% CI 1.044 to 1.065) and survival to 1 month increased from 12% to 23% (95% CI 1.058 to 1.086). Strong predictors of early and late survival were a short interval from collapse to defibrillation, bystander CPR, female gender and OHCA outside the home.
Conclusion In a long-term perspective in Sweden, survival to 1 month after ventricular fibrillation almost doubled. This was associated with a marked increase in bystander CPR. Strong predictors of outcome were a short delay to defibrillation, bystander CPR, female gender and place of collapse.
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