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The early minutes of in-hospital cardiac arrest: Shock or CPR? A population based prospective study

Skogvoll, Eirik; Nordseth, Trond
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/2353169
Date
2008
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  • Institutt for sirkulasjon og bildediagnostikk [1047]
  • Publikasjoner fra CRIStin - NTNU [20804]
Original version
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2008, 16(11)   10.1186/1757-7241-16-11
Abstract
Objectives: In the early minutes of cardiac arrest, timing of defibrillation and cardiopulmonary

resuscitation during the basic life support phase (BLS CPR) is debated. Aims of this study were to

provide in-hospital incidence and outcome data, and to investigate the relation between outcome

and time from collapse to defibrillation, time to BLS CPR, and CPR quality.

Methods: Resuscitation attempts during a 3-year period at St. Olav's University Hospital (960

beds) were prospectively registered. The times between collapse and initiation of BLS CPR, and

defibrillation were determined. CPR quality was assessed by the resuscitation team. The relation

between these variables and outcome (short term survival and discharge) was explored using nonparametric

correlation and logistic regression.

Results: CPR was started in a total of 223 arrests, an incidence of 77 episodes per 1000 beds per

year. Return of spontaneous circulation occurred in 40%, and 29 patients (13%) survived to

discharge. Median time from collapse to BLS CPR was 1 minute; CPR was judged to be of good

quality in half of the episodes. CPR during the first 3 minutes in ventricular fibrillation (VF/VT) was

negatively associated with survival, but later proved beneficial. For patients with non-shockable

rhythms, we found no association between outcome and time to BLS or CPR quality.

Conclusion: Our findings indicate that defibrillation should have priority during the first 3 minutes

of VF/VT. Later, patients benefit from CPR in conjunction with defibrillation. Patients presenting

with non-shockable rhythms have a grave prognosis, and the outcome was not associated with time

to BLS or CPR quality.
Publisher
BioMed Central
Journal
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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