Skip to main content

Responsiveness to EMT-performed basic CPR and its duration predict unachievable sustained return of spontaneous circulation and unavoidable hospital death in unwitnessed out-of-hospital cardiac arrests without bystander CPR

Introduction

Various criteria to terminate resuscitation have been reported. EMTs in Japan are not permitted to terminate resuscitation in the field. The aim of this study is to test the hypothesis that ECG rhythm response to basic CPR and its duration may predict hospital death.

Methods

The basal data were prospectively collected from 1,437 unwitnessed out-of-hospital cardiac arrests (OHCAs) that were resuscitated by EMTs without the ACLS technique in Ishikawa Prefecture (Figure 1). The cut-off points of basic CPR duration for outcomes were determined. Sensitivity and specificity were calculated.

Figure 1
figure1

Overview of out-of-hospital cardiac arrests analyzed.

Results

The improvement of the ECG rhythm by basic CPR predicted the sustained return of spontaneous circulation (SROSC) in hospital. The duration of EMT-performed CPR predicted the outcomes of the OHCAs that were unresponsive to the basic CPR (Figure 2).

Figure 2
figure2

Duration of EMT-performed BLS determines the incidence of SROSC at hospital and 1-year survival in unwitnessed OHCAs without CPR before EMT arrival.

Conclusions

Responsiveness to basic CPR and its duration may predict unavoidable death in hospital.

References

  1. 1.

    N Engl J Med. 2006, 355: 478-487. 10.1056/NEJMoa052620

  2. 2.

    JAMA. 2008, 300: 1432-1438. 10.1001/jama.300.12.1432

  3. 3.

    Resuscitation. 2010, 81: 679-684. 10.1016/j.resuscitation.2010.01.033

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to H Inaba.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Inaba, H., Takei, Y., Enami, M. et al. Responsiveness to EMT-performed basic CPR and its duration predict unachievable sustained return of spontaneous circulation and unavoidable hospital death in unwitnessed out-of-hospital cardiac arrests without bystander CPR. Crit Care 15, P293 (2011). https://doi.org/10.1186/cc9713

Download citation

Keywords

  • Public Health
  • Emergency Medicine
  • Cardiac Arrest
  • Basal Data
  • Hospital Death