- Paper Report
- Open Access
Basic life support
- Richard Venn1
© Current Science Ltd 2000
- Published: 14 August 2000
- Cardiopulmonary resuscitation
Management of out-of-hospital cardiac arrest impacts on the ICU as survivors frequently require organ support for variable periods. The quality of out-of-hospital CPR may also influence neurological outcome; we have all cared for patients who have eventually been successfully resuscitated following prolonged periods without CPR, but have suffered severe hypoxic brain damage as a result. This study is therefore of interest to the ICU physician because it investigates ways of improving bystander-initiated CPR before the arrival of the emergency services.
Prospective, randomised trial in which telephone dispatchers gave bystanders instructions for either CC or CCMV
Primary outcome was survival to hospital discharge
Study period 1992-1998; location Seattle-King County, Washington, USA
During this period there were 1296 randomised episodes of cardiac arrest, but 776 were excluded for three main reasons: absence of cardiac arrest; cardiac arrest due to drug overdose,alcohol intoxication or CO poisoning; and advanced life support notperformed. The remaining 520 cases were assigned to either CCMV (279) or CC (241). Baseline patient and episode characteristics were similar. The average time to arrival of the emergency services was 4 min. Survival to hospital discharge was 10.4% for CCMV and 14.6% for CC (P = 0.18). Dispatcher instructions were completely delivered in 62% for CCMV and 81% for CC (P = 0.005). Arrival of the emergency services was the principal reason for incomplete instruction delivery. Bystanders receiving instructions for CCMV were more likely to give up because of the complexity of the instructions than bystanders receiving instructions for CC (7.2% vs 2.9%).