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Incidence, response, and outcomes of cardiac arrest in Portland, Oregon

02 April 2018
Volume 8 · Issue 1

Abstract

Cardiac arrest is a serious medical event with a poor prognosis of survival, at less than 10% (Zive et al, 2011). Several studies have investigated out-of-hospital cardiac arrest (OHCA) response, treatment, and outcomes. Cardiac arrest databases such as the Resuscitation Outcomes Consortium (ROC) and the Cardiac Arrest Registry to Enhance Survival (CARES) have been created to provide evidence-based findings to develop emergency medical service (EMS) policies for treatment. The current study was completed to describe the cardiac arrest characteristics and outcomes of the EMS provider, American Medical Response (AMR) in Portland, Oregon, United States (US), for three metropolitan counties of approximately 1.6 million people (US Census Bureau, 2016a; 2016b; 2016c). The retrospective study described in this article used the AMR Multiple-EMS Data Systems (MEDS) database to generate data. Between 1 January 2013 and 31 December 2014, AMR responded to 2029 cardiac arrest events. In total, 45% of these cases were pronounced dead at the scene or untreated, and 55% were treated by paramedics. The most noteworthy finding was the effect of cardiopulmonary resuscitation (CPR) on successful return of spontaneous circulation and survival evidenced by the large differences in odds ratios and bivariate counts with CPR treatment. The study adds to the current knowledge base of OHCAs and builds upon existing cardiac arrest registries—particularly within the Portland Oregon (US) metropolitan area.

Out-of-hospital cardiac arrest (OHCA) is a global health concern. It is estimated that OHCA events occur in 235 000–325 000 people in the United States (US) every year (Zive et al, 2011). OHCA events have a low survival rate and there is considerable variation between US locations (Zive et al, 2011). As a result of poor prognosis and outcome variability, several cardiac arrest registries, such as the National Emergency Medical Service (EMS) Information System (NEMSIS), Resuscitation Outcomes Consortium-Epistary (ROC), and Cardiac Arrest Registry to Enhance Survival (CARES), have been created to compile data regarding OHCA incidence, EMS response, and patient outcomes. Standardised data allow researchers to devise the most effective means to increase chances of survival. Registries assist researchers to identify areas of concern, generate hypotheses, and drive policy and protocol changes using evidence-based criteria (Neumar et al, 2011).

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