References

Glover BM, Brown SP, Morrison L Wide variability in drug use in out-of-hospital cardiac arrest: A report from the resuscitation outcomes consortium. Resuscitation. 2012; 83:1324-1330 https://doi.org/http//dx..org/10.1016/j.resuscitation.2012.07.008

Haukoos J, Witt G, Gravitz C Out-of-hospital cardiac arrest in Denver, Colorado: epidemiology and outcomes. Acad Emerg Med. 2010; 17:(4)391-398 https://doi.org/http//dx..org/10.1111/j.1553-2712.2010.00707.x

Hess EP, White RD. Optimizing survival from out-of-hospital cardiac arrest. J Cardiovasc Electrophysiol. 2010; 21:(5)590-595 https://doi.org/http//dx..org/10.1111/j.1540-8167.2009.01706.x

Kleinman M, Goldberger Z, Rea T 2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2018; 137:(1)e7-e13 https://doi.org/https//.org/10.1161/CIR.0000000000000539

Meaney PA, Bobrow BJ, Mancini ME Cardiopulmonary resuscitation quality: Improving cardiac resuscitation outcomes both inside and outside the hospital. Circulation. 2013; 128:(4)417-435 https://doi.org/http//dx..org/10.1161/CIR.0b013e31829d8654

Nehme ZZ, Andrew EE, Cameron PP Direction of first bystander call for help is associated with outcome from out-of-hospital cardiac arrest. Resuscitation. 2014; 85:(1)42-48 https://doi.org/http//dx..org/10.1016/j.resuscitation.2013.08.258

Neumar RW, Barnhart JM, Berg RA Implementation strategies for improving survival after out-of-hospital cardiac arrest in the United States. Circulation. 2011; 123:(24)2898-2910 https://doi.org/https//dx..org/10.1161/CIR.0b013e31821d79f3

Nichol G, Thomas E, Callaway C Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA. 2008; 300:(12)1423-1431

US Census Bureau. Clackamas County. American Fact Finder. 2016a. https://tinyurl.com/j92cwr2 (accessed 12 March 2018)

Clark County. American Fact Finder. 2016b. https://tinyurl.com/j92cwr2 (accessed 12 March 2018)

Multnomah County. American Fact Finder. 2016c. https://tinyurl.com/j92cwr2 (accessed 12 March 2018)

Vadeboncoeur T, Stolz U, Panchal A Chest compression depth and survival in out-of-hospital cardiac arrest. Resuscitation. 2014; 85:(2)182-188 https://doi.org/http//dx..org/10.1016/j.resuscitation.2013.10.002

van Diepen S, Abella B, Bobrow B Multistate implementation of guideline-based cardiac resuscitation systems of care: description of the HeartRescue project. Am Heart J. 2013; 166:(4)647-653.e2 https://doi.org/http//dx..org/10.1016/j.ahj.2013.05.022

Wissenberg M, Lippert FK, Folke F Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA. 2013; 310:(13)1377-1384 https://doi.org/http//dx..org/10.1001/jama.2013.278483

Zive D, Koprowicz K, Daya M Variation in out-of-hospital cardiac arrest resuscitation and transport practices in the Resuscitation Outcomes Consortium: ROC Epistry-Cardiac Arrest. Resuscitation. 2011; 82:(3)277-284 https://doi.org/http//dx..org/10.1016/j.resuscitation.2010.10.022

patient care
practice

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

02 April 2018
Features
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).

Subscribe to get full access to International Paramedic Practice

Thank you for visiting International Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed

Register
Or continue by

Signing in with your registered email address

Cardiac arrest
Cardiopulmonary resuscitation (CPR)
Resuscitation
Emergency medical services (EMS)
Paramedic
ROSC