Results: From 1991 to 1997, 9,899 consecutive cardiac arrest cases were enrolled with these characteristics: male (67.2%), witnessed (44.7%), bystander CPR (14.2%), defibrillation response interval (DRI) < 8 minutes (82.0%),
asystole (40.8%), PEA (21.2%), VF/VT (38.0%), and overall survival (4.3%). Among the 3,888 asystole patients, 9 (0.2%) survived to discharge and 4 of these were unwitnessed arrests with no bystander CPR. There were, however, no survivors if the DRI exceeded 8 minutes. Logistic regression indicated that independent predictors of survival to admission and their odds ratios (95% CI) were 'DRI in minutes' 0.87 (0.77-0.98) and 'bystander witnessed' 2.6 (1.5-4.4). Tir� de OPALS Stats Provincial (Urbain, Suburbain, rural) Question : BLS-D signifie (normalement) Ambulance BLS avec D-Fib Est-ce que OPALS a isol� statistiquement l'intervation des PRs ? Charles Tir� de : 10. David A Petrie MD, V.J. De Maio (M Sc), I.G. Stiell (MD, M Sc), J. Dreyer (MD), M. Martin, J O'Brien for the OPALS Study Group. Factors Affecting Survival of Prehospital Asystolic Cardiac Arrest in a BLS-D System. Academic Emergency Medicine. May 2000;7(5) 509 (abstract). (back to top) Objectives: Previous studies have shown a very low but meaningful survival rate in prehospital cardiac arrest with an initial rhythm of asystole. There may be, however, an identifiable subgroup in which resuscitation efforts are futile. This study identified potential field criteria for predicting 100% non-survival when the presenting rhythm is asystole in a BLS-D System. Methods: This prospective cohort study was a component of Phases I and II of the Ontario Prehospital Advanced Life Support (OPALS) Study, was conducted in 21 Ontario communities with BLS-D level of care, and included all adult arrests of presumed cardiac etiology according to the Utstein Style. Analyses included descriptive and appropriate univariate tests as well as multivariate stepwise logistic regression to determine predictors of survival to hospital admission. Results: From 1991 to 1997, 9,899 consecutive cardiac arrest cases were enrolled with these characteristics: male (67.2%), witnessed (44.7%), bystander CPR (14.2%), defibrillation response interval (DRI) < 8 minutes (82.0%), asystole (40.8%), PEA (21.2%), VF/VT (38.0%), and overall survival (4.3%). Among the 3,888 asystole patients, 9 (0.2%) survived to discharge and 4 of these were unwitnessed arrests with no bystander CPR. There were, however, no survivors if the DRI exceeded 8 minutes. Logistic regression indicated that independent predictors of survival to admission and their odds ratios (95% CI) were 'DRI in minutes' 0.87 (0.77-0.98) and 'bystander witnessed' 2.6 (1.5-4.4). Conclusions: In a BLS-D system, there is a very low but measurable survival rate for prehospital aysstolic cardiac arrest. DRI > 8 minutes was associated with 100% non-survival whereas unwitnessed arrests with no bystander CPR did not. These data add to the growing literature which will help guide ethical decision making for protocol development in EMS systems. Improved specificity in prehospital termination guidelines could lead to more efficient resource utilization and less exposure to occupational risk. http://www.ohri.ca/programs/clinical_epidemiology/opals/abstracts_2002.asp --- URG-L Pour modifier votre adresse de courriel sur URG-L, envoyez un avis a [EMAIL PROTECTED] en indiquant votre nouvelle adresse ainsi que l'ancienne et le nom de la liste.
