Abstract
Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8%) occurring in a RACF.A shockable rhythm was present in 179 (7.6%) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66%); 173 (97%) received an EMS attempted resuscitation. ROSC was achieved in 71 (41%) patients and 15 (8.7%) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92%) of whom 804 (37%) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22%) and 10 patients (1.2%) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8% vs. 4.7%, p=0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95% CI 2.4-3.7) and the presence of bystander CPR (OR 4.6, 95% CI 3.7-5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 58-62 |
| Number of pages | 5 |
| Journal | Resuscitation |
| Volume | 83 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2012 |
| Externally published | Yes |
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Keywords
- Aged care facilities
- Elderly
- Epidemiology
- Nursing homes
- Out-of-hospital cardiac arrest
- Outcomes
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Emergency
- Emergency Medicine
Cite this
Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia. / Deasy, C.; Bray, J. E.; Smith, K.; Harriss, L. R.; Bernard, S. A.; Davidson, Patricia M; Cameron, P.
In: Resuscitation, Vol. 83, No. 1, 01.2012, p. 58-62.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia
AU - Deasy, C.
AU - Bray, J. E.
AU - Smith, K.
AU - Harriss, L. R.
AU - Bernard, S. A.
AU - Davidson, Patricia M
AU - Cameron, P.
PY - 2012/1
Y1 - 2012/1
N2 - Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8%) occurring in a RACF.A shockable rhythm was present in 179 (7.6%) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66%); 173 (97%) received an EMS attempted resuscitation. ROSC was achieved in 71 (41%) patients and 15 (8.7%) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92%) of whom 804 (37%) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22%) and 10 patients (1.2%) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8% vs. 4.7%, p=0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95% CI 2.4-3.7) and the presence of bystander CPR (OR 4.6, 95% CI 3.7-5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.
AB - Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8%) occurring in a RACF.A shockable rhythm was present in 179 (7.6%) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66%); 173 (97%) received an EMS attempted resuscitation. ROSC was achieved in 71 (41%) patients and 15 (8.7%) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92%) of whom 804 (37%) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22%) and 10 patients (1.2%) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8% vs. 4.7%, p=0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95% CI 2.4-3.7) and the presence of bystander CPR (OR 4.6, 95% CI 3.7-5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.
KW - Aged care facilities
KW - Elderly
KW - Epidemiology
KW - Nursing homes
KW - Out-of-hospital cardiac arrest
KW - Outcomes
UR - http://www.scopus.com/inward/record.url?scp=83555177361&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=83555177361&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2011.06.030
DO - 10.1016/j.resuscitation.2011.06.030
M3 - Article
C2 - 21756967
AN - SCOPUS:83555177361
VL - 83
SP - 58
EP - 62
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
IS - 1
ER -