Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia

C. Deasy, J. E. Bray, K. Smith, L. R. Harriss, S. A. Bernard, Patricia M Davidson, P. Cameron

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)58-62
Number of pages5
JournalResuscitation
Volume83
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

Out-of-Hospital Cardiac Arrest
Resuscitation
Allied Health Personnel
Cardiopulmonary Resuscitation
Ambulances
Heart Arrest
Registries
Patient Care
Resuscitation Orders
Survival
Equipment and Supplies

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 journalArticle

Deasy, C. ; Bray, J. E. ; Smith, K. ; Harriss, L. R. ; Bernard, S. A. ; Davidson, Patricia M ; Cameron, P. / Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia. In: Resuscitation. 2012 ; Vol. 83, No. 1. pp. 58-62.
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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.",
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AU - Davidson, Patricia M

AU - Cameron, P.

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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.

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