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Zhu H, Liu J, Yang T, Zhang Y, Xu Y, Xu Y, Wu H, Li L, Luo Y, Wen C, Yu T. Incidence and temporal trends of out-of-hospital cardiac arrest in Shenzhen, China (2011-2018). Resusc Plus 2025; 22:100882. [PMID: 40008323 PMCID: PMC11851179 DOI: 10.1016/j.resplu.2025.100882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Revised: 01/21/2025] [Accepted: 01/23/2025] [Indexed: 02/27/2025] Open
Abstract
Background Out-of-hospital cardiac arrest (OHCA) is a significant global public health issue, few studies describe characteristics and trends in China. This study examines OHCA features and trends in Shenzhen, one of the fastest-growing cities. Methods This retrospective study analysed data from the Shenzhen Emergency Center database (2011-2018), including ambulance dispatch and pre-hospital medical records. Descriptive statistics and temporal trends were used to examine the incidence, patients characteristics, pre-hospital treatment, and outcome. Results Among 18,772 medical cause OHCA cases, the crude incidence rate was 17.4 per 100,000 population, with an age-standardised rate of 38.4. Incidence increased over time. Resuscitation was attempted in 43.8% of cases, with a median patient age of 56 years and 73.5% being male. Most arrest (69.0%) occurred at home, and 82% were presumed to be cardiac cause.The median response time was 11.2 min. Bystander cardiopulmonary resuscitation (CPR) rates increased from 4.6% in 2011 to 14.5% in 2018, while bystander automated external defibrillator (AED) use remained low (0.2%). Pre-hospital electrocardiogram (ECG) recording improved from 40.6% to 91.9%, with shockable rhythms 2.2%. Intravenous access was established in 69.7% of patients, 51.9% received epinephrine, 19.29% received pre-hospital defibrillation, and 16.4% underwent advanced airway management. The pre-hospital Return of Spontaneous Circulation (ROSC) rate increased from 2.7% to 5.8%, with a total ROSC rate of 3.11%. Conclusions OHCA incidence in Shenzhen is lower than both domestic and international levels but increasing. Low bystander intervention rated and prolonged response times contribute to poor outcome, underscoring the need for system improvements.
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Affiliation(s)
- Hong Zhu
- Shenzhen Emergency Medical Center, 2 Antoshan Road Shenzhen City Guangdong Province China
| | - Junpeng Liu
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
- Emergency Department of Huizhou Central People’s Hospital, 41 Erling North Road Huizhou City Guangdong Province China
| | - Tianqi Yang
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
| | - Yan Zhang
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
| | - Yanjun Xu
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
| | - Yunfeng Xu
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
| | - Hao Wu
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
| | - Li Li
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
| | - Yufeng Luo
- Emergency Department of Huizhou Central People’s Hospital, 41 Erling North Road Huizhou City Guangdong Province China
| | - Cai Wen
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
| | - Tao Yu
- Department of Emergency Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang Xi Road Guangzhou City Guangdong Province China
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Qin Z, Zheng S, Liu C, Ren Y, Wang R, Zhang S, Gu X, Li Y, Yan X, Xu T. The knowledge, training, and willingness of first year students in Xuzhou, China to perform bystander cardiopulmonary resuscitation: a cross-sectional study. Front Public Health 2024; 12:1444970. [PMID: 39381766 PMCID: PMC11458465 DOI: 10.3389/fpubh.2024.1444970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 09/12/2024] [Indexed: 10/10/2024] Open
Abstract
Background Bystander Cardiopulmonary Resuscitation (CPR) can significantly improve the rate of return of spontaneous circulation in patients with cardiac arrest. Since first year students with no specific academic background are energetic and quick to learn, many Chinese schools offer first-aid training course including CPR to them before they start school. However, data on CPR knowledge, training, and willingness among first year students are lacking in most regions of China, which makes the effectiveness of CPR training unknown. Objectives To evaluate first year students' knowledge level, training experience and rescue willingness for CPR of first year students in Xuzhou, and to analyze the influencing factors of CPR knowledge level and rescue willingness of first year students in Xuzhou. Design A cross-sectional study. Participations A total of 9,887 first year students from three universities in Xuzhou city were selected by multi-stage random cluster sampling method. Methods A self-designed five-part structured questionnaire was used to investigate the knowledge, training and willingness of CPR among first year students. Independent sample t-test, χ2 -test and Logistic regression were used for data analysis. Results The average score of CPR knowledge was 2.44 (±1.60), 99.13% of the respondents were willing to participate in CPR training, and 66.25% had received CPR training. Respondents with rural household registration, relatives who had suffered from serious diseases, relatives engaged in the medical profession, good self-rated quality of life, CPR training, and willing to CPR training had higher CPR knowledge levels. 76.77% of the respondents were willing to perform bystander CPR. Women, those who had received CPR training, and those who were willing to receive CPR training were more willing to help patients with sudden cardiac arrest. Lack of first aid knowledge and skills (82.61%) was the biggest obstacle hindering respondents from performing rescue. Conclusion Most of the first year students of Xuzhou University in China have CPR training experience and have a strong willingness to train. Most are willing to perform bystander CPR, but have a low knowledge level. Colleges and universities can adopt diversified training methods, make plans for regular CPR retraining and other strategies to improve the quality and effect of CPR training for college students.
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Affiliation(s)
- Zhaohui Qin
- Research Center for Medical and Health Emergency Rescue, The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Shuyao Zheng
- The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Chenxu Liu
- Research Center for Medical and Health Emergency Rescue, The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Yuxin Ren
- School of Stomatology, Xuzhou Medical University, Xuzhou, China
| | - Ran Wang
- The First Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Sitian Zhang
- Research Center for Medical and Health Emergency Rescue, The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Xiao Gu
- Research Center for Medical and Health Emergency Rescue, The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Yichen Li
- Research Center for Medical and Health Emergency Rescue, The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Xianliang Yan
- The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
| | - Tie Xu
- Research Center for Medical and Health Emergency Rescue, The Second Clinical Medical School, Xuzhou Medical University, Xuzhou, China
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Kawai Y, Yamamoto K, Miyazaki K, Asai H, Fukushima H. Effects of Post-Hospital Arrival Factors on Out-of-Hospital Cardiac Arrest Outcomes During the COVID-19 Pandemic. Crit Care Explor 2024; 6:e1154. [PMID: 39254650 PMCID: PMC11390052 DOI: 10.1097/cce.0000000000001154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
IMPORTANCE The relationship between post-hospital arrival factors and out-of-hospital cardiac arrest (OHCA) outcomes remains unclear. OBJECTIVES This study assessed the impact of post-hospital arrival factors on OHCA outcomes during the COVID-19 pandemic using a prediction model. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, data from the All-Japan Utstein Registry, a nationwide population-based database, between 2015 and 2021 were used. A total of 541,781 patients older than 18 years old who experienced OHCA of cardiac origin were included. MAIN OUTCOMES AND MEASURES The primary exposure was trends in COVID-19 cases. The study compared the predicted proportion of favorable neurologic outcomes 1 month after resuscitation with the actual outcomes. Neurologic outcomes were categorized based on the Cerebral Performance Category score (1, good cerebral function; 2, moderate cerebral function). RESULTS The prediction model, which had an area under the curve of 0.96, closely matched actual outcomes in 2019. However, a significant discrepancy emerged after the pandemic began in 2020, where outcomes continued to deteriorate as the virus spread, exacerbated by both pre- and post-hospital arrival factors. CONCLUSIONS AND RELEVANCE Post-hospital arrival factors were as important as pre-hospital factors in adversely affecting the prognosis of patients following OHCA during the COVID-19 pandemic. The results suggest that the overall response of the healthcare system needs to be improved during infectious disease outbreaks to improve outcomes.
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Affiliation(s)
- Yasuyuki Kawai
- All authors: Department of Emergency and Critical Care Medicine, Nara Medical University, Nara, Japan
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Zheng W, Zheng J, Wang C, Pan C, Zhang J, Liu R, Bian Y, Ma J, Cheng K, Xu F, Chen Y. The development history, current state, challenges, and future directions of the BASIC-OHCA registry in China: A narrative review. Resusc Plus 2024; 18:100588. [PMID: 38439934 PMCID: PMC10909623 DOI: 10.1016/j.resplu.2024.100588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
Out-of-hospital cardiac arrest is a major public health problem worldwide due to its high burden and poor outcomes. Despite progress in treatment, patient outcomes remain unsatisfactory, particularly in low-resource settings. The establishment of a registry is the first step towards gaining a comprehensive understanding of prevailing local conditions and identifying potential opportunities for improving patient survival. Here, we provide a narrative review of the BASeline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA), the first national OHCA registry in China, to introduce its development history, current state, challenges and future directions. We aim to enhance cross-cultural understanding by providing insights from China, while also serving as a reference for the implementation of large-scale registries in low-resource settings.
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Affiliation(s)
| | | | - Chunyi Wang
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Chang Pan
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Jianbo Zhang
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Rugang Liu
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Yuan Bian
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Jingjing Ma
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Kai Cheng
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Feng Xu
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Yuguo Chen
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - On behalf of the BASIC-OHCA Coordinators and Investigators
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
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Tang X, Wang Y, Ma H, Wang A, Zhou Y, Li S, Pei R, Cui H, Peng Y, Piao M. Detection and Evaluation for High-Quality Cardiopulmonary Resuscitation Based on a Three-Dimensional Motion Capture System: A Feasibility Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:2154. [PMID: 38610365 PMCID: PMC11014185 DOI: 10.3390/s24072154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/11/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Abstract
High-quality cardiopulmonary resuscitation (CPR) and training are important for successful revival during out-of-hospital cardiac arrest (OHCA). However, existing training faces challenges in quantifying each aspect. This study aimed to explore the possibility of using a three-dimensional motion capture system to accurately and effectively assess CPR operations, particularly about the non-quantified arm postures, and analyze the relationship among them to guide students to improve their performance. We used a motion capture system (Mars series, Nokov, China) to collect compression data about five cycles, recording dynamic data of each marker point in three-dimensional space following time and calculating depth and arm angles. Most unstably deviated to some extent from the standard, especially for the untrained students. Five data sets for each parameter per individual all revealed statistically significant differences (p < 0.05). The correlation between Angle 1' and Angle 2' for trained (rs = 0.203, p < 0.05) and untrained students (rs = -0.581, p < 0.01) showed a difference. Their performance still needed improvement. When conducting assessments, we should focus on not only the overall performance but also each compression. This study provides a new perspective for quantifying compression parameters, and future efforts should continue to incorporate new parameters and analyze the relationship among them.
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Affiliation(s)
- Xingyi Tang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China; (X.T.); (Y.W.); (H.M.); (A.W.); (Y.Z.); (S.L.); (R.P.)
| | - Yan Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China; (X.T.); (Y.W.); (H.M.); (A.W.); (Y.Z.); (S.L.); (R.P.)
| | - Haoming Ma
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China; (X.T.); (Y.W.); (H.M.); (A.W.); (Y.Z.); (S.L.); (R.P.)
| | - Aoqi Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China; (X.T.); (Y.W.); (H.M.); (A.W.); (Y.Z.); (S.L.); (R.P.)
| | - You Zhou
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China; (X.T.); (Y.W.); (H.M.); (A.W.); (Y.Z.); (S.L.); (R.P.)
| | - Sijia Li
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China; (X.T.); (Y.W.); (H.M.); (A.W.); (Y.Z.); (S.L.); (R.P.)
| | - Runyuan Pei
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China; (X.T.); (Y.W.); (H.M.); (A.W.); (Y.Z.); (S.L.); (R.P.)
| | - Hongzhen Cui
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing 100083, China; (H.C.); (Y.P.)
| | - Yunfeng Peng
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing 100083, China; (H.C.); (Y.P.)
| | - Meihua Piao
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, China; (X.T.); (Y.W.); (H.M.); (A.W.); (Y.Z.); (S.L.); (R.P.)
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Zheng J, Lv C, Zheng W, Zhang G, Tan H, Ma Y, Zhu Y, Li C, Han X, Yan S, Pan C, Zhang J, Hou Y, Wang C, Bian Y, Liu R, Cheng K, Ma J, Zheng Z, Song R, Wang M, Gu J, McNally B, Ong MEH, Chen Y, Xu F. Incidence, process of care, and outcomes of out-of-hospital cardiac arrest in China: a prospective study of the BASIC-OHCA registry. Lancet Public Health 2023; 8:e923-e932. [PMID: 37722403 DOI: 10.1016/s2468-2667(23)00173-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/10/2023] [Accepted: 07/21/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is an important global public health issue, but its epidemiology and outcomes in low-income and middle-income countries remain largely unknown. We aim to comprehensively describe the incidence, process of care, and outcomes of OHCA in China. METHODS In the prospective, multicentre, population-based Baseline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA) registry study, participating sites were selected from both urban and rural areas in all seven geographical regions across China. All patients with OHCA assessed by emergency medical service (EMS) staff were consecutively enrolled from Aug 1, 2019, to Dec 31, 2020. Patients with suspected cardiac arrest assessed by bystanders whose return of spontaneous circulation was achieved without the need for defibrillation or EMS personnel cardiopulmonary resuscitation were excluded. Patients with all key variables missing were excluded, including resuscitation attempt, age, sex, witnessed status, cause, all process of care indicators, and all outcome measures. In this analysis, we included data for EMS agencies serving 25 monitoring sites (20 urban and five rural) that included the entire serving population, data for the whole of 2020, and at least 50 OHCA patients in 2020. Data were collected and reported using the Utstein template. We calculated the crude incidence of EMS-assessed OHCA in 2020. We also report data on baseline characteristics (including sex, cause, location of OHCA, and presence of shockable rhythm), process of care (including EMS response time, cardiopulmonary resuscitation, defibrillation, and advanced life support), and outcomes of non-traumatic OHCA between Aug 1, 2019, and Dec 31, 2020, including survival and survival with favourable neurological outcomes at discharge or 30 days, and at 6 and 12 months. FINDINGS Of 115·1 million people served by the 25 participating sites, 132 262 EMS-assessed patients with OHCA were enrolled, and resuscitation was attempted for 42 054 (31·8%) patients between Aug 1, 2019, and Dec 31, 2020. The crude incidence of EMS-assessed OHCA was 95·7 per 100 000 population (95% CI 95·6-95·8) in 2020. Among 38 227 individuals with non-traumatic OHCA, 25 958 (67·9%) were male, 30 282 (79·2%) had a cardiac arrest at home, 32 523 (85·1%) had a presumed cardiac cause, and 2297 (6·0%) presented with an initial shockable rhythm. 4049 (11·5%) of 35 090 patients with an unwitnessed or bystander-witnessed OHCA received dispatcher-assisted cardiopulmonary resuscitation and 7121 (20·3%) received bystander cardiopulmonary resuscitation; only 14 (<0·1%) patients were assessed by bystanders with an automated external defibrillator. The median EMS response time was 12 min (IQR 9-16). At hospital discharge or 30 days, 441 (1·2%) of 38 227 survived, 304 (0·8%) survived up to 6 months, and 269 (0·7%) up to 12 months. At hospital discharge or 30 days, 309 (0·8%) survived with favourable neurological outcomes, 257 (0·7%) had favourable neurological outcomes at 6 months, and 236 (0·6%) at 12 months. INTERPRETATION Our findings revealed a high burden of EMS-assessed OHCA with a low proportion of resuscitation attempts. The suboptimal implementation of chain of survival and unsatisfactory prognosis call for national efforts to improve the care and outcomes of patients with OHCA in China. FUNDING The National Science & Technology Fundamental Resources Investigation Program of China, the State Key Program of the National Natural Science Foundation of China, Taishan Pandeng Scholar Program of Shandong Province, the Key Research & Development Program of Shandong Province, the Interdisciplinary Young Researcher Groups Program of Shandong University, the Clinical Research Center of Shandong University, the ECCM Program of Clinical Research Center of Shandong University, and the Natural Science Foundation of Shandong Province.
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Affiliation(s)
- Jiaqi Zheng
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Chuanzhu Lv
- Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences (No 2019RU013), Hainan Medical University, Haikou, China; Key Laboratory of Emergency and Trauma, Ministry of Education, Hainan Medical University, Haikou, China
| | - Wen Zheng
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Guoqiang Zhang
- Department of Emergency Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Huiqiong Tan
- Emergency and Intensive Care Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yu Ma
- Chongqing Key Laboratory of Emergency Medicine, Chongqing Emergency Medical Center (Chongqing University Central Hospital), Chongqing, China
| | - Yimin Zhu
- Department of Emergency Medicine, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics, Hunan Provincial People's Hospital (The First Affiliated Hospital), Hunan Normal University, Changsha, China
| | - Chaoqian Li
- Department of Emergency Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaotong Han
- Department of Emergency Medicine, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabonomics, Hunan Provincial People's Hospital (The First Affiliated Hospital), Hunan Normal University, Changsha, China
| | - Shengtao Yan
- Department of Emergency Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Chang Pan
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Jianbo Zhang
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Yaping Hou
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Chunyi Wang
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Yuan Bian
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Rugang Liu
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Kai Cheng
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Jingjing Ma
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Zhaolei Zheng
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Ruixue Song
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Mingjie Wang
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Jianhua Gu
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | | | | | - Yuguo Chen
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China
| | - Feng Xu
- Department of Emergency Medicine, Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, and The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, Jinan, China.
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Jones D, Pearsell J, Wadeson E, See E, Bellomo R. Rapid Response System Components and In-Hospital Cardiac Arrests Rates 21 Years After Introduction Into an Australian Teaching Hospital. J Patient Saf 2023; 19:478-483. [PMID: 37493361 DOI: 10.1097/pts.0000000000001145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
OBJECTIVES The aims of the study are: (1) to evaluate the epidemiology of in-hospital cardiac arrests (IHCAs) 21 years after implementing a rapid response teams (RRTs); and (2) to summarize policies, procedures, and guidelines related to a national standard pertaining to recognition of and response to clinical deterioration in hospital. METHODS The study used a prospective audit of IHCA (commencement of external cardiac compressions) in ward areas between February 1, 2021, and January 31, 2022. Collation, summary, and presentation of material related to 8 "essential elements" of the Australian Commission for Safety and Quality in Health Care consensus statement on clinical deterioration. RESULTS There were 3739 RRT calls and 244 respond blue calls. There were 20 IHCAs in clinical areas, with only 10 occurring in general wards (0.36/1000 admissions). The median (interquartile range) age was 69.5 years (60-77 y), 90% were male, and comorbidities were relatively uncommon. Only 5 patients had a shockable rhythm. Survival was 65% overall, and 80% and 50% in patients on the cardiac and general wards, respectively. Only 4 patients had RRT criteria in the 24 hours before IHCA. A detailed summary is provided on policies and guidelines pertaining to measurement and documentation of vital signs, escalation of care, staffing and oversight of RRTs, communication for safety, education and training, as well as evaluation, audit, and feedback, which underpinned such findings. CONCLUSIONS In our mature RRT, IHCAs are very uncommon, and few are preventable. Many of the published barriers encountered in successful RRT use have been addressed by our policies and guidelines.
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Affiliation(s)
- Daryl Jones
- From the Department of Intensive Care and Deteriorating Patient Committee, Austin Health, Victoria, Australia
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Nacer DT, de Sousa RMC, Miranda AL. Outcomes after Clinical and Traumatic Out-of-Hospital Cardiac Arrest. Arq Bras Cardiol 2023; 120:e20220551. [PMID: 37493651 PMCID: PMC10374265 DOI: 10.36660/abc.20220551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/27/2023] [Accepted: 04/05/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Data on out-of-hospital cardiac arrest are still scarce, very varied, and indicate a poor prognosis for traumatic events. OBJECTIVES To describe the out-of-hospital/in-hospital survival, survival time, and neurological conditions of those treated by advanced life support units and submitted to cardiopulmonary resuscitation and compare the results of clinical and traumatic cardiac arrests. METHODS This is a cohort study carried out in three stages; in the first two, data were collected from the Mobile Emergency Care Service forms and medical records; then, the Brain Performance Category Scale was applied in the third stage. The sample consisted of resuscitated victims aged ≥18 years. Fisher's and log-rank tests were used to compare the causes, considering a significance level of 5%. RESULTS 852 patients were analyzed; 20.66% were hospitalized, 4.23% survived until transfer or discharge, and 58.33% had a favorable outcome one year after arrest. There was an association between pre/in-hospital survival and the nature of the occurrence (p=0.026), but there was no difference between the survival curves (p=0.6). CONCLUSIONS Survival of hospitalization after out-of-hospital cardiac arrest was low; however, most who survived to be discharged achieved a favorable outcome after one year. The survival time of those hospitalized after clinical and traumatic events were similar, but pre-hospital survival was higher among trauma patients.
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Affiliation(s)
- Daiana Terra Nacer
- Universidade de São PauloEscola de EnfermagemSão PauloSPBrasilUniversidade de São Paulo – Escola de Enfermagem, São Paulo, SP – Brasil
| | - Regina Márcia Cardoso de Sousa
- Universidade de São PauloEscola de EnfermagemSão PauloSPBrasilUniversidade de São Paulo – Escola de Enfermagem, São Paulo, SP – Brasil
| | - Anna Leticia Miranda
- Universidade Federal de Minas GeraisFaculdade de MedicinaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais – Faculdade de Medicina – Campus Saúde, Belo Horizonte, MG – Brasil
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9
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Zhou G, Wang Y, Sun Z, Yuan M, Ma Y, Wu Q, Wu C, Xu J, Li Y, Liu Y, Wang Z, Song C. Survival outcome among patients with out-of-hospital cardiac arrest who received cardiopulmonary resuscitation in China: a systematic review and meta-analysis. Eur J Med Res 2023; 28:8. [PMID: 36600249 PMCID: PMC9811716 DOI: 10.1186/s40001-022-00955-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study aimed to assess the survival outcomes among patients with out-of-hospital cardiac arrest (CA) who received cardiopulmonary resuscitation (CPR) in China. METHODS Relevant studies, published between January 1, 2010 and September 5, 2022, were retrieved from databases, including EMBASE, PubMed, Cochrane Library, the China Biology Medicine disk, China National Knowledge Infrastructure, and Wanfang databases. We included clinical studies in which all patients were diagnosed with CA and underwent out-of-hospital CPR, and the outcome variables were at least one of the following: return of spontaneous circulation (ROSC), survival to admission, survival to hospital discharge, 1-month survival, achieved good neurological outcomes, and 1-year survival. Two investigators independently extracted the study data and assessed its quality using a modified Newcastle-Ottawa Scale tool. The data were pooled using random-effects models. RESULTS Of the 3620 identified studies, 49 (63,378 patients) were included in the meta-analysis. The pooled ROSC rate was 9.0% (95% confidence interval [CI] 7.5-10.5%, I2 = 97%), the pooled survival to admission rate was 5.0% (95% CI 2.7-8.0%, I2 = 98%), and the pooled survival to discharge rate was 1.8% (95% CI 1.2-2.5%, I2 = 95%). Additionally, the ROSC rate of patients with bystander CPR was significantly higher than that of those without bystander CPR, and the pooled odds ratio (OR) was 7.92 (95% CI 4.32-14.53, I2 = 85%). The ROSC rate of participants who started CPR within 5 min was significantly higher than that of those who started CPR after 5 min, and the pooled OR was 5.92 (95% CI 1.92-18.26, I2 = 85%). The ROSC rate of participants with defibrillation was significantly higher than that of those without defibrillation, and the pooled OR was 8.52 (95% CI 3.72-19.52, I2 = 77%). CONCLUSION The survival outcomes of out-of-hospital CPR in China are far below the world average. Therefore, the policy of providing automated external defibrillators (AEDs) in public places and strengthening CPR training for healthcare providers and public personnel should be encouraged and disseminated nationwide. Trial registration This study was registered in PROSPERO (CRD42022326165) on 29 April 2022.
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Affiliation(s)
- Guozhong Zhou
- grid.218292.20000 0000 8571 108XDepartment of Science and Research, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
| | - Yan Wang
- grid.218292.20000 0000 8571 108XDepartment of Emergency Medicine, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
| | - Zihong Sun
- grid.285847.40000 0000 9588 0960School of Basic Medical Sciences, Kunming Medical University, Kunming, 650051 Yunnan China
| | - Mingqi Yuan
- grid.218292.20000 0000 8571 108XIntensive Care Unit, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
| | - Yunlin Ma
- grid.218292.20000 0000 8571 108XDepartment of Emergency Medicine, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
| | - Qianxi Wu
- grid.218292.20000 0000 8571 108XIntensive Care Unit, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
| | - Chunyan Wu
- grid.218292.20000 0000 8571 108XIntensive Care Unit, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
| | - Jing Xu
- grid.218292.20000 0000 8571 108XEmergency Center, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
| | - Yongyi Li
- Emergency Center of Yunnan Province, Kunming, 650031 Yunnan China
| | - Yunchuan Liu
- grid.218292.20000 0000 8571 108XNursing Department, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
| | - Zhenzhou Wang
- Emergency Center of Yunnan Province, Kunming, 650031 Yunnan China
| | - Chao Song
- grid.218292.20000 0000 8571 108XDepartment of Medical Imaging, Anning First People’s Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302 Yunnan China
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Effect of a Targeted Ambulance Treatment Quality Improvement Programme on Outcomes from Out-of-Hospital Cardiac Arrest: A Metropolitan Citywide Intervention Study. J Clin Med 2022; 12:jcm12010163. [PMID: 36614963 PMCID: PMC9820951 DOI: 10.3390/jcm12010163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
The performance of ambulance crew affects the quality of pre-hospital treatment, which is vital to the survival for out-of-hospital cardiac arrest (OHCA) patients, yet remains suboptimal in China. In this retrospective analysis study, we aimed to examine the effect of a citywide quality improvement programme on provision of prehospital advanced life support (ALS) by emergency medical service (EMS) system. EMS-treated adult OHCA patients after the implementation of the programme (1 January 2021 to 30 June 2022) were compared with historical controls (1 June 2019 to 31 August 2020) in Suzhou. Multivariable logistic regression analysis and propensity score matching procedures were applied to compare the outcomes between two periods for total OHCA cases and subgroup of cases treated by fixed or non-fixed ambulance crews. A total of 1465 patients (pre-period/post-period: 610/855) were included. In the 1:1 matched analysis of 591 cases for each period, significant improvement (p < 0.05) was observed for the proportion of intravenous (IV) access (23.4% vs. 68.2%), advanced airway management (49.2% vs. 57.0%), and return of spontaneous circulation (ROSC) at handover (5.4% vs. 9.0%). The fixed ambulance crews performed better than non-fixed group in IV access and advanced airway management for both periods. There were significant increases in IV access (AOR 12.66, 95%CI 9.02−18.10, p < 0.001), advanced airway management (AOR 1.67, 95% CI 1.30−2.16, p < 0.001) and ROSC at handover (AOR 2.37, 95%CI 1.38−4.23, p = 0.002) after intervention in unfixed group, while no significant improvement was observed in fixed group except for IV access (AOR 7.65, 95%CI 9.02−18.10, p < 0.001). In conclusion, the quality improvement program was positively associated with the provision of prehospital ALS interventions and prehospital ROSC following OHCA. The fixed ambulance crews performed better in critical care provision and prehospital outcome, yet increased protocol adherence and targeted training could fill the underperformance of non-fixed crews efficaciously.
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Zheng K, Bai Y, Zhai QR, Du LF, Ge HX, Wang GX, Ma QB. Correlation between the warning symptoms and prognosis of cardiac arrest. World J Clin Cases 2022; 10:7738-7748. [PMID: 36158514 PMCID: PMC9372869 DOI: 10.12998/wjcc.v10.i22.7738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/21/2022] [Accepted: 06/17/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A low survival rate in patients with cardiac arrest is associated with failure to recognize the condition in its initial stage. Therefore, recognizing the warning symptoms of cardiac arrest in the early stage may play an important role in survival.
AIM To investigate the warning symptoms of cardiac arrest and to determine the correlation between the symptoms and outcomes.
METHODS We included all adult patients with all-cause cardiac arrest who visited Peking University Third Hospital or Beijing Friendship Hospital between January 2012 and December 2014. Data on population, symptoms, resuscitation parameters, and outcomes were analysed.
RESULTS Of the 1021 patients in the study, 65.9% had symptoms that presented before cardiac arrest, 25.2% achieved restoration of spontaneous circulation (ROSC), and 7.2% survived to discharge. The patients with symptoms had higher rates of an initial shockable rhythm (12.2% vs 7.5%, P = 0.020), ROSC (29.1% vs 17.5%, P = 0.001) and survival (9.2% vs 2.6%, P = 0.001) than patients without symptoms. Compared with the out-of-hospital cardiac arrest (OHCA) without symptoms subgroup, the OHCA with symptoms subgroup had a higher rate of calls before arrest (81.6% vs 0.0%, P < 0.001), health care provider-witnessed arrest (13.0% vs 1.4%, P = 0.001) and bystander cardiopulmonary resuscitation (15.5% vs 4.9%, P = 0.002); a shorter no flow time (11.7% vs 2.8%, P = 0.002); and a higher ROSC rate (23.8% vs 13.2%, P = 0.011). Compared to the in-hospital cardiac arrest (IHCA) without symptoms subgroup, the IHCA with symptoms subgroup had a higher mean age (66.2 ± 15.2 vs 62.5 ± 16.3 years, P = 0.005), ROSC (32.0% vs 20.6%, P = 0.003), and survival rates (10.6% vs 2.5%, P < 0.001). The top five warning symptoms were dyspnea (48.7%), chest pain (18.3%), unconsciousness (15.2%), paralysis (4.3%), and vomiting (4.0%). Chest pain (20.9% vs 12.7%, P = 0.011), cardiac etiology (44.3% vs 1.5%, P < 0.001) and survival (33.9% vs 16.7%, P = 0.001) were more common in males, whereas dyspnea (54.9% vs 45.9%, P = 0.029) and a non-cardiac etiology (53.3% vs 41.7%, P = 0.003) were more common in females.
CONCLUSION Most patients had warning symptoms before cardiac arrest. Dyspnea, chest pain, and unconsciousness were the most common symptoms. Immediately recognizing these symptoms and activating the emergency medical system prevents resuscitation delay and improves the survival rate of OHCA patients in China.
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Affiliation(s)
- Kang Zheng
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Yi Bai
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Qiang-Rong Zhai
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Lan-Fang Du
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Hong-Xia Ge
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Guo-Xing Wang
- Department of Emergency Medicine, Beijing Friendship Hospital, Beijing 100050, China
| | - Qing-Bian Ma
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
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Zheng K, Du L, Cao Y, Niu Z, Song Z, Liu Z, Liu X, Xiang X, Zhou Q, Xiong H, Chen F, Zhang G, Ma Q. Monitoring cardiopulmonary resuscitation quality in emergency departments: a national survey in China on current knowledge, attitudes, and practices. BMC Emerg Med 2022; 22:33. [PMID: 35227198 PMCID: PMC8887136 DOI: 10.1186/s12873-022-00590-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/23/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To investigate current knowledge, attitudes, and practices for CPR quality control among emergency physicians in Chinese tertiary hospitals. METHODS Anonymous questionnaires were distributed to physicians in 75 tertiary hospitals in China between January and July 2018. RESULTS A total of 1405 respondents answered the survey without obvious logical errors. Only 54.4% respondents knew all criteria of high-quality CPR. A total of 91.0% of respondents considered CPR quality monitoring should be used, 72.4% knew the objective method for monitoring, and 63.2% always/often monitored CPR quality during actual resuscitation. The main problems during CPR were related to chest compression: low quality due to fatigue (67.3%), inappropriate depth (57.3%) and rate (54.1%). The use of recommended monitoring methods was reported as follows, ETCO2 was 42.7%, audio-visual feedback devices was 10.1%, coronary perfusion pressure was 17.9%, and invasive arterial pressure was 31.1%. A total of 96.3% of respondents considered it necessary to participate in regular CPR retraining, but 21.4% did not receive any retraining. The ideal retraining interval was considered to be 3 to 6 months, but the actual interval was 6 to 12 months. Only 49.7% of respondents reported that feedback devices were always/often used in CPR training. CONCLUSION Chinese emergency physicians were very concerned about CPR quality, but they did not fully understand the high-quality criteria and their impact on prognosis. CPR quality monitoring was not a routine procedure during actual resuscitation. The methods recommended in guidelines were rarely used in practice. Many physicians had not received retraining or received retraining at long intervals. Feedback devices were not commonly used in CPR training.
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Affiliation(s)
- Kang Zheng
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Lanfang Du
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, 100191, China
| | - Yu Cao
- Department of Emergency Medicine, Sichuan University West China Hospital, Chengdu, 610041, China
| | - Zhendong Niu
- Department of Emergency Medicine, Sichuan University West China Hospital, Chengdu, 610041, China
| | - Zhenju Song
- Department of Emergency Medicine, Zhongshan Hospital Fudan University, Shanghai, 200032, China
| | - Zhi Liu
- Department of Emergency Medicine, China Medical University First Hospital, Shenyang, 110001, China
| | - Xiaowei Liu
- Department of Emergency Medicine, China Medical University First Hospital, Shenyang, 110001, China
| | - Xudong Xiang
- Department of Emergency Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, China
| | - Qidi Zhou
- Department of Emergency Medicine, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Hui Xiong
- Department of Emergency Medicine, Peking University First Hospital, Beijing, 100034, China
| | - Fengying Chen
- Department of Emergency Medicine, The Affiliated Hospital of Innor Mongolia Medical University, Innor Mongolia, 010050, China
| | - Guoqiang Zhang
- Department of Emergency Medicine, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Qingbian Ma
- Department of Emergency Medicine, Peking University Third Hospital, Beijing, 100191, China.
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Hou L, Wang Y, Wang W. Optimization of the Pre-Hospital Rescue System for Out-of-Hospital Cardiac Arrest in China. China CDC Wkly 2022; 4:52-55. [PMID: 35586459 PMCID: PMC8796719 DOI: 10.46234/ccdcw2022.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/06/2021] [Indexed: 12/04/2022] Open
Abstract
Out-of-hospital cardiac arrest (OHCA) presents a significant public health challenge in China. A sharp contrast in survival rate after OHCA exists between China and more developed countries. Due to the short life-saving time window, emergency medical services (EMS) and bystanders peripheral to EMS are key contributors to survival after OHCA. Here we discuss limitations and challenges for current EMS in rescuing OHCA by reviewing requirements for EMS in China. We call for an updated public health-based pre-hospital rescue system that includes establishing a cardiac arrest registry, promoting a "Three Early's" campaign [early dialing of emergency hotline 120, early cardiopulmonary resuscitation (CPR), and early defibrillation], and operating a mechanism comprised of professional public health institutions (EMS, CDC, specialized disease prevention and control institutions, and health education institutions) as well as many governmental departments, such as healthcare, industry and information technology, and education, and non-governmental organizations, such as the Red Cross Society. Following the optimization of the pre-hospital rescue system and the participation of the whole population in self-rescue and mutual rescue, we believe that a dramatic improvement in OHCA survival will come about in China.
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Affiliation(s)
- Lei Hou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,Lei Hou,
| | - Yumeng Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,Public Health School, Baotou Medical College, Baotou, Inner Mongolia Autonomous Region, China
| | - Wenlei Wang
- The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China
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Longer retrieval distances to the automated external defibrillator reduces survival after out-of-hospital cardiac arrest. Resuscitation 2021; 170:44-52. [PMID: 34767901 DOI: 10.1016/j.resuscitation.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/22/2022]
Abstract
AIMS To evaluate and compare survival after out-of-hospital (OHCA), where an automated external defibrillator (AED) was used, in densely, moderately and thinly populated areas. Also, to evaluate the association between AED retrieval distance and survival after OHCA. METHODS From 2014 to 2018, AEDs used during OHCA in the region of Southern Denmark were systematically collected. OHCAs were included if the OHCA address was known. OHCAs at nursing homes were excluded. To evaluate population density, a map with 1000 × 1000 meter grid cells was used with each cell color-graded according to the number of inhabitants. Densely, moderately and thinly populated areas were defined as ≥200 inhabitants, 20-199 inhabitants and 0-19 inhabitants per km2, respectively. Primary outcome was 30-day survival. RESULTS A total of 423 cases of OHCA were included, of which 207 (49%) occurred in densely populated areas, while 78 (18%) and 138 (33%) occurred in moderately and thinly populated areas, respectively. AED retrieval distances were: densely populated 105 m (IQR 5-450), moderately populated 220 m (IQR 5-450) and thinly populated 350 m (IQR 5-1500) (P < 0.001). Thirty-day survival was 40%, 31% and 34%, respectively (P = 0.3). In a multivariable regression analysis, mortality increased with 10% per 100 m an AED was placed further away from the site of OHCA. CONCLUSION Survival after OHCA, where an AED was used, did not seem to differ in thinly, moderately and densely populated areas. The length of the AED retrieval distance, however, was correlated with reduced survival after adjusting for other potentially explanatory variables.
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