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J Korean Soc Emerg Med > Volume 13(1); 2002 > Article
Journal of The Korean Society of Emergency Medicine 2002;13(1): 5-11.
Clinical Analysis of Resuscitation in Victims of Out-of-Hospital Cardiac Arrest
Jong Kun Kim, Michael SungPil Choe, Kang Suk Seo, Dong Hwan Seoul, Jung Bae Park, Jae Myung Jung
1Department of Emergency Medicine, Taegu Fatima Hospital, Korea. kim7155@yahoo.co.kr
2Department of Emergency Medicine, Kyungpook National University Hospital, Taegu, Korea.
ABSTRACT
PURPOSE:
The purpose of this research is to estimate the overall survival rate and to understand the factors influencing hospital discharge when cardiopulmonary resuscitaion is attempted on out-of-hospital cardiac arrest victims.
METHODS:
From March 2000 to February 2001, we studied prospectively 71 consecutive victims with out-of-hospital cardiac arrest. We used the same record based on the "Utstein Style".
RESULTS:
Fifty-three of the 71 patients were transported by 119 ambulance; the remainder were transported by non-119 ambulance. An initial rhythm of pulseless electrical activity(PEA) was present in 66.2% of the patients, ventricular fibrillation(VF)/ventricular tachycardia in 22.5%, and asystole in 11.3%. Fifty-five of the 71 (77.5%) were cardiac arrest cases witnessed by a layman. The number of cardiac etiologies was 24 (33.8%), non-cardiac etiologies 36 (50.7%), and unknown causes 11 (15.5%). There were no statistical differences in return of spontaneous circulation (ROSC) and survival rate related to the causes of cardiac arrest, initial EKG rhythm, and method of transportation. Of the 71 patients, 29 patients (40.2%) experienced ROSC; seven patients survived.
CONCLUSION:
With the increase in cardiovascular disease and traffic accidents, the number of out-of-hospital cardiac arrests has risen accordingly. However, the survival rate has not changed much compared to the past. Major factors contributing to the unchanged survival rate are lack of bystander CPR, defibrillation in the prehospital stage, inappropriate CPR by EMT, early pronouncement of death, and unskilled CPR by the physician, and improvement in these areas are necessary in order to bring about a change .
Key words: Out-of-hospital cardiac arrest
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