Sunday, October 1, 2017

Bystander CPR is associated with improved neurologically favourable survival in cardiac arrest following drowning

Title: Bystander CPR is associated with improved neurologically favourable survival in cardiac arrest following drowning

Authors: Joshua M. Tobin, William D. Ramos, Yongjia Pu, Peter G. Wernicki,
Linda Quan, Joseph W. Rossano

Journal: Resuscitation, June 2017


Long term prognosis following a drowning cardiac arrest is always difficult, multiple studies have found little consistent correlation with scene and clinical findings and outcome. One factor that is often studied with any type of cardiac arrest is bystander CPR, as the earlier CPR is started the better the patient should do. This study is aimed at determining factors associated with good neurologic outcome following drowning cardiac arrest.

Study details

Method: Retrospective analysis of CARES database

  • All patients who suffered drowning cardiac arrest
  • Stratified bystander CPR vs no bystander CPR
  • Multi-variate analysis: bystander CPR, AED use, location, gender, witnessed status, shockable rhythm, age
  • Survivors stratified by neurologic outcome

Results
  • 908 patients included
  • Bystander CPR in 428 (47%)
  • Majority of cases no AED
  • Majority of the cases male, unwitnessed, in public place
  • First rhythm non-shockable in 93%
  • 123 patients survived to discharge (14%)
    • 97 (80%) favorable neuro outcome
    • Associated with favorable outcome: bystander CPR, witnessed, younger
    • Not associated with favorable outcome: Public, male, shockable rhythm
Conlusion

"Bystander CPR is associated with improved neurologic outcome following cardiac arrest from drowning. Shockable rhythms were uncommon and not associated with improved outcomes."


Reference





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