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Sep 13, 2018

ERC congress - Resuscitation 2018

2 - Emergency response management and outcomes of out-of-hospital sudden cardiac arrest patients at exercise and sport facilities in Queensland, Australia

Emergency response management

CPR

AED

exercise facilities

sport facilities

sudden cardiac arrest

Abstract

Abstract

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Keywords

Emergency response management

CPR

AED

exercise facilities

sport facilities

sudden cardiac arrest

Abstract

Aim: In the event of an out-of-hospital sudden cardiac arrest (OHSCA) timely cardiopulmonary resuscitation (CPR) and utilisation of an automated external defibrillator (AED) are crucial to increase the chances of survival. This study aims to analyse the emergency response management and outcomes of OHSCA patients at exercise and sport facilities (ESF) in Queensland, Australia. Methods: The de-identified electronic OHSCA data was obtained from the Queensland Ambulance Services (QAS) for the eight year period between 2007 and 2015. The data was systematically extracted, coded and categorised before analysing using descriptive, correlational and logistic regression models in SPSS version 24. Potential cases with ambiguous case descriptions as to the type of location were manually reviewed by street address for relevance. This study was approved by the Central Queensland University Human Research Ethics Committee (Approval Number: H15/06-138). Results: There were 250 OHSCA cases at ESF after exclusions (e.g. vehicle trauma, home, <18 years old) and key word search by type of sports. The OHSCA patients had a mean age of 59.39 (95% CI: 57.36, 61.43, range:74) and were mostly male (n=187, 86.6%) (Table 1). The average time it took for the paramedics to arrive on scene was 8.74 minutes (95% CI: 7.85, 9.62, range=48) with no significant difference across geographic locations (p<.05). Following paramedic’s arrival and treatment, 38.8% (n=97) of the OHSCA patients improved, while 32.4% (n=81) died mostly on the scene (25.2%, n=63). On-arrival, 75.6% (n=189) of the OHSCA patients were being applied CPR that showed 6.8% more improvement of the patients compared to no CPR or AED by the bystanders (Figure 1). Only at 12.4% (n=31) of the ESF both CPR and AED were applied by the bystanders that was associated with 4% less deaths than CPR only. However, the logistic regression model showed that effective CPR was 1.9 times a better predictor for improved OHSCA patient outcomes (Table 2). On-arrival, 75.6% (n=189) of the OHSCA patients were being applied CPR that showed 6.8% more improvement of the patients compared to no CPR or AED by the bystanders (Figure 1). Only at 12.4% (n=31) of the ESF both CPR and AED were applied by the bystanders that was associated with 4% less deaths than CPR only. However, the logistic regression model showed that effective CPR was a 1.9 times a better predictor for improved OHSCA patient outcomes (Table 2). Conclusions: These findings show that emergency management of cardiac events at ESF in Queensland are suboptimal. This study has implications for ESF operators to revise their risk management programs including medical emergency plans and procedures, and ensure they have staff currently trained in CPR and use of an AED to be capable of properly responding to an unexpected SCA event.

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© Copyright 2019 Morressier GmbH.
All rights reserved.