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

Deasy, C; Bray, JE; Smith, K; Harriss, LR; Bernard, SA; Davidson, PM; Cameron, P

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

Deasy, C Bray, JE Smith, K Harriss, LR Bernard, SA Davidson, PM

Cameron, P

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Publication Type:: Journal Article
Citation:: Resuscitation, 2012, 83 (1), pp. 58 - 62
Issue Date:: 2012-01-01

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Field	Value	Language
dc.contributor.author	Deasy, C	en_US
dc.contributor.author	Bray, JE	en_US
dc.contributor.author	Smith, K	en_US
dc.contributor.author	Harriss, LR	en_US
dc.contributor.author	Bernard, SA	en_US
dc.contributor.author	Davidson, PM https://orcid.org/0000-0003-2050-1534	en_US
dc.contributor.author	Cameron, P	en_US
dc.date.available	2011-06-24	en_US
dc.date.issued	2012-01-01	en_US
dc.identifier.citation	Resuscitation, 2012, 83 (1), pp. 58 - 62	en_US
dc.identifier.issn	0300-9572	en_US
dc.identifier.uri	http://hdl.handle.net/10453/18616
dc.description.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. © 2011 Elsevier Ireland Ltd.	en_US
dc.relation.ispartof	Resuscitation	en_US
dc.relation.isbasedon	10.1016/j.resuscitation.2011.06.030	en_US
dc.subject.classification	Emergency & Critical Care Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Resuscitation	en_US
dc.subject.mesh	Registries	en_US
dc.subject.mesh	Incidence	en_US
dc.subject.mesh	Survival Rate	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Follow-Up Studies	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Urban Population	en_US
dc.subject.mesh	Homes for the Aged	en_US
dc.subject.mesh	Victoria	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Out-of-Hospital Cardiac Arrest	en_US
dc.title	Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	83	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1110 Nursing	en_US
dc.location.activity	Hangzhou, China
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	83	en_US

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. © 2011 Elsevier Ireland Ltd.

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http://hdl.handle.net/10453/18616