Initial cardiac rhythm correlated to emergency department survival.
Clinical medicine. Cardiology · 2009-02-09 · Randomised trial
Abstract
BACKGROUND: This study attempted to correlate the initial cardiac rhythm and survival from prehospital cardiac arrest, as a secondary end-point. METHODS: Prospective, randomized, double-blinded clinical intervention trial where bicarbonate was administered to 874 prehospital cardiopulmonary arrest patients in prehospital urban, suburban, and rural emergency medical service environments. RESULTS: This group's manifested an overall survival rate of 13.9% (110 of 793) of prehospital cardiac arrest patients. The most common presenting arrhythmia was ventricular fibrillation (VF) (45.0%), asystole (ASY) (34.4%), and pulseless electrical activity (PEA) (15.7%). Less commonly found were normal sinus rhythm (NSR) (1.8%), other (1.8%), ventricular tachycardia (VT) (0.6%), and atrioventricular block (AVB) (0.5%) as prearrest rhythms. The best survival was noted in those with a presenting rhythm of AVB (57.1%), VT (33.3%), VF (15.7%), NSR (14.3%), PEA (11.2%), and ASY (11.1%) (p = 0.02). However, there was no correlation between the final cardiac rhythm and outcome, other than an obvious end-of-life rhythm. CONCLUSION: The most common presenting arrhythmia was VF (45%), while survival is greatest in those presenting with AVB (57.1%).
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mortality & survival · Other drugs · Rural & remote · Sodium bicarbonate · Urban
Related articles
- Prehospital cardiac arrest outcome is adversely associated with antiarrythmic agent use, but not associated with presenting complaint or medical history. (Emerg Med J, 2004)
- The influence of urban, suburban, or rural locale on survival from refractory prehospital cardiac arrest. (Am J Emerg Med, 2004)
- Prehospital cardiac arrest and the adverse effect of male gender, but not age, on outcome. (J Womens Health (Larchmt), 2003)
- Sodium bicarbonate improves outcome in prolonged prehospital cardiac arrest. (Am J Emerg Med, 2006)
- Witnessed arrest, but not delayed bystander cardiopulmonary resuscitation improves prehospital cardiac arrest survival. (Emerg Med J, 2004)
- Machine Learning to Predict Individualized Treatment Effects of Sodium Bicarbonate for Patients With Out-of-Hospital Cardiac Arrest. (Crit Care Med, 2025)