Do prehospital resuscitations performed by medical emergency services make a difference? A report on resuscitations performed in an university hospital

Abstract

Objective: In this study, we aim to investigate the effect of medical emergency service, whether it is used or not, on cardiopulmonary resuscitations (CPR) of patients who presented with cardiopulmonary arrest (CPA) in our emergency department (ED). Material and Methods: All patients who received CPR in the emergency department (ED) of an university hospital from 01.01.2013 to 31.12.2013 were surveyed retrospectively. Age, gender, cardiac activity in presentation (CPA or spontaneous circulation present), their way of transport to ED (via emergency ambulance service or other), duration of CPR, whether CPR was performed or not during patient transfer, outcome of CPR and lactate levels were recorded. Results: Two hundred and eight patients were included in the study. One hundred and nine patients (52.4%) presented with CPA and 99 patients (47.6%) developed CPA in ED. Ninety four of those 109 patients with CPA in presentation were transported by an ambulance while CPR was in progress and 36 of them responded CPR which was continued in ED. On the contrary, of 15 patients who were brought by untrained friends and family without CPR, only 5 responded CPR which was performed in ED. The correlation between being transferred by ambulance or by other means and the result of CPR in ED was found statistically insignificant (p=0.475). However, return of spontaneous circulation rates for in-hospital CPAs were significantly higher (p<0.001). Conclusion: The close success rates of patient survival in non-professional patient transport without any CPR effort and profesional transport by prehospital medical emergency service are both confusing and alarming. Prehospital medical care must be thoroughly studied and all problems should be addressed by the authorities.