Outcome of Cardiopulmonary Resuscitation Sawanpracharak Hospital Protocols on Return of Spontaneous Circulation in Out of Hospital Cardiac Arrest

Abstract

Objective         : To study the outcomes of the implementation of cardiopulmonary resuscitation (CPR) on out-of-hospital cardiac arrest (OHCA) patients on the return of spontaneous circulation (ROSC) and survival rate.

Method             :  This quasi-experimental research studied patients with OHCA who were treated by the advanced emergency medical service team at Sawanpracharak Hospital, Nakhonsawan Province. Researcher compared 2 groups of patients 1) before the implementation of CPR protocol (the pre-protocol group) from November 2019 to June 2020 with 41 patients 2) after the implementation of CPR protocol (the post-protocol group) from July 2020 to February 2021 with 41 patients. Data were collected from the OHCA patient datasheet and studied for the ROSC before arriving at the hospital and survival within 24 , 48 hours of hospital admission and survival to discharge. Statistical comparison of differences between the two groups were the t-test, the chi-square test or Fisher's exact test, and the level of statistical significance was determined at p-value < 0.05.

Results              : The study showed in the pre-protocol group, the number of patients who had ROSC before arriving at the hospital, survived within 24 hours and 48 hours of hospital admission and survived to discharge was at 4.9%, 7.3%, 2.4% and 0% respectively. Moreover, it was found that in the post-protocol group, the number of patients who had ROSC before arriving the hospital, survived within 24 hours, 48 hours of hospital admission and survived to discharge was at 7.3%, 17.1%, 7.3%, and 7.3%, accordingly. There was no difference in the survival rates in both groups (P-values were 0.64, 0.18, 0.32 and 0.99, respectively).

Conclusions    :  There were no differences in patients who had ROSC before arriving at the hospital, survival within 24 hours, within 48 hours of hospital admission and survival to discharge in the group before and after using the CPR protocol. It was also found that the group after applying the CPR protocol was more likely to survive to discharge.

Keywords        :  Out-of-hospital cardiac arrest, Return of spontaneous circulation, Emergency medical service