Details of the initial management of cardiac arrest occurring in the workplace in a French urban area.
BACKGROUND
Our goal was to evaluate the details and management of cardiac arrest (CA) occurring in the working environment.


METHODS
We conducted a 10-year retrospective study based on the medical records of the Garches mobile intensive care unit. CA occurring in the workplace ("Inside W." group) was matched with two CA outside the workplace ("Outside W." group), with regard to sex, age and year of occurrence. The Chain of Survival and prognosis factors were analysed in a bi-multivariate analysis.


RESULTS
From 1993 to 2002, 72 CA were included in the "Inside W." group, with 79% arising from suspected cardiac aetiology (there was a similar proportion in the "Outside W." group). Some variables in the cardiac aetiology patients were higher in the "Inside W." group compared to the "Outside W." group (P < 0.05): early external chest compression [(ECC), 37%, n = 20 versus 16%, n = 16)] and ventricular fibrillation as initial recorded rhythm (40%, n = 33 versus 16%, n = 16). The proportion of use of automated external defibrillator (AED) was similar in the two groups. The workplace was not associated with a better outcome, with 9% patients discharged alive compared to 4% n = 6, P > 0.05. Early ECC and defibrillation attempted with an AED were associated with patients discharged alive from the intensive care unit in a multivariate analysis (P < 0.05), but not the workplace and cardiac aetiology.


CONCLUSIONS
Although our study did not support that concept that the workplace was a safer place, there was a better chain of survival for CA applied within workplace settings. Basic Life Support teaching and installation of AEDs could be helpful, though further cost-effectiveness studies are needed.
Descatha
Alexis
A
SAMU des Hauts-de-Seine, SMUR de Garches, Hôpital R. Poincaré, AP-HP, 92380 Garches, France. alexis.descatha@rpc.ap-hop-paris.fr
Frederic
Muriel
M
Devere
Charles
C
Dolveck
François
F
Goddet
Sybille
S
Baer
Michel
M
Chauvin
Marcel
M
Fletcher
Dominique
D
Templier
François
F
D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D005602:France; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014505:Urban Population; D017132:Workplace