title: Transfer of care is associated with longer unsuccessful resuscitations.
abstract: OBJECTIVE
  Accepted guidelines define when to terminate unsuccessful resuscitations. We examined whether such resuscitations last longer for transported arrests in the field compared with those occurring in the emergency department (ED).
  
  
  METHODS
  This was a retrospective study of patients who died in an urban, academic ED over 32 months starting from January 2001. Total length of resuscitation and the interval occurring in-ED were compared for arrests in the ED and transported arrests from the field.
  
  
  RESULTS
  A total of 132 patients met the criteria, of whom 71 (53.8%) arrested in the field. Mean overall resuscitation times were longer for arrests occurring in the field (44 minutes; 95% confidence interval [CI], 39-48) compared with those in the ED (19 minutes; 95% CI, 16-22; P < .001). Mean resuscitation intervals occurring in the ED were no different for arrests occurring in the field (16 minutes; 95% CI, 13-19) than in the ED (19 minutes; 95% CI, 16-22; P > .05).
  
  
  CONCLUSIONS
  Unsuccessful resuscitations were longer and beyond guideline recommendations when arrests occurred in the field and were transported. The interval of resuscitation that occurred in the ED was the same whether or not prehospital resuscitation occurred.
authors.affiliation: Division of Emergency Medicine, Box 356123, University of Washington Medical Center, Seattle, WA 98195, USA. strote@u.washington.edu
authors.forename: Jared
authors.initials: J
authors.lastname: Strote
authors.forename: Pamela
authors.initials: P
authors.lastname: Kohler
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D012189:Retrospective Studies; D013997:Time Factors; D014193:Trauma Centers; D014505:Urban Population