Analysis of prehospital care for cardiac arrest in an urban setting in Japan.
BACKGROUND
In Japan, the management of prehospital care for cardiopulmonary arrest (CPA) has recently changed.


OBJECTIVE
The characteristics of prehospital care for CPA were analyzed to identify predictors of prehospital return of spontaneous circulation (PROSC) and good recovery.


METHODS
The characteristics of prehospital management of 713 out-of-hospital CPA patients in the First Western District of Saitama Prefecture, Japan, were retrospectively analyzed.


RESULTS
Overall, PROSC rate was 9.5% (n = 68), and 2.2% of patients (n = 16) made a good recovery. Significant positive predictors of PROSC were: duration from the first call to hospital arrival, witnessed collapse, ventricular fibrillation at scene, and epinephrine administration. Establishment of supraglottic airway was a significant negative predictor of PROSC. Significant positive predictors of good recovery were younger age, ventricular fibrillation at scene, and PROSC. Changes to the life support protocol based on 2005 guidelines did not affect the outcome.


CONCLUSIONS
Epinephrine was effective in increasing PROSC; however, it did not improve recovery of such patients. The findings also suggest that out-of-hospital care providers should not try to establish a supraglottic airway.
Yanagawa
Youichi
Y
Department of Traumatology and Critical Care Medicine, National Defense Medical College (NDMC), Namiki Tokorozawa Saitama, Japan.
Sakamoto
Toshihisa
T
D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D004632:Emergency Medical Services; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005931:Glottis; D006323:Heart Arrest / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal; D007564:Japan; D008297:Male; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function; D012189:Retrospective Studies; D013566:Sympathomimetics / Q000627:therapeutic use; D014505:Urban Population
D013566:Sympathomimetics; D004837:Epinephrine