Out-of-hospital cardiac arrest: first documented experience in a Mexican urban setting.
OBJECTIVE
Out-of-hospital cardiac arrest is one of the leading causes of death in Mexico, but many survival and prognostic factors are unknown. The aim of this study was to assess out-of-hospital cardiac arrest in a Mexican city.


METHODS
This was a prospective, cohort study that evaluated the records of the major ambulance services in the city of Queretaro, Mexico. Means, standard deviation, and percentages for the categorical variables were obtained. Logistic regression was performed to determine the effects between interventions, times, and return of spontaneous circulation (ROSC).


RESULTS
For an 11-month period, 148 out-of-hospital cardiac arrest cases were recorded. The mean age of the victims was 54 +/- 22.6 years and 90 (65.3%) were males. Forty-nine cases were related to cardiac disease, 46 to other disease, 27 to trauma, 18 to terminal illnesses, and three to drowning. Twelve (8.6%) patients had a pulse upon hospital arrival, but none survived to discharge. No victims were defibrillated prior to ambulance arrival. The collapse-assessment interval was 22.5 +/- 19:1 minutes, the mean value for the ambulance response times was 13:6 +/-10:4 minutes. Basic emergency medical technicians applied chest compressions to 40 victims (27.2%), controlled the airway in 32 (21.8%), and defibrillated seven (4.8%). Chest compressions and airway control showed an OR of 8 and 12 respectively for ROSC.


CONCLUSIONS
The poor survival rate in this study emphasizes the need to improve efforts in provider training and public education. Authorities must promote actions to enhance prehospital emergency services capabilities, shorten response times, and provide community education to increase the chances of survival for out-of-hospital cardiac arrest victims in Mexico.
Fraga-Sastrías
Juan Manuel
JM
Academia Mexicana de Medicina Prehospitalaria, Queretaro, Mexico. juan.fragas@uvmnet.edu
Asensio-Lafuente
Enrique
E
Martínez
Ricardo
R
Bárcenas
Iris A
IA
Prieto-Sagredo
Julio
J
Castillo
Lilia
L
Pinet-Peralta
Luis Mauricio
LM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D007223:Infant; D008800:Mexico; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D014505:Urban Population; D055815:Young Adult