Cardiac arrest in Irish general practice: an observational study from 426 general practices.
METHODS
Sudden Cardiac Death accounts for approximately 5000 deaths in Ireland each year. Nationally, out-of-hospital cardiac arrest has a very low resuscitation rate, reported at less than 5%. Ireland has a well developed general practice network which routinely manages emergencies arising in the community setting. However, little is known about its potential impact on Sudden Cardiac Death. This study reports on the incidence and management of cardiac arrest in Irish general practice.


METHODS
A national training/equipment project in defibrillation in general practice (MERIT) has established a network to prospectively report all cardiac arrests with a resuscitation attempt in general practice. Three monthly surveys of the network record events; structured debriefing uses a modified Utstein template to detail events and their outcomes.


RESULTS
426 practices reported data during a 36-month period (85-97% response rate to surveys), reporting 144 events, of which data are available on 136 events. 88.4% of events were witnessed, 31.6% by general practice staff. 58.2% of events occurred in the general practice or in the patient's home. The general practitioner (GP) was on scene before the ambulance in 72.6% of cases and 52.3% of the patients involved were patients of the GP attending. 52.3% of patients were defibrillated, 32.6% had return of spontaneous circulation at some point and 26 patients (19.5%) were discharged from hospital.


CONCLUSIONS
Cardiac arrest in general practice is compatible with structured, effective interventions and significant rates of successful resuscitation. All general practices should be capable of providing this care.
Bury
Gerard
G
Centre for Immediate Care Services, University College Dublin, Belfield, Dublin, Ireland. gerard.bury@ucd.ie
Headon
Mary
M
Dixon
Mark
M
Egan
Mairead
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult