Pre-hospital cardiac arrest in Prague, Czech Republic--the Utstein-style report.
OBJECTIVE
This study aimed to report results of pre-hospital cardiopulmonary resuscitation (CPR) in the city of Prague in accordance with 'Utstein-style' recommendations.


METHODS
This is a prospective study of out-of-hospital cardiac arrest (OHCA) survival in the city of Prague treated by emergency medical service (EMS). EMS Prague is a typical municipal, two-tiered ambulance service, based on the presence of a physician on the scene in all life-threatening emergencies, especially in cardiac arrests, serious breathing problems, chest-pain cases, seizures, serious trauma, etc. Since 2002, all cases of OHCA CPRs performed by EMS Prague ambulance crew are evaluated in accordance with 'Utstein-style' recommendations, including hospital-outcome score as measured by Cerebral Performance Categories (CPCs).


RESULTS
In 2008, our ambulance crew performed 493 CPRs. Return of spontaneous circulation (ROSC) was achieved in 278 cases (56.3%), survival of the event in 211 cases (42.8%) and survival to hospital discharge with good neurological outcome (CPC 1 or 2) in 74 cases (15.0%). Appropriate figures for patients with first shockable rhythm (n=146) were 106 (72.6%) for ROSC, 91 (62.3%) for survived event and 51 (34.9%) for survival to discharge with good neurological outcome. Pre-hospital CPR incidence was 41.1 per 100,000 inhabitants. The majority of cases had a cardiac origin (363, 73.6%). The physician attending the arrest declared the reason unknown in 40 cases (8.1%), as a respiratory disease in 20 cases (4.1%) and in 36 cases (7.3%) the arrest was a result of trauma, drowning or poisoning.
Franek
Ondrej
O
EMS Prague, Korunni 98, Prague 10, Czech Republic. ondrej.franek@email.cz
Pokorna
Milana
M
Sukupova
Petra
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000401:mortality* / Q000706:statistics & numerical data; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018153:Czech Republic; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D017408:Guidelines as Topic; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011446:Prospective Studies; D011787:Quality of Health Care; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D014505:Urban Population; D055815:Young Adult