Survival of resuscitated cardiac arrest patients with ST-elevation myocardial infarction (STEMI) conveyed directly to a Heart Attack Centre by ambulance clinicians.
OBJECTIVE
This study reports survival outcomes for patients resuscitated from out-of-hospital cardiac arrest (OHCA) subsequent to ST-elevation myocardial infarction (STEMI), and who were conveyed directly by ambulance clinicians to a specialist Heart Attack Centre for expert cardiology assessment, angiography and possible percutaneous coronary intervention (PCI).


METHODS
This is a retrospective descriptive review of data sourced from the London Ambulance Service's OHCA registry over a one-year period.


RESULTS
We observed excellent survival rates for our cohort of patients with 66% of patients surviving to be discharged from hospital, the majority of whom were still alive after one year. Those who survived tended to be younger, to have had a witnessed arrest in a public place with an initial cardiac rhythm of VF/VT, and to have been transported to the specialist centre more quickly than those who did not.


CONCLUSIONS
A system allowing ambulance clinicians to autonomously convey OHCA STEMI patients who achieve a return of spontaneous circulation directly to a Heart Attack Centre is highly effective and yields excellent survival outcomes.
Clinical Audit and Research Unit, London Ambulance Service NHS Trust, 8-20 Pocock Street, London SE1 0BW, United Kingdom. Electronic address: rachael.fothergill@lond-amb.nhs.uk.
Rachael T
RT
Fothergill
Clinical Audit and Research Unit, London Ambulance Service NHS Trust, 8-20 Pocock Street, London SE1 0BW, United Kingdom.
Lynne R
LR
Watson
Clinical Audit and Research Unit, London Ambulance Service NHS Trust, 8-20 Pocock Street, London SE1 0BW, United Kingdom.
Gurkamal K
GK
Virdi
Medical Directorate, London Ambulance Service NHS Trust, 220 Waterloo Road, SE1 8SD, United Kingdom.
Fionna P
FP
Moore
Medical Directorate, London Ambulance Service NHS Trust, 220 Waterloo Road, SE1 8SD, United Kingdom.
Mark
M
Whitbread
D000552:Ambulances; D002300:Cardiac Care Facilities; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate
Ambulance; Heart Attack Centre; Out-of-hospital cardiac arrest; PCI; ST-elevation myocardial infarction; STEMI