title: The scene time interval and basic life support termination of resuscitation rule in adult out-of-hospital cardiac arrest.
abstract: We validated the basic life support termination of resuscitation (BLS TOR) rule retrospectively using Out-of-Hospital Cardiac Arrest (OHCA) data of metropolitan emergency medical service (EMS) in Korea. We also tested it by investigating the scene time interval for supplementing the BLS TOR rule. OHCA database of Seoul (January 2011 to December 2012) was used, which is composed of ambulance data and hospital medical record review. EMS-treated OHCA and 19 yr or older victims were enrolled, after excluding cases occurred in the ambulance and with incomplete information. The primary and secondary outcomes were hospital mortality and poor neurologic outcome. After calculating the sensitivity (SS), specificity (SP), and the positive and negative predictive values (PPV and NPV), tested the rule according to the scene time interval group for sensitivity analysis. Of total 4,835 analyzed patients, 3,361 (69.5%) cases met all 3 criteria of the BLS TOR rule. Of these, 3,224 (95.9%) were dead at discharge (SS,73.5%; SP,69.6%; PPV,95.9%; NPV, 21.3%) and 3,342 (99.4%) showed poor neurologic outcome at discharge (SS, 75.2%; SP, 89.9%; PPV, 99.4%; NPV, 11.5%). The cut-off scene time intervals for 100% SS and PPV were more than 20 min for survival to discharge and more than 14 min for good neurological recovery. The BLS TOR rule showed relatively lower SS and PPV in OHCA data in Seoul, Korea.
authors.affiliation: Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
authors.forename: Tae Han
authors.identifier: 0000-0003-3855-081X
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sang Do
authors.identifier: 0000-0003-4953-2916
authors.initials: SD
authors.lastname: Shin
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yu Jin
authors.identifier: 0000-0003-2562-615X
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Inje University College of Medicine, Seoul, Korea.
authors.forename: Chu Hyun
authors.identifier: 0000-0002-9466-104X
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
authors.forename: Jeong Eun
authors.identifier: 0000-0002-5457-745X
authors.initials: JE
authors.lastname: Kim
mesh_terms: D000328:Adult; D022561:Advanced Cardiac Life Support / Q000401:mortality*; D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D003422:Critical Care / Q000706:statistics & numerical data; D003661:Decision Support Techniques; D004554:Electric Countershock / Q000401:mortality*; D004632:Emergency Medical Services; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000401:mortality* / Q000628:therapy; D016079:Refusal to Treat; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: Cardiopulmonary Resuscitation; Decision Support Technique; Out-of-Hospital Cardiac Arrest