title: Survival to Discharge After Cardiac Arrest Attended by a Doctor-Paramedic Helicopter Emergency Medical Service: An Utstein-style Multiservice Review of 1085 Activations.
abstract: BACKGROUND
  The presentation of outcomes after cardiac arrest presented by emergency medical service and in-hospital teams in the Utstein style allows for comparative analysis of populations and systems. Essex and Herts Air Ambulance Trust (EHAAT) and the East Anglian Air Ambulance (EAAA) are doctor-plus-paramedic prehospital care teams that respond to a large number of medical cardiac arrests.
  
  
  OBJECTIVE
  To report the outcomes of medical cardiac arrests according to the Utstein style.
  
  
  METHODS
  Retrospective database analysis and hospital follow-up of all cardiac arrests attended by either service over a 31-month period. Traumatic cardiac arrests were excluded.
  
  
  METHODS
  survival and cerebral performance category at discharge from the hospital.
  
  
  RESULTS
  There were 429 patients attended by the two services; 193 patients achieved return of spontaneous circulation, which was sustained at the time of handover to the hospital team. Of 140 patients for whom complete follow-up was available, the overall survival rate was 50.7%, 86% of whom had a Cerebral Performance Category of 1 or 2. The overall survival-to-discharge rate for all patients attended was 11.7%.
  
  
  CONCLUSIONS
  Benchmarking of performance is essential to understand reasons for variability, and to allow individual systems to reflect on their own practices. We have described 31 months of data that pertain to medical cardiac arrest cases attended by our services and demonstrated a comparable survival rate to discharge with good neurological outcome.
authors.affiliation: Essex and Herts Air Ambulance Trust, Colchester, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Chesters
authors.affiliation: Department of Emergency Medicine, Queen Mary, University of London and Bart's Health NHS Trust, London, UK; East Anglian Air Ambulance, Norwich, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Harris
authors.affiliation: East Anglian Air Ambulance, Norwich, UK.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Hodgetts
authors.affiliation: East Anglian Air Ambulance, Norwich, UK.
authors.forename: Nadine
authors.initials: N
authors.lastname: Keefe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: Utstein; cardiac arrest; helicopter emergency medical services