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Out-of-Hospital Cardiac Arrest: First Documented Experience in a Mexican Urban Setting

Published online by Cambridge University Press:  28 June 2012

Juan Manuel Fraga-Sastrías*
Affiliation:
Academia Mexicana de Medicina Prehospitalaria, Queretaro, Mexico Universidad del Valle de Mexico, Campus Querétaro, Querétaro, Mexico
Enrique Asensio-Lafuente
Affiliation:
Academia Mexicana de Medicina Prehospitalaria, Queretaro, Mexico Universidad del Valle de Mexico, Campus Querétaro, Querétaro, Mexico
Ricardo Martínez
Affiliation:
Universidad del Valle de Mexico, Campus Querétaro, Querétaro, Mexico
Iris A. Bárcenas
Affiliation:
Universidad del Valle de Mexico, Campus Querétaro, Querétaro, Mexico
Julio Prieto-Sagredo
Affiliation:
Academia Mexicana de Medicina Prehospitalaria, Queretaro, Mexico Neurofisiología Comparada, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
Lilia Castillo
Affiliation:
Asociación Mexicana Para la Prevención de la Insuficiencia Cardiaca (AMEPPIC), Mexico City, Mexico
Luis Mauricio Pinet-Peralta
Affiliation:
Academia Mexicana de Medicina Prehospitalaria, Queretaro, Mexico
*
Unidad de SimulaciónUniversidad del Valle de México, Campus Querétaro. Paseo Jurica 105-25PBJurica-Querétaro 76100. México E-mail:[email protected]

Abstract

Objective:

Out-of-hospital cardiac arrest is one of the leading causes of death in Mexico, but many survival and prognostic factors are unknown. The aim of this study was to assess out-of-hospital cardiac arrest in a Mexican city.

Methods:

This was a prospective, cohort study that evaluated the records of the major ambulance services in the city of Queretaro, Mexico. Means, standard deviation, and percentages for the categorical variables were obtained. Logistic regression was performed to determine the effects between interventions, times, and return of spontaneous circulation (ROSC).

Results:

For an 11-month period, 148 out-of-hospital cardiac arrest cases were recorded. The mean age of the victims was 54 ±22.6 years and 90 (65.3%) were males. Forty-nine cases were related to cardiac disease, 46 to other disease, 27 to trauma, 18 to terminal illnesses, and three to drowning. Twelve (8.6%) patients had a pulse upon hospital arrival, but none survived to discharge. No victims were defibrillated prior to ambulance arrival. The collapse-assessment interval was 22.5 ±19:1 minutes, the mean value for the ambulance response times was 13:6 ±10:4 minutes. Basic emergency medical technicians applied chest compressions to 40 victims (27.2%), controlled the airway in 32 (21.8%), and defibrillated seven (4.8%). Chest compressions and airway control showed an OR of 8 and 12 respectively for ROSC.

Conclusions:

The poor survival rate in this study emphasizes the need to improve efforts in provider training and public education. Authorities must promote actions to enhance prehospital emergency services capabilities, shorten response times, and provide community education to increase the chances of survival for out-of-hospital cardiac arrest victims in Mexico.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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References

1. Asensio, E, Narváez, R, Dorantes, J, et al. : Conceptos actuales sobre la muerte súbita. Gac Med Mex 2005;141(2):8998. [in Spanish]Google Scholar
2. Stiell, I, Wells, G, Field, B, et al. : Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS Study Phase II. Ontario prehospital advanced life support. JAMA 1999;281(13):1175–81.Google ScholarPubMed
3. Diem, S, Lantos, J, Tulsky, J: Cardiopulmonary resuscitation on television: Miracles and misinformation. N Eng J Med 1996;334:15781582.CrossRefGoogle ScholarPubMed
4. Sayre, M, Berg, RA, Cave, D, et al. : Hands only (compression-only) cardiopulmonary resucitation: A call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest. A science advisory for the public from the American Heart Association emergency cardiovascular committee. Circulation 2008;117:15.CrossRefGoogle Scholar
5. De Maio, V, Stiel, V, Wells, G, Spaite, D: Optimal defibrillation response intervals for maximum out-of-hospital cardiac arrest survival rates. Ann Emerg Med 2003;42(2):242250.CrossRefGoogle ScholarPubMed
6. American Heart Association: American Heart Association Guidelines for ca rdiopulmonary resuscitation and emergency cardiac care. Circulation 2005;114(24).Google Scholar
7. Fraga-S, JM, Asensio-Lafuente, E, Illescas-F, GJ: Resultados de una encuesta sobre los servicios médicos de urgencias prehospitalarias realizada en México. Gac Med Mex 2007;143 (2):123130. [in Spanish]Google Scholar
8. Cummins, RO, Ornato, JP, Thies, WH, Pepe, PE: Improving survival from sudden cardiac arrest: The “chain of survival” concept: A statement for health professionals from the advanced cardiac life support subcommittee and the emergency cardiac care committee, American Heart Association. Circulation 1991;83(5):18321847.CrossRefGoogle ScholarPubMed
9. Finn, JC, Jacobs, I, Colman, C, Oxer, H: Outcomes of out-of-hospital cardiac arrest in patients in Perth, Western Australia 1996–1999. Resuscitation 2001;51(3):247255.CrossRefGoogle ScholarPubMed
10. Rudner, R, Jalowiecki, P, Kerpel, E, et al. : Survival after out-of hospital cardiacarrest in Katowice (Poland):Out come report acco rding to the “Utstein Style”. Resuscitation 2004;61(3):315325.CrossRefGoogle Scholar
11. Cheung, W, Flynn, M, Thanakrishnan, G, et al. : Survival after out-of-hospital cardiac arrest in Sydney, Australia. Crit Care Resusc 2006;8(4):321327.Google ScholarPubMed
12. Bunch, T, White, RD, Khan, A, Packer, D: Impact of age on long term survival and quality of life following out-of-hospital cardiac arrest. Crit Care Med 2004;32(4):963967.CrossRefGoogle ScholarPubMed
13. Secretaría de Salud del Distrito Federal: Centro regulador de urgencias médicas: Estadísticas de regulación médica. Available at http://www.salud.df.gob.mx/content/view/1250/34/. Accessed May 2008.Google Scholar
14. Herlitz, J, Engdahl, J, Svensson, L, et al. : Can we define patients with no chance of survival after out-of-hospital cardiac arrest? Heart 2004;90(10):11141118.CrossRefGoogle ScholarPubMed