Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia

Deasy, C., Bray, J.E., Smith, K., Harriss, L.R., Bernard, S.A., Davidson, P.M., and Cameron, P. (2012) Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia. Resuscitation, 83 (1). pp. 58-62.

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Abstract

Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia.

Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR.

Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8%) occurring in a RACF. A shockable rhythm was present in 179 (7.6%) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66%); 173 (97%) received an EMS attempted resuscitation. ROSC was achieved in 71 (41%) patients and 15 (8.7%) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92%) of whom 804 (37%) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22%) and 10 patients (1.2%) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8% vs. 4.7%, p = 0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95% CI 2.4–3.7) and the presence of bystander CPR (OR 4.6, 95% CI 3.7–5.8) was associated with the paramedic decision to resuscitate.

Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.

Item ID: 40498
Item Type: Article (Refereed Research - C1)
Keywords: aged care facilities; out-of-hospital cardiac arrest; nursing homes; elderly; outcomes; epidemiology
ISSN: 1873-1570
Date Deposited: 16 Sep 2015 03:18
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110305 Emergency Medicine @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111718 Residential Client Care @ 33%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 40%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920502 Health Related to Ageing @ 40%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 20%
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