Abstract
Aim: To determine the feasibility of transporting post-cardiac arrest patients to tertiary-care facilities, the rate of re-arrest, and the rate of critical events during critical care transport team (CCTT) care. Methods: Retrospective chart review of cardiac arrest patients transported via CCTT between 1/1/2001 and 5/31/2009. Demographic information, re-arrest, and critical events during transport were abstracted. We defined critical events as hypotension (systolic blood pressure < 90mm. Hg), hypoxia (oxygen saturation < 90%), or both hypotension and hypoxia at any time during CCTT care. Comparisons were performed using Chi-squared test and a Cox proportional hazards model was employed to determine predictors of events. Results: Of the 248 patients studied, the majority was male (61%), presented in ventricular fibrillation or ventricular tachycardia (VF/VT, 50%), and comatose (80%). Re-arrest was uncommon (N= 15; 6%). Critical events affected 58 patients (23%) during transport. Median transport time was 63. min (IQR 51, 81) in both those who experienced a critical event and those who did not. Vasopressor use was associated with any decompensation during CCTT (Hazard Ratio 1.81; 95%CI 1.29, 2.54). Three patients (20%) suffering re-arrest survived to hospital discharge. Survival (Chi square 11.77; p< 0.01) and good neurologic outcome (Chi square 5.93; p= 0.01) were higher in patients who did not suffer any event during transport. Conclusions: Transport of resuscitated cardiac arrest patients to a tertiary-care facility via CCTT is feasible, and the duration of transport is not associated with re-arrest during transport. Repeat cardiac arrest occurs infrequently, while critical events are more common. Outcomes are worse in those experiencing an event.
Original language | English (US) |
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Pages (from-to) | 938-942 |
Number of pages | 5 |
Journal | Resuscitation |
Volume | 81 |
Issue number | 8 |
DOIs | |
State | Published - Aug 2010 |
Externally published | Yes |
Keywords
- Cardiac arrest
- EMS
- Helicopter
- Hypothermia
- Resuscitation
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Emergency
- Emergency Medicine
- Medicine(all)