Comparison between in-hospital and out-of-hospital cardiac arrest: Epidemiology, etiology and outcome

Abstract

s / Resuscitation 96S (2015) 43–157 115 patients had cardiac arrest, while 27.2% (n=83) of patients had hemodynamic instability and 28.5% (n=87) had other condition requiring vascular access during transportation to hospital. 23.3% (n=71) of patients had trauma, while 76.7% (n=234) of patients had non-trauma related condition. Most IO insertions were performed by physicians – 69.3% (n=214), while in 30.7% (n=95) of cases IO access was performed by doctor’s assistant. IO access was considered successful if the IO route was established and used to administer medications and/or fluids. Successful insertion on the first attempt was achieved in 90% (n=278) of patients. In 10% (n=31) cases IO accesswas not established due to different reasons – bone but not marrow entered, failure to remove the trocar needle after insertion, inability to identify the insertion site correctly and improper needle length in obese patients. Six unsuccessful IO line insertions were observed in children, including 5 in infants. The second attempt was performed for 4 patients and it was successful. Needle dislodgment was observed in 7 cases after initially successful IO access. Vast majority of unsuccessful attempts were performed with B.I.G. device. There was only 1 unsuccessful IO insertion reported with EZ-IO, but the number of EZ-IO insertions is too small tomake statistical analysis. There was no statistical difference in success of IO line placement performed by physicians or doctor’s assistants (OR=1.04; p=0.19). Overall 88.8% success ratewas achieved by physicians and 85.3% – by doctor’s assistants. http://dx.doi.org/10.1016/j.resuscitation.2015.09.271