General Practitioner Pre-Hospital Resuscitation Contribution to out of Hospital Cardiac Arrest Survival; A Retrospective Study

Abstract

Background: Out of hospital cardiac arrest survival remains low in most countries. No previous studies examined general practitioner (GP) pre-hospital resuscitation contribution to OHCA survival in the Middle East region. This study describes GP prehospital resuscitation and investigates its contribution to out of hospital cardiac arrest (OHCA) survival in pilot regions of Kuwait. Method: A retrospective observational study using data from Emergency Medical Services (EMS) archived registry in Kuwait to describe GP prehospital resuscitation attempts in pilot regions of Kuwait (n=601) over 10 months period (21 February-31 December 2017) from Hawali and Al Farwanya provinces. We then compared OHCA demographics, resuscitation and outcomes during GP presence to those arrests from the community. Primary outcomes: survival to 30 days. Secondary outcome; return of spontaneous circulation (ROSC). Results: A total of 601 out of OHCA events from Kuwait EMS archived data were extracted. Of these, 314 OHCA cases met the inclusion criteria. When GP on scene, OHCA patients were more likely to survive to 30 days 7% (p=0.029). However, in terms of prehospital ROSC, no significant change was noted 7% (p=0.191). “GP present group” were more likely to be witness rate 55% (p ≤ 0.001), receive early CPR 48% (p ≤ 0.001) and defibrillation 4% (p ≤ 0.001) rates was reported in OHCA patients resuscitated by GPs. Conclusion: In summary, general practitioner pre-hospital resuscitation can enhance OHCA survival to 30 days in regions of Kuwait. We propose expansion to other regions and building GP prehospital resuscitation database to improve OHCA survival.