The significance of pre-arrest factors in out-of-hospital XXXX witnessed by emergency medical services: A report from the Victorian Ambulance Cardiac Arrest Registry.

@entity1 @entity662 @entity1296 @entity1165 @entity117 @entity391 @entity772 @entity158 @entity1167
BACKGROUND: The significance of pre-arrest factors in out-of-hospital @entity1167 (OHCA) witnessed by emergency medical services (EMS) is not well established. The purpose of this study was to assess the association between prodromal symptoms and pre-arrest clinical observations on the arresting rhythm and survival in EMS witnessed OHCA. METHODS: Between 1st January 2003 and 31st December 2011, 1056 adult EMS witnessed arrests of a presumed cardiac aetiology were identified from the Victorian Ambulance Cardiac Arrest Registry. Pre-arrest prodromal features and clinical characteristics were extracted from the @entity1 care record. Backward elimination logistic regression was used to identify pre-arrest factors associated with an initial shockable rhythm and survival to hospital discharge. RESULTS: The median age was 73.0 years, 690 (65.3%) were male, and the rhythm of arrest was shockable in 465 (44.0%) cases. The most commonly reported prodromal symptoms prior to arrest were @entity662 (48.8%), dyspnoea (41.8%) and altered consciousness (37.8%). An unrecordable systolic blood pressure was observed in 34.4%, a respiratory rate <13 or >24min(-1) was present in 43.1%, and 45.5% had a Glasgow @entity772 score <15. In the multivariable analysis, the following pre-arrest factors were significantly associated with survival: age, public location, aged care facility, @entity662 , arm or shoulder @entity158 , dyspnoea, @entity1296 , @entity391 , @entity1165 , pulse rate, systolic blood pressure, respiratory rate, Glasgow @entity772 score, @entity117 and inotrope administration. CONCLUSION: Pre-arrest factors are strongly associated with the arresting rhythm and survival following EMS witnessed OHCA. Potential opportunities to improve outcomes exist by way of early recognition and management of @entity1 at risk of OHCA.
