Payot, C.; Fehlmann, C.A.; Suppan, L.; Niquille, M.; Lardi, C.; Sarasin, F.P.; Larribau, R. Factors Influencing Physician Decision Making to Attempt Advanced Resuscitation in Asystolic Out-of-Hospital Cardiac Arrest. Preprints2021, 2021070447. https://doi.org/10.20944/preprints202107.0447.v1
APA Style
Payot, C., Fehlmann, C.A., Suppan, L., Niquille, M., Lardi, C., Sarasin, F.P., & Larribau, R. (2021). Factors Influencing Physician Decision Making to Attempt Advanced Resuscitation in Asystolic Out-of-Hospital Cardiac Arrest. Preprints. https://doi.org/10.20944/preprints202107.0447.v1
Chicago/Turabian Style
Payot, C., Francois Pierre Sarasin and Robert Larribau. 2021 "Factors Influencing Physician Decision Making to Attempt Advanced Resuscitation in Asystolic Out-of-Hospital Cardiac Arrest" Preprints. https://doi.org/10.20944/preprints202107.0447.v1
Abstract
The objective of this study was to identify the key elements used by prehospital emergency physicians (EP) to decide whether or not to attempt advanced life support (ALS) in asystolic out-of-hospital cardiac arrest (OHCA). From 01.01.2009 to 01.01.2017, all adult victims of asystolic OHCA in Geneva, Switzerland, were retrospectively included. Patients with signs of "obvious death" or with a Do-Not-Attempt-Resuscitation order were excluded. Patients were categorized as having received ALS if this was mentioned in the medical record, or, failing that, if at least one dose of adrenaline had been administered during cardio-pulmonary resuscitation (CPR). Prognostic factors known at the time of EP's decision were included in a multivariable logistic regression model. 784 patients were included. Factors favourably influencing the decision to provide ALS were witnessed OHCA (OR=2.14, 95%CI1.43–3.20) and bystander CPR (OR=4.10, 95%CI2.28–7.39). Traumatic aetiology (OR=0.04, 95%CI0.02–0.08), age >80 years (OR=0.14, 95%CI0.09–0.24) and a Charlson comorbidity index greater than 5 (OR=0.12, 95%CI0.06–0.27) were the factors most strongly associated with the decision not to attempt ALS. Factors influencing the EP’s decision to attempt ALS in asystolic OHCA are the relatively young age of the patients, few comorbidities, presumed medical aetiology, witnessed OHCA and bystander CPR.
Keywords
out-of-hospital cardiac arrest; emergency physician; medical decision; asystole; advanced life support; Charlson comorbidity index; emergency medical service; prehospital emergency
Subject
Medicine and Pharmacology, Emergency Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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