Cardiac Arrest Frequency

chaz90

chaz90

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It's very interesting to me how many factors other than call volume seem to go into cardiac arrest frequency for the average EMS provider or system. I was surprised in another thread how widely spread our exposures to cardiac arrest are, even for those working in high volume systems with thousands of responses annually.

The raw statistics should be fairly easy to gather for all those with access to the data gathering components of their ePCR systems. For my own calls in 2015, I worked 10 cardiac arrests and had another 11 DOAs. Combined, those represented about 3% of my calls for the year. My department as a whole had about 1.3% workable cardiac arrests and 1.2% DOAs. I've heard 1% of call volume tossed around for cardiac arrest frequency in the past, but I'm not certain if that separates working codes from DOAs or is even accurate. I would expect our local percentages to be higher than average as we theoretically only respond on ALS 911 calls.

What factors do you think go into cardiac arrest frequency for your area or service? Some are obvious. IFT services, or those that work a sizable percentage of transfers in addition to 911, are going to affect the numbers dramatically, so I'd say filter it to 911 responses only to start out. Patient demographics and PCP coverage (possibly tied with socioeconomic status to some degree) are likely going to have an effect, as is rural vs. urban and how many of your patients live alone. Anyone else have any insight or your own rough percentages?
 
We serve a huge 55+ population and get a lot of the older generations who travel out here for the weather.

I have been a medic for a year now and have had 3 arrests the we ended up transporting, 4 that were DOA and 1 that we worked and then called on scene. These are not counting traumatic full arrests.
 
Last year, had 7 worked arrests, 2 rosc- both recieved cpr prior to arrival, 1 survived to hospital discharge.
 
I've been here 1.5 years and probably have worked at least 30 arrests....ill have to double check. If you want arrests, you work with me lol.

Massive county with a good portion in nursing homes and middle aged people who keep trying to be young.
 
I seem to work a disproportionately large number of arrests. I just looked back, since I started at the service a year ago I've worked 9 codes and 4 DOA. (11 instances of Narcan)

But, I usually only work one day a week and took most of the summer off, so take that for what it's worth.
 
Been a medic little over 3 months and have had 6 workable arrests, 3 DOA, and only 2 of which were transported. If we are just talking medical arrests. 350k-400k pop, priority tiered dispatch, bls fire and als ems, high crime and poverty.
 
We ran 800 calls in Jan.

16 were cardiac arrests.

8 had ROSC and as of now, 5 have left the hospital neuro intact.

This is an abnormal month for us though, we usually get around 8 or 9 per month.
 
roninwarrior said:
We ran 800 calls in Jan.

16 were cardiac arrests.

8 had ROSC and as of now, 5 have left the hospital neuro intact.

This is an abnormal month for us though, we usually get around 8 or 9 per month.
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50% ROSC? Impressive. Just out of curiosity, are your cardiac arrest protocols different from the AHA's BLS/ACLS guidelines?
 
redundantbassist said:
50% ROSC? Impressive. Just out of curiosity, are your cardiac arrest protocols different from the AHA's BLS/ACLS guidelines?
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Nope, standard AHA guidelines. It was a pretty crazy month and a lot of those arrests got early CPR and defib from police first responders equipped with AED's. It is a pretty phenomenal ROSC and discharge rate and it's certainly not typical for us.
 
Over my first 250 calls in the local system, I worked around 5-6 arrests. This was around 3 years ago in mostly suburban central NJ. One was 2ndary to presumed OD, two were transported due to ROSC, the rest were DOA.

I believe the number of SNFs within your service area is a good starting point when considering the frequency of cardiac arrests.
 
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We seem to have a relatively high number of codes in my area (Lake co, FL), since we have a huge elderly population, a bunch of nursing homes, and are semi-rural with few vagrants.
 
Another question would be how many of these arrests are you either the first or second medic directing care? There's evidence that 2 medics is ideal. If one shows up to arrest after arrival of the first due medics and you stand there handing them stuff or are just doing CPR, should that count as "experience"? Considering that some scenes will have much more than 2 medics on scene, do they all get to count the arrest, or just the ones running the show? Does the supervisor that shows up to "supervise" get to count the arrest towards his or her experience? If ALS first responders initiate the resusc do they count it, or do the ones who actually transport the patient?
 
In my case, I'm usually the only medic. My partner is either a basic or an A. I may or may not have fire and police to act as a LivingLucas™
 
So I just did my first yearly review today and was the attending paramedic on 11 cardiac arrests (it did not specify worked vs. not worked), 9 intubations, 1 cardioversion, and 1 chest decompression. The system ran over 115K calls and Im guessing I authored around 800 PCRs. Its been a crazy 1 year since graduating paramedic school.
 
Since Nov 30 (when I started with my current agency) I have been on 5 codes, with two of them obtaining ROSC in the field
 
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