VirginiaEMT
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Just curious, for all of you verterans out there, how many codes that are resucitated actually live to walk around and have a normal(or not normal) life?
How many codes make it?
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DV_EMT
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I've seen a few people at the hospital (Probably 6/10) code and survive. One lady coded x3 and still managed to walk out no problem. Pretty intense.
In hospital roughly 40%, out of hospital <1%. There is an article that details this, I'll try and dig it up later.
Edit: These are percentages of meaningful recoveries. Not people who lay in the ICU for three days, or those that never regain any function. The rate of ROSC is much higher than these two figures.
Edit: These are percentages of meaningful recoveries. Not people who lay in the ICU for three days, or those that never regain any function. The rate of ROSC is much higher than these two figures.
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DV_EMT
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I thought there was one listed on the AHA CAB study too about mortality rates from 911 -> Hospital-> Home. Something like 3.6% or something which was an improvement from 2.9%? I think the AHA study is listed on Amercan Red Cross Webpage as a refrence for the new CAB method.
DV_EMT
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Thanks. I stand corrected. I was short changing us. That article does break down neurologically intact survival and they are listing it around 4%.
Shishkabob
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It depends on the agency. National average is pretty low. My agency's average is 7+% survival to discharge with good neurological outcomes.
I have heard my agency has fairly high ROSC rates. (im trying to find the numbers). But contributing factors are our response times, use of the LUCAS and resqpod devices, we are also allowed to induce therapuetic hypothermia.
Do other agencies who use some of those devices see higher ROSC rates?
Do other agencies who use some of those devices see higher ROSC rates?
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Smash
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Do any of those things actually help?
Response times: Probably.
LUCAS: No.
ResQPod: Definitely not.
Hypothermia: Not according to the current evidence, unless you happen to have unusually long transport times (as in hours). Maybe it will if induction is started during the arrest, but that trial is still being carried out.
You really think the LUCAS do not help? I think they're fantastic. Continuous compressions while we move out of the house, twisty stairs, etc and also while we unload at the ED.
Smash
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It's not what I think. I think that they are a great concept. But I know from the available scientific evidence that they do not have a positive effect on outcomes.
EDIT: And I have never transported a dead person, nor do I think (with a small number of rare exceptions) that anyone should, so it is really a moot point whether they are better when getting down stairs or out of houses.
EDIT: And I have never transported a dead person, nor do I think (with a small number of rare exceptions) that anyone should, so it is really a moot point whether they are better when getting down stairs or out of houses.
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Smash
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You must have an interesting interpretation of the word "nice". I also have no idea how that relates to the conversation.
Aidey
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Even if you don't transport people without a pulse, the LUCAS is nice to have if people code again while en route to the hospital.
Shishkabob
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My new agency has the Lucas, and while I havent worked a code with this agency yet, they say it slows a code down a lot once it gets on scene. You have the Lucas pumping, a person bagging once every 15 seconds, and a med being pushed every so often... otherwise you're just standing around waiting.
I typed that kind of quickly....i meant its nice to have (LUCAS) enroute when its just you or your partner in the back
18G
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I don't agree. Evidence show's that high quality and continuous chest compressions contribute to higher success rates with ROSC. With knowing this, how would a device that provides continuous and perfect chest compressions not be beneficial? As was already stated, these devices eliminate pauses during the move from scene to ambulance and they enable quality compressions during transport.
And with the use of EtCO2, if an arrest patient has a good value indicating decent cellular metabolism then why not provide resuscitation longer (ie transport)?
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I agree that it is a leap of faith from "LUCAS does better compressions" (which is pretty obvious) to "the better compressions lead to better outcomes".... and I'll admit I'm sure I have some built in bias for the device. Here is the first study I found:
Early Survival After Cardiac Arrest In A Pilot Study Using The LUCAS Device Compared To Manual Chest Compressions During CPR
Conclusion: In this pilot study, there was a trend to improved early survival when mechanical chest compressions with the LUCAS device were used during CPR. These findings are promising and will be used for power analysis in a prospective multicenter trial.
Brandon O
Puzzled by facies
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Most recent data on the LUCAS is that it's as good but no better than perfect-quality manual compressions.
With regard to the OP, the question is too vague to be meaningfully answered. It's a hugely heterogenous population, depending on region, type of arrest, downtime, bystander CPR, etc. Many places have taken to reporting their "Utstein" arrest numbers, which is the "best case" population, partly to be able to give high numbers, partly because it's the population most likely to be at all salvageable. These are witnessed out-of-hospital arrests with an initial shockable rhythm, and a few areas in the country (Seattle is the continuing superstars) have broken 50% in survival to neurologically-intact hospital discharge, which is always the ultimate goal. But by any other measurement it's less than this, and for most cases, you end up with just a few percent surviving.
So go teach a CPR class. Because the dead don't rise if the public won't lay hands.
With regard to the OP, the question is too vague to be meaningfully answered. It's a hugely heterogenous population, depending on region, type of arrest, downtime, bystander CPR, etc. Many places have taken to reporting their "Utstein" arrest numbers, which is the "best case" population, partly to be able to give high numbers, partly because it's the population most likely to be at all salvageable. These are witnessed out-of-hospital arrests with an initial shockable rhythm, and a few areas in the country (Seattle is the continuing superstars) have broken 50% in survival to neurologically-intact hospital discharge, which is always the ultimate goal. But by any other measurement it's less than this, and for most cases, you end up with just a few percent surviving.
So go teach a CPR class. Because the dead don't rise if the public won't lay hands.