The second link in the chain of survival in out-of-hospital cardiac arrest

Abstract

Introduction: Early recognition and calling for help, early cardiopulmonary resuscitation (CPR), early defibrillation, and post-resuscitation care are the four links in the chain of survival in cases of sudden cardiac arrest. Objective: To determine the incidence of Basic Life Support (BLS) measures being implemented by the eyewitnesses in cases of out-of-hospital cardiac arrest before the arrival of the ambulance, as well as telephone-assisted CPR, and whether the measures taken affected the rate of achieving the return of spontaneous circulation (ROSC). Material and Methods: The study is retrospective and observational. It was conducted for a year at the Institute for Emergency Medical Assistance Novi Sad. The study included patients with sudden cardiac arrest who were resuscitated by ambulance teams. Results: There were 148 patients enrolled in the study. In the group of patients who survived, there were fewer unrecognized cardiac arrests by the dispatcher, more telephone-assisted CPRs and fewer cases of no CPR measures undertaken by the eyewitnesses before the arrival of the ambulance. In the group of patients who survived, the only statistically significant event was cardiac arrest in the presence of the ambulance team. Conclusion: The implementation of telephone-assisted CPR protocol in dispatch centres would increase the number of cases in which bystanders could implement BLS measures before the arrival of the medical team.