scholarly journals MP50: National survey of 9-1-1 ambulance communication centers’ resources related to prehospital recognition of agonal breathing and cardiac arrest

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S60
Author(s):  
C. Vaillancourt ◽  
M. Charette ◽  
K. Cyr ◽  
S. Hodges ◽  
V. Thiruganasambandamoorthy ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
National Survey ◽  
Performance Monitoring ◽  
Survival Rates ◽  
Future Research ◽  
Increase Response Rate ◽  
Multi Centre Study ◽  
Bystander Cpr ◽  
Performance Statistics ◽  
And Performance

Introduction: 9-1-1 telecommunicators receive minimal education on agonal breathing, often resulting in unrecognized out-of-hospital cardiac arrest (OHCA). We successfully piloted an educational intervention that significantly improved telecommunicators’ OHCA recognition and bystander CPR rates in Ottawa. We sought to better understand the operations of Canadian 9-1-1 communications centers (CC) in preparation for a multi-centre study of this intervention. Methods: We conducted a National survey of all Canadian CCs. Survey domains included information on organizational structure, dispatch system used, education curriculum, and performance monitoring. It was peer-reviewed, translated in French, pilot-tested, and distributed electronically using a modified Dillman method. We designated respondents in each CC before distribution and used targeted follow-up and small incentives to increase response rate. Respondents also described functioning of neighboring CCs if known. Results: We received information from 51/51 provincial and 1/25 territorial CCs, representing 99.7% of the Canadian population. CCs largely utilize the Medical Dispatch Priority System (MPDS) platform (93%), many are Province/Ministry regulated (50%) and most require a High School diploma as minimum entry level education (78%). Telecommunicators receive initial in-class training (median 1.3 months, IQR 0.3-1.9; range 0.1-2.2), often followed by a preceptorship (84.4%) (median 1.0 months, IQR 0.7-1.7; range 0.4-6.0). Educational curriculum includes information on agonal breathing in 41% of CC, without audio examples in 34%. Among responding CCs, over 39,000 suspected OHCA 9-1-1 calls are received annually. Few CCs maintain local performance statistics on OHCA recognition (25%), bystander CPR rates (25%) or survival rates (50%). Most (97%) expressed interest in future research collaborations. Conclusion: Most Canadian telecommunicators receive no or minimal education in recognizing agonal breathing. Further training and improved OHCA monitoring may assist recognition and enhance outcomes.

scholarly journals Young adults’ perception of mandatory CPR training in Australian high schools: a qualitative investigation

2018 ◽  
Vol 15 (2) ◽  
Author(s):  
Tiana Andrews ◽  
Luke Price ◽  
Brennen Mills ◽  
Lisa Holmes
Keyword(s):  
High School ◽  
Cardiac Arrest ◽  
High Schools ◽  
Qualitative Interviews ◽  
Survival Rates ◽  
First Aid Training ◽  
Training Cost ◽  
Bystander Cpr ◽  
And Performance ◽  
Cpr Training

IntroductionBystander cardiopulmonary resuscitation (CPR) can be performed by any member of the public who witnesses a cardiac arrest and has the knowledge, training and skills to perform it. Even though bystander CPR has been shown to greatly improve the victim’s chance of survival, its training and performance rates are alarmingly low.MethodsOne potentially effective intervention to tackle this issue is to implement mandatory CPR training programs in high schools. We undertook in-depth qualitative interviews with 28 recent Australian high school graduates. The interviews were transcribed and then analysed, with participants’ answers used to draw conclusions on the acceptability of mandatory CPR high school training.ResultsResults suggested those that had undertaken basic first aid training in high school would be more open and confident to perform bystander CPR. Among those who had not undertaken training, cost and access were identified as the key barriers. Regardless of whether participants had or had not previously undertaken training, they understood the importance of CPR for the treatment of cardiac arrest victims.ConclusionAmong our sample, there was overwhelming support for the concept of mandatory CPR training being implemented in high schools. Should such a program be applied, there is the potential for this to have an impact on bystander CPR provision, and hence cardiac arrest survival rates, within the wider Australian community.

scholarly journals MP25: Assessing the learning impact of the Northern City of Heroes public exhibit on bystander cardiopulmonary resuscitation response

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S51-S51
Author(s):  
M. Moskalyk ◽  
R. Ohle ◽  
A. Henson ◽  
S. McIsaac ◽  
C. Barriault ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Informal Learning ◽  
Survival Rates ◽  
Community Response ◽  
Direct Result ◽  
Future Research ◽  
Informal Curriculum ◽  
Science Centre ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Northern City

Innovation Concept: In Sudbury, ON 44% of out-of-hospital cardiac arrest (OHCA) patients receive bystander CPR (bCPR), and only 4.7% survive cardiac arrest. The Northern City of Heroes (NCH) community initiative was launched in April 2019 with a goal of improving survival from OHCA through hands-only bCPR in the municipality. One NCH initiative is an interactive exhibit at Science North, a science centre in Sudbury that hosts 250,000 visitors annually. The exhibit employs simulation trainers for CPR, accompanying signage and interactive elements. The goals of the exhibit are to activate bCPR, change and measure behaviours through exhibit interactions on how to deliver excellent CPR, and improve survival rates in OHCA patients. Methods: Data is being collected from 3000 visitors using self-reported surveying via SurveyGizmo to assess likelihood of performing bCPR, pre and post interacting with the exhibit. Visitor behaviour will be examined at the exhibit using video-recorded interactions and coding those behaviours using BORIS software. Behavioural data will be analyzed using the Visitor Engagement Framework (VEF) where initiation, transition and breakthrough learning-behaviours are coded and an exhibit Visitor Engagement Profile (VEP) is created. The VEF and VEP are tools used in informal learning settings to assess exhibit impacts on learning. Curriculum, Tool, or Material: The use of an easily-apprehendable, hands-on exhibit tool located in a public setting, such as a science centre, creates a platform for engaging large and diverse public audiences. This type of bCPR exhibitry has not been implemented in other similar environments. The informal learning setting allows the science centre staff to engage in personalized interactions that can solidify the quality of learning and confidence in employing the new skills developed. Conclusion: The NCH exhibit and new strategies for embedding informal curriculum are powerful tools to reach diverse audiences, build knowledge and skills, and have a measurable impact on bCPR and OHCA survival rates. Data is being captured and tracked by Health Sciences North around the City of Greater Sudbury's bCPR and OHCA survival rates to monitor long-term impacts of the NCH community initiatives. Limitations of the study may be found in the focused demographics as well as the nature of self-reported learning. Future research directions include broader geographical surveying to assess improvements in community response to OHCA as a direct result of an interactive bCPR exhibitry.

scholarly journals LO72: Implementation of an educational program to improve the cardiac arrest diagnostic accuracy of ambulance communication officers: a concurrent control before-after study

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S52-S53
Author(s):  
C. Vaillancourt ◽  
A. Kasaboski ◽  
M. Charette ◽  
L. Calder ◽  
L. Boyle ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Educational Program ◽  
Survival Rates ◽  
Control Site ◽  
Chi Square ◽  
Concurrent Control ◽  
Initial Rhythm ◽  
Bystander Cpr ◽  
The Impact ◽  
Hospital Cardiac Arrest

Introduction: Most ambulance communication officers receive minimal education on agonal breathing, often leading to unrecognized out-of-hospital cardiac arrest (OHCA). We sought to evaluate the impact of an educational program on cardiac arrest recognition, and on bystander CPR and survival rates. Methods: Ambulance communication officers in Ottawa, Canada received additional training on agonal breathing, while the control site (Windsor, Canada) did not. Sites were compared to their pre-study performance (before-after design), and to each other (concurrent control). Trained investigators used a piloted-standardized data collection tool when reviewing the recordings for all potential OHCA cases submitted. OHCA was confirmed using our local OHCA registry, and we requested 9-1-1 recordings for OHCA cases not initially suspected. Two independent investigators reviewed medical records for non-OHCA cases receiving telephone-assisted CPR in Ottawa. We present descriptive and chi-square statistics. Results: There were 988 confirmed and suspected OHCA in the “before” (540 Ottawa; 448 Windsor), and 1,076 in the “after” group (689 Ottawa; 387 Windsor). Characteristics of “after” group OHCA patients were: mean age (68.1 Ottawa, 68.2 Windsor); Male (68.5% Ottawa, 64.8% Windsor); witnessed (45.0% Ottawa, 41.9% Windsor); and initial rhythm VF/VT (Ottawa 28.9, Windsor 22.5%). Before-after comparisons were: for cardiac arrest recognition (from 65.4% to 71.9% in Ottawa p=0.03; from 70.9% to 74.1% in Windsor p=0.37); for bystander CPR rates (from 23.0% to 35.9% in Ottawa p=0.0001; from 28.2% to 39.4% in Windsor p=0.001); and for survival to hospital discharge (from 4.1% to 12.5% in Ottawa p=0.001; from 3.9% to 6.9% in Windsor p=0.03). “After” group comparisons between Ottawa and Windsor (control) were not statistically different, except survival (p=0.02). Agonal breathing was common (25.6% Ottawa, 22.4% Windsor) and present in 18.5% of missed cases (15.8% Ottawa, 22.2% Windsor p=0.27). In Ottawa, 31 patients not in OHCA received chest compressions resulting from telephone-assisted CPR instructions. None suffered injury or adverse effects. Conclusion: While all OHCA outcomes improved over time, the educational intervention significantly improved OHCA recognition in Ottawa, and appeared to mitigate the impact of agonal breathing.

Abstract 227: Sudden Cardiac Arrest During Exercise Occurs Infrequently and With Few Warning Symptoms

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Katherine S Allan ◽  
Brian E Grunau ◽  
Morgan Haines ◽  
Armin Nowroozpoor ◽  
James Christenson ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Metropolitan Areas ◽  
Sudden Cardiac Arrest ◽  
The Other ◽  
Future Research ◽  
Moderate Exercise ◽  
Metabolic Equivalent ◽  
Shockable Rhythm ◽  
Future Events ◽  
Bystander Cpr

Introduction: The incidence and details of sudden cardiac arrest (SCA) during exercise in the general population are not well described. We describe a cohort ages 2-85 who experienced an SCA within ≤ 1 hour of moderate to vigorous activity in 4 metropolitan areas of British Columbia, Canada. Methods: We reviewed prehospital records of consecutive out-of-hospital cardiac arrests (OHCAs) in the provincial BC OHCA Registry from June 17 2017 to August 16 2018. We included non-traumatic OHCAs treated by EMS occurring within ≤ 1 hour of exercise. We defined SCA as an OHCA of no obvious cause, witnessed/unwitnessed, survived/died. We assigned an estimated metabolic equivalent (MET) score to each type of physical activity. We defined moderate exercise as a MET score of 3-5.9 and vigorous as ≥6. Results: A total of 2674 OHCAs occurred during the study period of which 56 SCAs (2.1%) occurred within ≤1 hour of participation in 23 types of exercise (Figure 1). The incidence of SCA during exercise was 1.45 (95% CI 1.10-1.88) per 100,000 population. The median age was 56.5 [IQR 45-69] and 87.5% (49/56) were male. Most exercise related SCAs occurred in public (49/56 87.5%), 83.3% (45/54) were bystander witnessed and 85% (46/54) received bystander CPR. Over 70% (40/56) had a shockable rhythm. The survival rate was 55.4% (31/56). Half of the SCAs collapsed during exercise (49.1%; 26/53) while the other half collapsed within ≤1 hour after exercising (51%; 27/53). Symptom data were available in 46% of patients (23/50) with most experiencing chest pain, dizziness, feeling unwell or seizure just prior to collapse. Conclusions: SCAs during exercise are rare and frequently occur in a public location. Survival is high and may be related to witnessed and public location status. Equal numbers of SCAs collapsed during or ≤ 1 hour of exercising and symptoms were present in almost half. Future research is needed to determine what factors could predict those at highest risk for SCA in order to prevent future events.

Abstract 18304: Are Prolonged Resuscitation Efforts Worthwhile? Patient Outcomes by Time to Restoration of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest Patients

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kristian Kragholm ◽  
Monique Anderson ◽  
Carolina Malta Hansen ◽  
Phillip J. Schulte ◽  
Michael C. Kurz ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Survival Rates ◽  
Spontaneous Circulation ◽  
Significant Survival ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Bystander Cpr ◽  
Using Data ◽  
Favorable Neurological Outcome ◽  
Hospital Cardiac Arrest

Introduction: How long resuscitation attempts should be continued before termination of efforts is not clear in patients with out-of-hospital cardiac arrest (OHCA). We studied outcomes in patients with return of spontaneous circulation (ROSC) across quartiles of time from 9-1-1 call to ROSC. Hypothesis: Survival with favorable neurological outcome is seen in all time intervals from 9-1-1 call to ROSC. Methods: Using data from Resuscitation Outcomes Consortium (ROC) Prehospital Resuscitation clinical trials: IMpedance valve and an Early vs. Delayed analysis (PRIMED) available via National Institute of Health, patients with ROSC not witnessed by the emergency medical service (EMS) were identified and grouped by quartiles of time from 9-1-1 call to ROSC. We defined favorable neurological outcome as modified Rankin Scale (mRS) scores of ≤3. Results: Included were 3,431 OHCA patients with ROSC. Median time from 9-1-1 call to ROSC was 22.8 min (25%-75% 17 min–29.2 min); 953 (27.8%) survived to discharge (20.4% mRS ≤3). Significant survival and favorable neurological outcome were seen in each quartile (Figure). In patients who received bystander cardiopulmonary resuscitation (CPR), survival rates were 60.9%, 33.2%, 18.3% and 11.1% across quartiles of time to ROSC versus (vs.) 51.5%, 25.6%, 13.3% and 8.9% in patients without bystander CPR; corresponding rates of favorable neurological outcome were 50.7%, 23.8%, 12.2% and 9.1% vs. 40.1%, 16.6%, 8% and 4.8%. Correspondingly, survival rates in defibrillated patients were 70.1%, 45.9%, 25.5% and 16.4% vs. 36.3%, 9.5%, 6% and 3.4% in non-defibrillated patients; corresponding rates of favorable neurological outcome were 59.8%, 33.4%, 18.3% and 11.4% vs. 24.4%, 4.1%, 1.9% and 1.8%. Conclusions: Survival with favorable neurological outcome was seen in all quartiles of time to ROSC, even in cases without bystander CPR or shocks delivered. This suggests that EMS personnel should not terminate resuscitation efforts too early.

AS22 Impact of dispatch-assisted CPR instructions on bystander CPR and survival rates: A before-after multi-centre study

Resuscitation ◽  
2011 ◽  
Vol 82 ◽  
pp. S6 ◽  
Author(s):  
Christian Vaillancourt ◽  
Ann Kasaboski ◽  
Manya Charette ◽  
Stanley Morrow ◽  
George A. Wells ◽  
...  
Keyword(s):  
Survival Rates ◽  
Multi Centre Study ◽  
Centre Study ◽  
Bystander Cpr

Abstract 243: Bystander CPR May Not Improve Survival from Cardiac Arrest in Patients with Epilepsy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Eric Stecker ◽  
Audrey Uy-Evanado ◽  
Kyndaron Reinier ◽  
Carmen Teodorescu ◽  
Karen Gunson ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Metastatic Cancer ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
Medical Examiner ◽  
Multiple Sources ◽  
Unexpected Death ◽  
Bystander Cpr ◽  
Patients With Epilepsy ◽  
The Impact

Introduction: Sudden cardiac arrest (SCA) is the major cause of death among patients with epilepsy and occurs in the absence of a terminal seizure in approximately two-thirds. We aimed to evaluate the effectiveness of conventional cardiac arrest resuscitation factors (Utstein elements) in predicting survival among patients with epilepsy. Methods: This analysis was conducted as part of a large, ongoing, population-based study of SCA in the Northwest US (the Oregon Sudden Unexpected Death Study, community pop. approx. 1 million). Data were obtained from multiple sources (first responders, medical practitioners and medical examiner) between 2002 and 2011 for adult patients with attempted resuscitation. Those with non-cardiac causes of arrest (e.g. severe COPD or metastatic cancer) were excluded. Those with a history of infantile febrile seizures or alcoholic withdrawal seizures were considered non-epileptic. The impact of Utstein resuscitation factors on survival to hospital discharge among patients with epilepsy was evaluated, as were differences in survival for each Utstein factor among patients with and without epilepsy. Results: There were 63 patients with epilepsy and 1403 patients without epilepsy who underwent resuscitation for SCA. The overall survival rate among patients with epilepsy was lower (3% vs 12%, p=0.014) despite identical rates of ROSC (36%, p=0.91). Survival was unaffected by any Utstein variable (age, gender, initial arrhythmia, witnessed status, location, bystander CPR, response time) and was lower for epilepsy patients receiving bystander CPR than for non-epilepsy patients (table). Conclusions: SCA survival rates for patients with epilepsy are low and are not appreciably improved by conventional resuscitation techniques. It is important to explore the basis for these observations and consider modifications to EMS activation, response and post-resuscitation hospital care in order to improve survival for patients with epilepsy.

scholarly journals Multi-centre implementation of an Educational program to improve the Cardiac Arrest diagnostic accuracy of ambulance Telecommunicators and survival outcomes for sudden cardiac arrest victims: the EduCATe study design and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christian Vaillancourt ◽  
Manya Charette ◽  
Sarika Naidoo ◽  
Monica Taljaard ◽  
Matthew Church ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Educational Program ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
Interrupted Time Series ◽  
National Study ◽  
Before And After ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

Abstract Background Sudden cardiac death remains a leading cause of mortality in Canada, resulting in more than 35,000 deaths annually. Most cardiac arrest victims collapse in their own home (85% of the time) and 50% are witnessed by a family member or bystander. Survivors have a quality of life similar to the general population, but the overall survival rate for out-of-hospital cardiac arrest (OHCA) rarely exceeds 8%. Victims are almost four times more likely to survive when receiving bystander CPR, but bystander CPR rates have remained low in Canada over the past decade, not exceeding 15–25% until recently. Telecommunication-assisted CPR instructions have been shown to significantly increase bystander CPR rates, but agonal breathing may be misinterpreted as a sign of life by 9–1-1 callers and telecommunicators, and is responsible for as much as 50% of missed OHCA diagnoses. We sought to improve the ability and speed with which ambulance telecommunicators can recognize OHCA over the phone, initiate timely CPR instructions, and improve survival. Methods In this multi-center national study, we will implement and evaluate an educational program developed for ambulance telecommunicators using a multiple baseline interrupted time-series design. We will compare outcomes 12 months before and after the implementation of a 20-min theory-based educational video addressing barriers to recognition of OHCA while in the presence of agonal breathing. Participating Canadian sites demonstrated prior ability to collect standardized data on OHCA. Data will be collected from eligible 9–1-1 recordings, paramedic documentation and hospital medical records. Eligible cases will include suspected or confirmed OHCA of presumed cardiac origin in patients of any age with attempted resuscitation. Discussion The ability of telecommunication-assisted CPR instructions to improve bystander CPR and survival rates for OHCA victims is undeniable. The ability of telecommunicators to recognize OHCA over the phone is unequivocally impeded by relative lack of training on agonal breathing, and reluctance to initiate CPR instructions when in doubt. Our pilot data suggests the potential impact of this project will be to increase absolute OHCA recognition and bystander CPR rates by at least 10%, and absolute out-of-hospital cardiac arrest survival by 5% or more. Trial registration Prospectively registered on March 28, 2019 at ClinicalTrials.gov identifier: NCT03894059.

scholarly journals Creation of a Sudden Cardiac Arrest Safety Net

2021 ◽  
Vol 5 (1) ◽  
pp. 58-64
Author(s):  
Mary McCormack ◽  
Carole Zarcone ◽  
Kendra Hoepper ◽  
Pamela Watters
Keyword(s):  
Cardiac Arrest ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
Heart Association ◽  
Safety Net ◽  
The United States ◽  
Comfort Level ◽  
Post Test ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Bystander Cpr

Background: More than 350,000 episodes of out-of-hospital cardiac arrest (OHCA) occur annually in the United States, with less than half of the victims receiving bystander cardiopulmonary resuscitation (CPR). Provision of bystander CPR has been noted to increase survival rates two to three-fold; however, bystander CPR is initiated in less than 50 % of out of OHCA episodes in the United States.Aim: The purpose of this pilot study was to create a sudden cardiac arrest safety net on a college campus. The American Heart Association (AHA) CPR in Schools Program© was provided to college students, athletes, faculty and staff.Method: A multi-group educational intervention with a pre- and post-test design. Results: Participant knowledge level of CPR and AED use significantly improved on the post test. Additionally, after attending the sessions participants reported an increase in comfort level performing CPR and improved knowledge of the locations of the AEDs on campus. As a result of the program, nine additional AED’s have been placed in high-traffic areas on campus.Conclusion: Empowering laypersons with the skills and knowledge to respond to potential episodes of OHCA are integral steps towards improving patient outcomes.

Abstract 18150: Ventricular Arrhythmia During Post Cardiac Arrest Care: Prognostic Importance and Influence of Pre-hospital Defibrillation - A TTM Substudy

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jakob H Thomsen ◽  
Jesper Kjærgaard ◽  
Niklas Nielsen ◽  
David Erlinge ◽  
Michael Wanscher ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Survival Rates ◽  
Spontaneous Circulation ◽  
Temperature Management ◽  
Patients At Risk ◽  
Initial Rhythm ◽  
Life Threatening ◽  
Bystander Cpr ◽  
Prognostic Importance

Background: Ventricular arrhythmias (VA) are life threatening, even in patients admitted to an intensive care unit following out-of-hospital cardiac arrest (OHCA). Post cardiac arrest care includes hemodynamic stabilization and targeted temperature management (TTM) and while most patients are stabilized, VA may occur. We assessed the prognosis of OHCA patients with in-hospital VA and whether the number of pre-hospital defibrillations was predictive of in-hospital arrhythmic events. Method: We studied 934 (99%) comatose OHCA survivors from the TTM-trial (year: 2010-13) with available data on VA during the first 2 days of post cardiac arrest care and the number of pre-hospital defibrillation used to achieve return of spontaneous circulation (ROSC). The TTM trial showed no benefit of TTM at 33°C over 36°C in terms of mortality and neurological outcome. Results: The prevalence of VA was 16% and did not differ between the TTM groups (33°C= 82 (17%) vs. 36°C= 67 (15%), p=0.23). Patients with VA had similar 180-day survival rates (VA= 52% vs. no-VA= 53%, plog-rank= 0.63, Figure) and odds of unfavorable neurological outcome (OR=1.04 (0.73-1.48, p=0.83), compared to patients without VA. The number of pre-hospital defibrillations ranged from 0 to >20 and a twofold increase was associated with significantly higher odds of in-hospital VA, both combined (OR= 1.39 (1.22-1.59, p<0.0001), and separately as risk of ventricular tachycardia (OR= 1.39 (1.20-1.60, p<0.0001) and fibrillation (OR= 1.54 (1.23-1.93 p<0.001). This remained significant when adjusting for STEMI, initial rhythm, age, sex, bystander CPR, time to ROSC and admission lactate. Conclusion: Risk of VA is directly related to the number of pre-hospital defibrillations, which may be of value in predicting patients at risk of arrhythmia. VA occurring during post cardiac arrest care has no significant impact on prognosis, which supports continued active treatment in patients with recurrent VA after OHCA.

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