PMID- 33456384
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220419
IS  - 1478-4726 (Electronic)
IS  - 1478-4726 (Linking)
VI  - 5
IP  - 1
DP  - 2020 Jun 1
TI  - A service evaluation of transport destination and outcome of patients with 
      post-ROSC STEMI in an English ambulance service.
PG  - 32-36
LID - 10.29045/14784726.2020.06.5.1.32 [doi]
AB  - BACKGROUND: In the UK, there are approximately 60,000 cases of out-of-hospital 
      cardiac arrest (OHCA) each year. There is mounting evidence that 
      post-resuscitation care should include early angiography and primary percutaneous 
      coronary intervention (pPCI) in cases of OHCA where a cardiac cause is suspected. 
      Yorkshire Ambulance Service (YAS) staff can transport patients with a return of 
      spontaneous circulation (ROSC) directly to a pPCI unit if their post-ROSC ECG 
      shows evidence of ST elevation myocardial infarction (STEMI). This service 
      evaluation aimed to determine the factors that affect the transport destination, 
      hospital characteristics and 30-day survival rates of post-ROSC patients with 
      presumed cardiac aetiology. METHODS: All patient care records (PCRs) previously 
      identified for the AIRWAYS-2 trial between January and July 2017 were reviewed. 
      Patients were eligible for inclusion if they were an adult non-traumatic OHCA, 
      achieved ROSC on scene and were treated and transported by (YAS). Descriptive 
      statistics were used to analyse the data. RESULTS: 478 patients met the inclusion 
      criteria. 361/478 (75.6%) patients had a post-ROSC ECG recorded, with 149/361 
      (41.3%) documented cases of STEMI and 88/149 (59.1%) referred to a pPCI unit by 
      the attending clinicians. 40/88 (45.5%) of referrals made were accepted by the 
      pPCI units. Patients taken directly to pPCI were most likely to survive to 30 
      days (25/39, 53.8%), compared to patients taken to an emergency department (ED) 
      at a pPCI-capable hospital (34/126, 27.0%), or an ED at a non-pPCI-capable 
      hospital (50/310, 16.1%). CONCLUSION: Staff should be encouraged to record a 
      12-lead ECG on all post-ROSC patients, and make a referral to the regional 
      pPCI-capable centre if there is evidence of a STEMI, or a cardiac cause is 
      likely, since 30-day survival is highest for patients who are taken directly for 
      pPCI. Ambulance services should continue to work with regional pPCI-capable 
      centres to ensure that suitable patients are accepted to maximise potential for 
      survival.
CI  - (c) 2020 The Author(s).
FAU - Platt, Anthony
AU  - Platt A
AD  - Yorkshire Ambulance Service NHS Trust.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br Paramed J
JT  - British paramedic journal
JID - 101697267
PMC - PMC7783911
OTO - NOTNLM
OT  - out-of-hospital cardiac arrest
OT  - pPCI
OT  - post-ROSC care
COIS- None declared.
EDAT- 2021/01/19 06:00
MHDA- 2021/01/19 06:01
PMCR- 2021/06/01
CRDT- 2021/01/18 05:28
PHST- 2021/01/18 05:28 [entrez]
PHST- 2021/01/19 06:00 [pubmed]
PHST- 2021/01/19 06:01 [medline]
PHST- 2021/06/01 00:00 [pmc-release]
AID - 10.29045/14784726.2020.06.5.1.32 [doi]
PST - ppublish
SO  - Br Paramed J. 2020 Jun 1;5(1):32-36. doi: 10.29045/14784726.2020.06.5.1.32.