What question did this study set out to answer?

To evaluate the relationship between perishock pauses in chest compressions and survival to hospital discharge in patients with out-of-hospital cardiac arrest presenting with a shockable rhythm.

June 21, 2011CirculationOpen Access

Perishock Pause

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Why the study?

Do longer preshock and perishock pauses reduce survival to hospital discharge in out-of-hospital cardiac arrest patients presenting with a shockable rhythm?

Population

Out-of-hospital cardiac arrest patients in the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest…

Comparison

Longer preshock pause and perishock pause vs Shorter preshock pause and perishock pause

Design

Cohort

Follow-up

Until hospital discharge

Authors

SCSheldon CheskesSunnybrook Health Science Centre RSRobert H. SchmickerUniversity of Washington JCJim ChristensonUniversity of British Columbia

Discussion

Member takes

Implication

Longer pauses were associated with lower survival in shockable OHCA; leaves open whether minimizing pauses improves outcomes in prospective trials.

Key Points

To evaluate the relationship between perishock pauses in chest compressions and survival to hospital discharge in patients with out-of-hospital cardiac arrest presenting with a shockable rhythm.
Analyzed data from the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest on patients with out-of-hospital cardiac arrest between December 2005 and June 2007 presenting with ventricular fibrillation or pulseless ventricular tachycardia (n=815).
Evaluated cardiopulmonary resuscitation process metrics for at least one defibrillatory shock using multivariable logistic regression adjusted for Utstein survival predictors.
Preshock pause ≥20 seconds was associated with significantly reduced survival compared with <10 seconds (OR 0.47, 95% CI 0.27 to 0.82), and perishock pause ≥40 seconds was associated with reduced survival compared with <20 seconds (OR 0.54, 95% CI 0.31 to 0.97).
Log-linear modeling showed a survival decrease of 18% and 14% for every 5-second increase in preshock and perishock pause intervals, respectively.
Postshock pause intervals demonstrated no independent, statistically significant association with changes in odds of survival to hospital discharge.

Structured PICO

Do longer preshock and perishock pauses reduce survival to hospital discharge in out-of-hospital cardiac arrest patients presenting with a shockable rhythm?

Population

Out-of-hospital cardiac arrest patients in the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest (December 2005 to June 2007) presenting with a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia) and having cardiopulmonary resuscitation process data for at least 1 shock (n=815).

Intervention

Longer preshock pause (≥20 seconds) and perishock pause (≥40 seconds)

Comparator

Shorter preshock pause (<10 seconds) and perishock pause (<20 seconds)

Outcome

Survival to hospital dischargehard clinical

Longer preshock and perishock pauses during cardiopulmonary resuscitation for shockable out-of-hospital cardiac arrest are independently associated with decreased survival to hospital discharge.

Cite This Study

Cheskes et al. (2011) studied this question.

synapsesocial.com/papers/6a6ff65b31a3df82432842f5 https://doi.org/10.1161/circulationaha.110.010736

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Implication

Longer pauses were associated with lower survival in shockable OHCA; leaves open whether minimizing pauses improves outcomes in prospective trials.

Perishock Pause

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Perishock Pause

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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