Transfer of care is associated with longer unsuccessful resuscitations

Accepted guidelines define when to terminate unsuccessful resuscitations. We examined whether such resuscitations last longer for transported arrests in the field compared with those occurring in the emergency department (ED).

This was a retrospective study of patients who died in an urban, academic ED over 32 months starting from January 2001. Total length of resuscitation and the interval occurring in-ED were compared for arrests in the ED and transported arrests from the field.

A total of 132 patients met the criteria, of whom 71 (53.8%) arrested in the field. Mean overall resuscitation times were longer for arrests occurring in the field (44 minutes; 95% confidence interval [CI], 39-48) compared with those in the ED (19 minutes; 95% CI, 16-22; P < .001). Mean resuscitation intervals occurring in the ED were no different for arrests occurring in the field (16 minutes; 95% CI, 13-19) than in the ED (19 minutes; 95% CI, 16-22; P > .05).

Unsuccessful resuscitations were longer and beyond guideline recommendations when arrests occurred in the field and were transported. The interval of resuscitation that occurred in the ED was the same whether or not prehospital resuscitation occurred.