Related Experiment Video
Updated: Jun 28, 2025
Ultrasonographic Assessment During Cardiopulmonary Resuscitation
Published on: October 24, 2020
Ongoing CPR with an onboard physician
Alfredo Echarri Sucunza1, Patricia Fernández Del Valle2, Jose Antonio Iglesias Vázquez3
1Servicio de Urgencias Extrahospitalarias de Navarra, Spain.
Insights
Transporting patients with ongoing cardiopulmonary resuscitation (CPR) is uncommon in emergency medical services (EMS) with onboard physicians. This strategy, though rarely effective, may offer benefits for select patients with advanced interventions.
Area of Science:
- Emergency Medicine
- Cardiology
- Critical Care
Background:
- Data on ongoing cardiopulmonary resuscitation (CPR) during transport by emergency medical services (EMS) with onboard physicians are limited.
- Understanding factors influencing transport decisions and patient outcomes is crucial for optimizing emergency care.
Purpose of the Study:
- To identify factors associated with transporting patients with ongoing CPR.
- To examine survival rates and neurological status at hospital discharge for these patients.
Main Methods:
- An observational study analyzed out-of-hospital cardiac arrest (OHCA) cases from January 1 to December 31, 2022.
- Patients undergoing CPR during transport were compared to those pronounced dead at the scene.
- Key patient characteristics, initial rhythms, and interventions were recorded.
Main Results:
- Out of 9321 cases, 3.7% were transported with ongoing CPR.
- Transported patients were younger, had arrests outside the home, witnessed by EMS, and had initial rhythms other than asystole.
- Mechanical CPR devices were used more frequently in transported patients.
- Seven patients (2%) survived to discharge, with five achieving good neurological recovery (CPC1).
Conclusions:
- Ongoing CPR during transport is an uncommon strategy in EMS with onboard physicians.
- While generally having limited efficacy, advancements like mechanical CPR devices and specialized hospital treatments (e.g., ICP, ECMO) may improve outcomes for select patients.
Introduction:
Recent data are not available on ongoing CPR for emergency services with an onboard physician. The aim of the present study was to identify factors associated with the decision to transport patients to hospital with ongoing CPR and examine their survival to hospital discharge with good neurological status.
Methods:
An observational study based on a registry of out-of-hospital cardiac arrests attended to by emergency services with an onboard physician. All OHCA cases occurring between the 1st of January and the 31st of December 2022 were included. Patients receiving ongoing CPR during transport to the hospital were compared with patients pronounced dead at the scene following arrival of the care team. The dependent variable was ongoing CPR during transport to the hospital. The main characteristics and the neurological status of patients surviving to discharge were described.
Results:
A total of 9321 cases were included, of which 350 (3.7%) were transported to hospital with ongoing CPR. Such patients were young (59.9 ± 20.1 years vs 64.6 ± 16.9 years; p < 0.001; 95%CI: 0.98 [0.98; 0.99]) with arrest taking place outside of the home (151 [44.5%] vs 4045 [68.01%]; p < 0.001; 95%CI: 0.41 [0.31; 0.54]) and being witnessed by EMS (126 [36.0%] vs 667 [11.0%]; p < 0.001; 95%CI: 4.31 [3.19; 5.80]), whilst initial rhythm differed from asystole (164 [47.6%] vs 4325 [73.0%]; p < 0.01; 95%CI: 0.44 [0.33; 0.60]) and a mechanical device was more often employed during resuscitation and transport to hospital (199 [56.9%] vs 2050 [33.8%]; p < 0.001; 95%CI: 2.75 [2.10; 3.59]). Seven patients (2%) were discharged alive from hospital, five with ad integrum neurological recovery (CPC1) and two with minimally impaired neurological function (CPC2).
Conclusions:
The strategy of ongoing CPR is uncommon in EMS with an onboard physician. Despite their limited efficacy, the availability of mechanical chest compression devices, together with the possibility of specific hospital treatments, mainly ICP and ECMO, opens up the possibility of this approach with determined patients.
Related Concept Videos
01:30Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
01:30Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes: