Ongoing CPR with an onboard physician.

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.