A Review of 3 Years of Cardiac Arrest Phone Calls to a State-Based Poisons Centre

Poisoning-related cardiac arrests have reported survival rates as low as 3%. These events are often unwitnessed, occur in private settings, and are less likely to receive bystander cardiopulmonary resuscitation. Non-shockable rhythms are frequently observed. However, detailed understanding of aetiologies and clinical characteristics remains limited.

We performed a retrospective review of cardiac arrest calls to a state-based poisons information centre between 2020 and 2023. Data was extracted into a preformatted table and cross-referenced with patient's electronic medical records. Two extractors were used.

A total of 53 cases were included. The median age was 36 years (IQR 22-51; range 15-66), with 29 (54%) male patients. Most arrests occurred in the community (n = 37, 70%). Hypoxia was the most common suspected single aetiology (n = 24), while cardiac toxins, through various mechanisms, accounted for 29 cases (55%). Non-shockable rhythms were present in 36 patients (68%). Despite this, 38 patients (71%) survived to hospital discharge, including 23 (64%) with non-shockable rhythms.

In this study, poisoning-related cardiac arrest was associated with a high survival rate, even in cases with non-shockable rhythms. Hypoxia and direct cardiac toxicity were identified as the primary aetiologies in many patients.