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Prehospital cardiac rhythm deterioration in a system providing only basic life support
Annals of Emergency Medicine
|August 1, 1983
Summary
Basic cardiac life support (BCLS) during cardiac arrest shows rhythms change over time. While some bradycardic rhythms convert to ventricular fibrillation (VF), most patients deteriorate to asystole within minutes.
Area of Science:
- Cardiology
- Emergency Medicine
- Critical Care
Background:
- Ambulance services provide basic cardiac life support (BCLS) with oxygenation.
- Studying cardiac rhythms during BCLS in patients with circulatory arrest is crucial.
Purpose of the Study:
- To investigate cardiac rhythm changes during BCLS in patients with circulatory arrest.
- To assess the effectiveness of BCLS in preventing cardiac deterioration.
Main Methods:
- Holter monitoring was attempted in 43 patients during ambulance transport.
- Technically adequate ECG traces were obtained in 21 patients over an average of 11.9 minutes.
- Initial and in-hospital ECGs were analyzed to track rhythm changes.
Main Results:
- Initially, tachydysrhythmia (VF/VT) was found in 10 patients, bradycardia/heart block in 9, and asystole in 2.
- Six patients with bradycardia converted to VF during BCLS, but this was not sustained.
- After an average of 12 minutes, 90% of those with initial bradycardia and 50% with initial VF/VT became asystolic.
Conclusions:
- BCLS can lead to significant cardiac rhythm changes during circulatory arrest.
- BCLS does not prevent cardiac deterioration, with most patients progressing to asystole.
- Early and sustained resuscitation efforts are vital for improving outcomes.