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Outcome of Conventional Bystander Cardiopulmonary Resuscitation in Cardiac Arrest Following Drowning

Published online by Cambridge University Press:  24 January 2020

Joshua M. Tobin Open the ORCID record for Joshua M. Tobin [Opens in a new window] ,
William D. Ramos ,
Joel Greenshields ,
Stephanie Dickinson ,
Joseph W. Rossano ,
Peter G. Wernicki ,
David Markenson ,
Kimberly Vellano ,
Bryan McNally  and
CARES Surveillance Group
Joshua M. Tobin*
Affiliation:
Keck School of Medicine of the University of Southern California, Division of Trauma Anesthesiology, Los Angeles, California USA
William D. Ramos
Affiliation:
Indiana University School of Public Health-Bloomington, Bloomington, Indiana USA
Joel Greenshields
Affiliation:
Indiana University School of Public Health-Bloomington, Bloomington, Indiana USA
Stephanie Dickinson
Affiliation:
Indiana University School of Public Health-Bloomington, Bloomington, Indiana USA
Joseph W. Rossano
Affiliation:
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania USA
Peter G. Wernicki
Affiliation:
Florida State University, College of Medicine, Tallahassee, Florida USA
David Markenson
Affiliation:
New York Medical College, Center for Disaster Medicine, Valhalla, New York USA
Kimberly Vellano
Affiliation:
CARES Program, Emory University, Woodruff Health Sciences Center, Atlanta, Georgia USA
Bryan McNally
Affiliation:
CARES Program, Emory University, Woodruff Health Sciences Center, Atlanta, Georgia USA
*
Correspondence: Joshua M. Tobin, MD Keck School of Medicine University of Southern California Division of Trauma Anesthesiology 2051 Marengo Street, IPT C4E100 Los Angeles, California 90033 USA E-mail: joshua.tobin@med.usc.edu
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Abstract

Introduction:

The concept of compressions only cardiopulmonary resuscitation (CO-CPR) evolved from a perception that lay rescuers may be less likely to perform mouth-to-mouth ventilations during an emergency. This study hopes to describe the efficacy of bystander compressions and ventilations cardiopulmonary resuscitation (CV-CPR) in cardiac arrest following drowning.

Hypothesis/Problem:

The aim of this investigation is to test the hypothesis that bystander cardiopulmonary resuscitation (CPR) utilizing compressions and ventilations results in improved survival for cases of cardiac arrest following drowning compared to CPR involving compressions only.

Methods:

The Cardiac Arrest Registry for Enhanced Survival (CARES) was queried for patients who suffered cardiac arrest following drowning from January 1, 2013 through December 31, 2017, and in whom data were available on type of bystander CPR delivered (ie, CV-CPR CO-CPR). The primary outcome of interest was neurologically favorable survival, as defined by cerebral performance category (CPC).

Results:

Neurologically favorable survival was statistically significantly associated with CV-CPR in pediatric patients aged five to 15 years (aOR = 2.68; 95% CI, 1.10–6.77; P = .03), as well as all age group survival to hospital discharge (aOR = 1.54; 95% CI, 1.01–2.36; P = .046). There was a trend with CV-CPR toward neurologically favorable survival in all age groups (aOR = 1.35; 95% CI, 0.86–2.10; P = .19) and all age group survival to hospital admission (aOR = 1.29; 95% CI, 0.91–1.84; P = .157).

Conclusion:

In cases of cardiac arrest following drowning, bystander CV-CPR was statistically significantly associated with neurologically favorable survival in children aged five to 15 years and survival to hospital discharge.

Keywords

bystander CPRcardiopulmonary resuscitationdrowningoutcome
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 2 , April 2020 , pp. 141 - 147
Copyright
© World Association for Disaster and Emergency Medicine 2020

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