Resuscitation in Prehospital Stage: Effectiveness and Influencing Factors

Background: Sudden cardiac arrest or sudden cardiac death is one of the leading causes of death all over the world. Of particular importance is out-of-hospital cardiac arrest (OHCA) - an important overworld public health issue. In order to help these people and improve their chances of survival, it is necessary to provide assistance as soon as possible. Bystanders are usually non-medical persons why it is more complicated to implement. The objectives of the study were to research effectiveness and influencing factors of resuscitation in prehospital stage and create suggestions and methodical recommendations as possible. Materials and Methods: A retrospective study was developed, which summarizes and analyzes the electronic call cards (IEK) of the Emergency Medical service of Latvia (EMS) for 2018 and 2019. IEK were selected that identified “successful resuscitation” and “unsuccessful resuscitation” as a complication of diagnosis (classification developed and validated by EMS of Latvia). Results: Overall 2538 resuscitations were performed, of which 27,6% were successful resuscitation. About a quarter (24,2%) of all resuscitations happened in a public place. The increase in the number of successful resuscitations is observed for resuscitation events that happened in public places. In most of cardiac arrest cases, bystanders did not perform CPR (60,3%). Arrival time of EMS in 2018 was 7,52 - 8,44 minutes and in 2019 was 7,75 - 8,23 minutes. The research shows that approximately 23% of cases the first monitored rhythm by EMS were VF/pVT. There is a significant difference in the increase in successful resuscitations if EMS performed defibrillation during the call. Conclusions: The most important influencing factors in the outcome of resuscitation are the patient’s age, the location, the first aid provided by bystanders, the time until the arrival of EMS and the first observed heart rhythm in a patient with cardiac arrest. It is necessary to create a register of AED (automated external defibrillator) devices in Latvia and their locations, to ensure the availability of data to the EMS service and the public.