Seyed ehsan Asadi - phd in Nursing, Esfahan Medical University, Esfahan, Iran

Background and Aim : Electrocardiogram (ECG) rhythms, particularly shockable rhythms, arecrucial for planning cardiac arrest treatment. There are varying opinions regarding treatmentguidelines depending on ECG rhythm types and documentation times within pre-hospital settingsor after hospital arrivals. We aimed to determine survival and neurologic outcomes based on ECGrhythm types and documentation times.Methods : This prospective observational study of 50 emergency medical centers was performedusing non-traumatic out-of-hospital cardiac arrest registry data between October 2016 and October2018. From among 3500adult participants, 2800 patients with pre-hospital and hospital ECGrhythm data were enrolled. Patients were divided into 3 groups: those with initial-shockable,converted-shockable, and never-shockable rhythms. Patient characteristics and survival outcomeswere compared between groups.Results : Total survival to discharge after cardiac arrest was 15.5%, and discharge with goodneurologic outcomes was 7.2%. Survival to discharge rates and favorable neurologic outcome ratesfor the initial-shockable group were the highest at 35.3% and 35.4%, respectively. There were nodifferences in survival to discharge rates and favorable neurologic outcome rates between theconverted-shockable (4.7% and 2.6%, respectively) and never-shockable groups (5.9% and 1.5%,respectively).Conclusion : Survival outcomes and TOR predictions varied depending on ECG rhythm types anddocumentation times within pre-hospital filed or emergency department and should, in the future,be considered in treatment algorithms and prognostications of patients with out-of-hospital cardiacarrest.

Cardiopulmonary Resuscitation; Electrocardiography; Heart Arrest; Out-of-Hospital Cardiac Arrest