Early in-hospital management of out-of-hospital cardiac arrest in Scotland: a national survey

Abstract

Guidelines recommend the use of mild therapeutic hypothermia (MTH) and percutaneous coronary intervention (PCI) in the early post-resuscitation management of select out-of-hospital cardiac arrest (OHCA) cases. This study aims to assess the current use of MTH and PCI in Scottish Emergency Departments (ED) and Intensive Care Units (ICU). We conducted a questionnaire survey of all the Scottish Emergency Medicine Consultants, EDs and ICUs. MTH was more commonly initiated in ICU than in the ED (19; 91 vs. 7; 37%, P<0.05). Only a minority two (11%) EDs routinely referred OHCA patients for early PCI and only three (16%) EDs receiving patients after OHCA had on-site access to PCI facilities. The use of MTH after OHCA appears to be widespread, although it is infrequently initiated in the ED. The utilization of PCI in OHCA management has yet to be widely established. Increased awareness may increase the use of promising therapies such as MTH and PCI following OHCA to save lives.