Should we take patients in cardiac arrest to hospital?

摘要

YES Out of hospital cardiac arrest is a leading cause of premature death, and overall long term survival is about 10% Two schools of thought towards cardiopulmonary resuscitation (CPR) have emerged in the past decade: the "glass 90% empty" sceptics, who see one arresting patient after another "come in dead and stay dead," versus the "glass 10% full" optimists, who look to return more survivors to productive life. Clinical decision rules derived over the past decade clarify when further resuscitation and transport to the hospital is futile and offer the potential to reduce ambulance transport and its inherent costs and risks. The best studied is the Basic Life Support Termination of Resuscitation (BLS-TOR) rule, which directs paramedics to stop CPR and not to transport the patient if they have not witnessed the cardiac arrest, no shock has been given (no shockable rhythm), and spontaneous circulation has not returned.