Cardiac Arrests Witnessed by Prehospital Providers Have Better Outcomes

Earlier administration of advanced cardiac care is the presumed reason that outcomes are better than for bystander-witnessed or unwitnessed out-of-hospital cardiac arrests.

In a prospective, population-based cohort study of out-of-hospital cardiac arrest (OHCA) during 1 year at 10 U.S. and Canadian sites, researchers compared outcomes among 9991 adult patients whose arrests were witnessed by emergency medical services (EMS) providers (10%); witnessed by bystanders (34%), with or without bystander-performed cardiopulmonary resuscitation (CPR); or unwitnessed (56%), with or without bystander-performed CPR.

Epinephrine was administered in significantly fewer EMS-witnessed cases than bystander-witnessed or unwitnessed cases (69% vs. 80% and 83%, respectively). Pulseless ventricular tachycardia/ventricular fibrillation was the most common initial rhythm in the bystander-witnessed with CPR group, and pulseless electr…

Reviewing Author

John A. Marx, MD, FAAEM