INFLUENCE ON OUTCOME AFTER CARDIAC-ARREST OF TIME ELAPSED BETWEEN CALL FOR HELP AND START OF BYSTANDER BASIC CPR

The exact impact of the 'interval between cardiac arrest (CA) and the start of basic cardiopulmonary resuscitation (CPR) performed by bystan ders' on outcome is not fully established. We retrospectively evaluate d data with regard to response intervals of 1195 out-of-hospital CA in terventions where bystander CPR was performed and continued by the eig ht mobile intensive care units (MICUs) participating in the Belgian Ce rebral Resuscitation Registry between 1982 and 1990. Partial correlati ons between time elapsed from CALL to CPR by lay public and outcome we re determined when the effect of response times of 1st and 2nd tier we re removed. The following groups were studied: ventricular fibrillatio n (VF), asystole and electromechanical dissociation (EMD), non-witness ed and witnessed. Good outcome was represented by initial restoration of spontaneous circulation (ROSC successes) and by prolonged survival (CPR successes) being 22.7 and 9.7%, respectively. The mean time +/- S .E.M. between CALL and CPR initiated by lay people for the studied pop ulation (n = 1195) was 2.5 +/- 0.1 min. The partial correlation coeffi cient between prolonged survival and time passed between CALL and byst ander CPR was negative for all types of CA, yet significance was reach ed only in the non-witnessed group. Using ROSC as the endpoint signifi cance is achieved in all groups except the VF patients, where the inte rvention times were shorter. In our population, prolonged survival was independently and negatively influenced by a delay between CALL and a ny CPR in the non-witnessed CA group (n = 421).