BACKGROUND: Sudden cardiac arrest is a leading cause of death in children and young adults. This study determined the incidence, cause, and outcomes of cardiovascular-related out-of-hospital cardiac arrest (OHCA) in individuals <35 years of age.

METHODS AND RESULTS: A retrospective cohort of OHCA in children and young adults from 1980 through 2009 was identified from the King County (Washington) Division of Emergency Medical Services' Cardiac Arrest Database. Incidence was calculated ...

BACKGROUND: During the past decade the use of coronary angiography after acute myocardial infarction has substantially increased. Among the possible contributing factors, the increasing availability of cardiac catheterization facilities was the focus of our investigation.

METHODS: We investigated whether the availability of cardiac catheterization facilities at an admitting hospital was associated with the likelihood that a patient would undergo coronary angiography. After adjusting for ...

CONTEXT: Delayed access to medical care in patients with acute myocardial infarction (AMI) is common and increases myocardial damage and mortality.

OBJECTIVE: To evaluate a community intervention to reduce patient delay from symptom onset to hospital presentation and increase emergency medical service (EMS) use.

DESIGN AND SETTING: The Rapid Early Action for Coronary Treatment Trial, a randomized trial conducted from 1995 to 1997 in 20 US cities (10 matched pairs; population range, ...

BACKGROUND: The potential impact of efforts in Europe to improve survival from out-of-hospital cardiac arrest is unclear, in part, because estimates of incidence and survival are uncertain. The aim of the investigation was to determine a representative European incidence and survival from cardiac arrest in all-rhythms and in ventricular fibrillation treated by the emergency medical services (EMS).

METHODS AND RESULTS: We used Medline to identify peer-reviewed articles published between 1 ...

BACKGROUND: The role of rescue breathing in cardiopulmonary resuscitation (CPR) performed by a layperson is uncertain. We hypothesized that the dispatcher instructions to bystanders to provide chest compression alone would result in improved survival as compared with instructions to provide chest compression plus rescue breathing.

METHODS: We conducted a multicenter, randomized trial of dispatcher instructions to bystanders for performing CPR. The patients were persons 18 years of age or ...

BACKGROUND: The potential impact of efforts to improve the chain of survival for out-of-hospital sudden cardiac arrest (SCA) is unclear in part because estimates of the incidence of treatable cases of SCA are uncertain. The aim of the investigation was to determine a representative national incidence of emergency medical services (EMS)-treated all-rhythm and ventricular fibrillation (VF) SCA as well as survival.

METHODS: We used Medline to identify peer-reviewed articles published ...

BACKGROUND: Public access defibrillation can improve survival but is involved in only a small fraction of out-of-hospital cardiac arrest. One approach to increase involvement is to couple emergency dispatch with mapping technology to identify public access automated external defibrillators (AEDs) that are on-site or nearby.

METHODS: We conducted a retrospective observational cohort investigation of out-of-hospital cardiac arrest who received dispatch by a community dispatch center ...

AIM: We examined the relationship between time from collapse to arrival of emergency medical services (EMS) and survival to hospital discharge for out-of-hospital ventricular fibrillation cardiac arrests in order to determine meaningful interpretations of this association.

METHODS: We calculated survival rates in 1-min intervals from collapse to EMS arrival. Additionally, we used logistic regression to determine the absolute probability of survival per minute of delayed EMS arrival. We ...

BACKGROUND: Early cardiopulmonary resuscitation (CPR) improves survival in out-of-hospital cardiac arrest, and dispatcher-delivered instruction in CPR can increase the proportion of arrest victims who receive bystander CPR before emergency medical service (EMS) arrival. However, little is known about the survival effectiveness of dispatcher-delivered telephone CPR instruction.

METHODS AND RESULTS: We evaluated a population-based cohort of EMS-attended adult cardiac arrests (n=7265) from ...

STUDY OBJECTIVE: To determine the reasons patients with suspected acute myocardial infarction (AMI) delay seeking medical care or do not call 911.

DESIGN: Telephone interview of patients hospitalized with suspected AMI.

SETTING: Nine hospitals in King County, Washington.

PARTICIPANTS: Patients admitted to a CCU or ICU between October 1, 1986, and December 31, 1987, with suspected AMI occurring out-of-hospital. Spouses of patients who met criteria but died during the hospitalization also ...

BACKGROUND: The incidence of sudden cardiac death is roughly 3 times greater in men than in women. However, in patients treated for out-of-hospital cardiac arrest, the relationships between sex and survival after adjustment for age and cardiac rhythm are unclear.

METHODS AND RESULTS: In this retrospective cohort study, we examined 7069 men and 2582 women who were treated for out-of-hospital cardiac arrest in Seattle and suburban King County between 1990 and 1998. We compared successful ...

STUDY OBJECTIVE: To assess the incidence of cardiac arrest among patients who use self-transport to seek medical care for chest pain.

METHODS: This was a retrospective cohort study of patients admitted to a CCU for suspected acute myocardial infarction (AMI) and patients experiencing out-of-hospital cardiac arrest preceded by symptoms in King County, Washington, between January 1, 1992, and July 31, 1994. Participants were identified through use of the databases compiled by the ...

The survival rate for patients with out-of-hospital cardiac arrest is low in communities where emergency service is provided solely by emergency medical technicians. We trained such technicians in a suburban community of 79,000 to recognize and treat out-of-hospital ventricular fibrillation with up to three defibrillatory shocks without the use of medications or special airway protection. Outcomes from cardiac arrest due to underlying heart disease were determined during two periods: two ...

OBJECTIVE: Although socioeconomic status (SES) has been linked to multiple health outcomes, there have been few studies of the effect of SES on the provision of bystander cardiopulmonary resuscitation (CPR) during cardiac arrest events and no studies that we know of on the effect of SES on the provision of dispatcher-assisted bystander CPR. This study sought to define the relationship between SES and the provision of bystander CPR in an emergency medical system that includes ...

Records on 1,297 people with witnessed out-of-hospital cardiac arrest, caused by heart disease and treated by both emergency medical technicians (EMTs) and paramedics, were examined to determine whether or not early cardiopulmonary resuscitation (CPR) initiated by bystanders independently improved survival. Bystanders initiated CPR for 579 patients (bystander CPR); for the remaining 718 patients, CPR was delayed until the arrival of EMTs (delayed CPR). Survival was significantly better ...