2018 cardiac arrest summary - mcb /...

2018 Cardiac Arrest Summary and Outcomes

2018

COX, MATT

OFFICE OF THE MEDICAL DIRECTOR 1417 N Lansing Ave Tulsa, OK 74106

of 20

2018 Utstein

Total Cardiac Arrests

1387

Acute Cardiac Event

723

VF/VT/AED Shockable Rhythm

68

Witnessed by Bystander

243

Bystander CPR Performed

148

Discharged Alive

26

Utstein Neurologic Score Totals

CPC 1: 21

CPC 2: 3

CPC 3: 1

CPC 4: 1

2018 Utstein: 38.23%

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*CARES Registry Utstein Data Obtained Via Annual Reports Available, https://mycares.net/sitepages/data.jsp

30.76%

38.60%

33.30%

22.68%

37.75%38.23%38.20%

36.10%

37.20%38.20%

36.50%37.30%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

2013 2014 2015 2016 2017 2018

Annual Utstein

Metro Tulsa/OKC CARES

Metro Tulsa/OKC 5 Year Utstein (2014-2018): 34.11%

https://mycares.net/sitepages/data.jsp

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547(39.43%)

840(60.56%)

1387

0

200

400

600

800

1000

1200

1400

1600

EMSA Eastern Division EMSA Western Division Combined

RESUSCITATIONS BY DIVISION 2018

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1271

1382

1323

1451

1423

1387

1150

1200

1250

1300

1350

1400

1450

1500

2013 2014 2015 2016 2017 2018

ANNUAL RESUSCITATIONS INITIATED

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36 (3%)

6 (0.4%)

6 (0.4%)

9 (0.6%)

44 (3%)

73 (5%)

133 (10%)

247 (18%)

327 (24%)

278 (20%)

177 (13%)

51 (4%)

0 50 100 150 200 250 300 350

0 MO-5YR

6YR-10YR

11YR-15YR

16YR-19YR

20YR-30YR

31YR-40YR

41YR-50YR

51YR-60YR

61YR-70YR

71YR-80YR

81YR-90YR

91YR+

Resuscitations by Age Group2018

N= 1387

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2

2

2

3

4

4

5

6

6

8

10

10

14

14

15

19

19

21

26

32

37

43

45 (3%)

57 (4%)

61 (4%)

63 (5%)

135 (10%)

723 (52%)

0 100 200 300 400 500 600 700 800

Anaphylactic Reaction

Hyperthermia

Ruptured Aortic Aneurysm

Toxic Agent

Electrocution

Other (specify)

Drowning

Alzheimers Disease

Seizure

Hypothermia

Choking

Intoxication

SIDS

Smoke Inhalation

Diabetes

Hanging

Pneumonia

Exsaguination

Pulmonary Embolus

Intracranial Event

End Stage Renal Disease

Sepsis

Metabolic

Trauma

Drug/OD

Cancer

Hypoxia

Acute Cardiac Event

Resuscitation Precipitating Events, 2018

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1

1

1

2

3

3

4

8

8

12

19

24

29

29

34

62

81

87

105

144

156

160

204

209

0 50 100 150 200 250

MERCY HOSPITAL - OKLAHOMA CITY

NORMAL REGIONAL MEDICAL CENTER- MOORE

OKLAHOMA CITY VA HOSPITAL

NORMAN REGIONAL MOORE

ALLIANCE HEALTH- MIDWEST

NORMAN REGIONAL HEALTHPLEX

ST ANTHONYS SOUTH

HILLCREST SOUTH HOSPITAL

OU MEDICAL CENTER EDMOND

INTEGRIS CANADIAN VALLEY HOSPITAL

THE CHILDRENS HOSPITAL

INTEGRIS DEACONESS

INTEGRIS HEALTH EDMOND

OSU MEDICAL CENTER

OKLAHOMA HEART HOSPITAL SOUTH

SSM HEALTH ST ANTHONY HOSPITAL

HILLCREST MEDICAL CENTER

OU MEDICAL CENTER

OKLAHOMA HEART HOSPITAL NORTH

INTEGRIS BAPTIST MEDICAL CENTER

ST JOHN MEDICAL CENTER

INTEGRIS SOUTHWEST MEDICAL CENTER

ST FRANCIS HOSPITAL

Not Transported

Resuscitations, Destination Count 2018

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*Excludes Incidents where EMS witnessed the cardiac arrest.

*Excludes incidents where EMS witnessed the cardiac arrest

**Excludes incidents where bystander CPR was performed by a healthcare provider (i.e. Nursing Homes, Clinics, etc.)

48%

52%

BYSTANDER CPR 2018EXCLUDES EMS WITNESSED

No Yes

N= 1184

49%

51%

BYSTANDER CPR 2018EXCLUDES EMS AND

HEALTHCARE PROVIDERNo Yes

N= 1136

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1

1

1

1

1

1

1

1

1

2

2

3

3

4

4

4

4

5

5

5

9

10

12

16

21

21

56

59

169 (12%)

964 (70%)

0 200 400 600 800 1000 1200

Athletic court

Athletic field

Cultural building

Dock or shipyard

Movie house or cinema

Public administrative building

Public Building

Swimming Pool

Wilderness area

Industrial/Construction Site

Sidewalk

Airport

School

Bar/Cafe/Restaurant

Other recreation area

Prison

Religious institution/Church

Apartment

Health care provider office

Other

Rehab Center

Hospital

Dr's Office

Workplace

Business

Parking Lot

Street and highway

Ambulance

Nursing home

Home/Residence

Location of Resuscitation, 2018

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*Excludes utilization by Emergency Responders (i.e. System Credentialed Providers) outside EMS agencies, Healthcare Providers (Clinics, Nursing Homes)

**Includes only incidents in Public Setting (i.e. excludes ambulance, nursing home, private residence, etc.) where an AED might be available.

95%

2% 3%

AED Utilization in Public Setting2018

No Yes, Applied without Defibrillation Yes, With Defibrillation

N= 181

of 20

432(31%) 398

(30%)

417(29%)

440(31%)

370(27%)

950(69%) 925

(70%)

1034(71%)

983(69%)

1017(73%)

0

200

400

600

800

1000

1200

2014 2015 2016 2017 2018

SUSTAINED ROSC TO ED ANNUALCOMPARISON

2014-2018Sustained ROSC No Sustained ROSC

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*ROSC is defined as any cardiac arrest patient that was delivered to the receiving facility with ROSC maintained, whether transient ROSC occurred or not.

**25% of ROSC patients survived from hospital admit to discharge.

73%

27%

Sustained ROSC2018

No YesN= 1387

25%

75%

Sustained ROSC Survivors2018

Alive DeadN= 370

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*Transient ROSC is Defined as any cardiac arrest patient that was a brief period of ROSC achieved, however was not delivered to the receiving facility with ROSC maintained.

** 4% of transient ROSC patients survived from hospital admit to discharge.

87%

13%

Transient ROSC2018

No Yes

N=1015

4%

96%

Transient ROSC Survivor2018

Survivor Non-Survivor

N=128

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131

118

95

125

93

0

20

40

60

80

100

120

140

2014 2015 2016 2017 2018

Sustained ROSC Total Survivors Annual Comparison2014-2018

144138

111

138

108

0

20

40

60

80

100

120

140

160

2014 2015 2016 2017 2018

Total Survivors Annual Comparison2014-2018

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*Includes all cardiac arrest patients for year 2018

84(78%)

3(3%)

9(8%)

12(11%)

0

10

20

30

40

50

60

70

80

90

CPC 1 CPC 2 CPC 3 CPC 4

SURVIVOR CPC COUNT, 2018

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76(52%)

81(59%)

70(63%)

106(77%)

84(78%)

18(13%)

22(16%)

9(8%)

9(7%)

3(3%)

27(19%) 24

(17%)

13(12%) 10

(7%)9

(8%)

23(16%)

11(18%)

19(17%)

13(9%)

12(11%)

0

20

40

60

80

100

120

2014 2015 2016 2017 2018

ANNUAL CPC COMPARISON, ALL SURVIVORS2014-2018


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644(46%)

462(33%)

190(14%)

49(4%) 31

(2%) 11(1%)

0

100

200

300

400

500

600

700

Asystole PEA VentricularFibrillation

Unknown AED Non-Shockable Rhythm

Unknown AEDShockable Rhythm

VentricularTachycardia-

Pulseless

INITIAL PULSELESS RHYTHMS, 2018

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Initial Pulseless Rhythm Survival 2018

10(2%)

634(98%)

Asystole Survival

Survival Non-Survival

N= 644

35(8%)

427(92%)

PEA


N= 462

8(16%)

41(84%)

AED Non-Shockable


N= 49

37(19%)

153(81%)

Ventricular Fibrillation


N= 190

5(45%)

6(55%)

Ventricular TachycardiaPulesless


N= 11

13(42%)

18(58%)

AED Shockable


N= 31

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5(50%)

26(74%)

30(81%)

4(80%)

7(88%)

12(92%)

0 0

3

0 0 0

2

3 3

0 0

1

3

6

1 1 1

00

5

10

15

20

25

30

35

Asystole PEA VF VT AED Non-Shockable

AED Shockable

CPC Score by Initial Pulseless Rhythm2018


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Survival Rates, Cardiac Arrest Witnessed By 2018

26(22%)

91(78%)

Bystander Witnessed


N= 117

26(13%

177(87%)

EMS/FD Witnessed


N= 203

16(7%)

230(93%)

Family Member Witnessed


N= 246

6(13%)

42(87%)

Healthcare Provider Witnessed


N= 48

34(4%)

739(96%)

Not Witnessed


N= 773

2018 cardiac arrest summary - mcb /...

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