Table 4.
Incidence, treatment characteristics, and outcome by region.
| Region | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 |
|---|---|---|---|---|---|---|---|---|---|
| All cardiac arrests | |||||||||
| Incidence* | 12.5 | 12.7 | 9.7 | 6.9 | 12.0 | 8.1 | 9.6 | 5.8 | 6.2 |
| Perinatal, % | 0.9 | 2.2 | 3.0 | 2.9 | 0.0 | 1.4 | 2.7 | 7.8 | 4.7 |
| Infants, % | 49.1 | 47.2 | 51.5 | 25.8 | 59.7 | 42.8 | 50.2 | 32.7 | 32.6 |
| Children, % | 24.1 | 28.9 | 14.9 | 23.9 | 17.9 | 23.2 | 18.4 | 27.8 | 20.5 |
| Adolescents, % | 25.9 | 21.7 | 30.6 | 47.4 | 22.4 | 32.6 | 28.7 | 31.7 | 42.1 |
| ALS on scene, % | 99.1 | 100.0 | 95.5 | 88.0 | 98.5 | 100.0 | 91.5 | 92.9 | 77.9 |
| EMS response, min | |||||||||
| Median | 5.2 | 4.4 | 4.0 | 5.3 | 5.2 | 5.2 | 5.0 | 5.8 | 6.7 |
| <8 minutes, % | 81.5 | 86.9 | 94.0 | 78.5 | 83.6 | 91.3 | 91.0 | 88.7 | 68.9 |
| EMS treated, % | 74.1 | 71.9 | 88.1 | 81.3 | 92.5 | 77.5 | 86.5 | 91.6 | 82.6 |
| Survival to discharge, %** | 1.9 | 5.7 | 3.7 | 8.3 | 11.9 | 9.6 | 12.6 | 8.9 | 12.2 |
| EMS-treated cardiac arrests | |||||||||
| Bystander CPR, %* | 47.5 | 41.7 | 26.3 | 54.7 | 53.2 | 66.4 | 69.4 | 45.2 | 51.6 |
| Witnessed, % | 30.0 | 24.7 | 27.1 | 30.6 | 21.0 | 32.7 | 28.5 | 37.1 | 29.9 |
| Initial rhythm, % | |||||||||
| VT/VF | 3.8 | 3.9 | 5.1 | 6.5 | 3.2 | 11.2 | 7.8 | 11.0 | 8.3 |
| PEA | 6.3 | 13.9 | 12.7 | 11.8 | 3.2 | 9.3 | 17.6 | 19.1 | 17.8 |
| Asystole | 76.3 | 64.1 | 74.6 | 67.1 | 79.0 | 73.8 | 64.2 | 48.8 | 55.4 |
| Other/Unknown | 13.8 | 18.1 | 7.6 | 14.7 | 14.5 | 5.6 | 10.4 | 21.2 | 18.5 |
| EMS interventions | |||||||||
| Airway | |||||||||
| Bag/valve mask, % | 80.0 | 92.3 | 88.1 | 99.4 | 96.8 | 90.7 | 98.4 | 96.5 | 95.5 |
| Intubation attempt, % | 56.3 | 34.7 | 62.7 | 65.3 | 45.2 | 74.8 | 81.9 | 70.7 | 70.7 |
| SGA attempt,% | 1.3 | 12.4 | 11.0 | 7.1 | 14.5 | 7.5 | 0.0 | 0.4 | 3.8 |
| Resuscitation drug, % | 32.5 | 69.5 | 90.7 | 62.9 | 61.3 | 72.9 | 76.7 | 60.1 | 59.9 |
| Epinephrine, % | 32.5 | 69.1 | 88.1 | 62.9 | 61.3 | 68.2 | 74.6 | 60.1 | 58.6 |
| Bicarbonate, % | 3.8 | 5.8 | 13.6 | 2.4 | 14.5 | 6.5 | 53.4 | 1.1 | 14.0 |
| Atropine, % | 23.8 | 24.3 | 33.9 | 24.7 | 33.9 | 43.0 | 34.2 | 19.4 | 25.5 |
| IV/IO attempts, % | 63.8 | 82.6 | 94.1 | 79.4 | 74.2 | 80.4 | 83.9 | 72.1 | 68.2 |
| EMS defibrillation, % | 6.3 | 6.6 | 5.9 | 8.8 | 8.1 | 16.8 | 13.5 | 17.3 | 14.0 |
| Shocks, mean*** | 0.8 | 1.1 | 1.8 | 1.2 | 1.4 | 2.0 | 4.1 | 2.7 | 2.8 |
| Scene time (min), median | 9.0 | 13.9 | 30.0 | 18.1 | 12.7 | 17.2 | 27.4 | 18.2 | 23.6 |
| Interquartile range | 6.7, 13.9 | 9.7, 18.8 | 25.0, 35.0 | 10.7, 24.1 | 7.7, 22.3 | 12.0, 23.0 | 20.1, 37.3 | 13.0, 25.2 | 13.5, 33.2 |
| Outcomes Transported to hosp., % | 92.5 | 99.2 | 40.7 | 91.2 | 88.7 | 74.8 | 46.6 | 93.6 | 74.5 |
| ROSC before ED, % | 2.5 | 12.0 | 23.7 | 20.0 | 11.3 | 21.5 | 34.7 | 16.3 | 28.0 |
| ROSC at ED arrival, % | 2.5 | 8.9 | 19.5 | 17.6 | 9.7 | 18.7 | 32.1 | 12.7 | 23.6 |
| Survival to discharge % | 2.6 | 8.0 | 4.2 | 10.2 | 12.9 | 12.5 | 14.7 | 9.8 | 14.7 |
| Odds ratio**** | 0.3 | referent | 0.5 | 1.0 | 5.3 | 1.1 | 1.6 | 0.5 | 1.7 |
| Confidence interval | 0.0, 1.8 | referent | 0.1, 1.8 | 0.4, 2.6 | 1.6, 17.6 | 0.3, 3.4 | 0.6, 4.9 | 0.2, 1.3 | 0.6, 5.2 |
*
For 100,000 person-years, adjusted for sex and age group; incidence rates by year significantly significant at p < 0.001, chi-squared test
**
Percent known
***
For those administered one or greater shocks
****
Adjusted for covariates of: 911 to EMS arrival time, bystander CPR, witness status, sex, initial rhythm, age group, and ALS EMS crew arrival before BLS.
Outcomes by region statistically significant at p < 0.001, likelihood ratio test with multivariate regression.
EMS, emergency medical services; ALS, advanced life support; SGA, supraglottic airway; CPR, cardiopulmonary resuscitation; IV, intravenous; IO, intraosseous; ROSC, return of spontaneous circulation