ปัจจัยที่มีความสัมพันธ์กับความสำเร็จในการฟื้นคืนชีพ กลุ่มผู้ป่วยที่มีภาวะหัวใจหยุดเต้นนอกโรงพยาบาลไม่เกิน 30 นาที

Supattra Laksanajan; Thassanee Soontorn; Affarn Mawee; Wisma Jehma; Chayada Lempan; Nurlaila Samae; Hathaithip Sittichai

Authors

Supattra Laksanajan Faculty of Nursing, Suratthani Rajabhat University
Thassanee Soontorn Faculty of Nursing, Suratthani Rajabhat University
Affarn Mawee Faculty of Nursing, Suratthani Rajabhat University
Wisma Jehma Faculty of Nursing, Suratthani Rajabhat University
Chayada Lempan Faculty of Nursing, Suratthani Rajabhat University
Nurlaila Samae Faculty of Nursing, Suratthani Rajabhat University
Hathaithip Sittichai Kanchanadit Hospital

Keywords:

spontaneous circulation return, emergency care, out-of-hospital cardiac arrest, emergency medical services

Abstract

Introduction: The survival rates of out-of-hospital cardiac arrest (OHCA) depend not only on rapid access to emergency medical services (EMS) but also critically on the ability and actions of bystanders.

Research objectives: This study aimed to examine factors associated with the return of spontaneous circulation (ROSC) in patients experiencing OHCA within 30 minutes prior to hospital arrival.

Research methodology: This retrospective study used data from medical records identified by the ICD-10 code for OHCA. The data came from a community hospital that provided outpatient and emergency services 24 hours a day. There were 90 cases included in the analysis. The research instrument was a structured data collection form for OHCA patients. It consisted of two parts: 1) general patient information and 2) variables derived from the conceptual framework. Content validity was assessed using the Index of Item-Objective Congruence. Values ranged from 0.60 to 1.00 for all items. Descriptive statistics, Chi-square tests,
and independent t-tests were used for statistical analysis.

Results: Age and comorbidities did not differ significantly between ROSC and non-ROSC groups (p > .05). In contrast, the suspected cause of cardiac arrest was the only covariate with a statistically significant difference between groups (p < .05). These three variables were analyzed for survival outcomes without covariate adjustment. EMS transport was significantly associated with ROSC (p < .05). No significant associations were found between the presence of a witness and ROSC, or between bystander CPR before hospital arrival and ROSC (p > .05).

Conclusions: The time from the emergency call to hospital arrival via EMS does not affect survival rates. Chest compressions performed by bystanders before EMS arrival do not significantly increase survival chances.

Implications: Efforts should focus on enhancing the quality of CPR delivered by community bystanders and optimizing EMS performance. Furthermore, the deployment of advanced life support teams is essential to provide timely and effective resuscitation.

Downloads

Download data is not yet available.

References

Oliveira NC, Oliveira H, Silva TLC, Boné M, Bonito J. The role of bystander CPR in out-of-hospital cardiac arrest: what the evidence tells us. Hellenic journal of cardiology 2025;82:86-98.

American Heart Association. American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16 Suppl 2):366–468.

Moriwaki K, Watanabe T, Yasuda M, Katagiri T, Ueki M, Kurita S, et al. An outcome study of adult in-hospital cardiac arrests in non-monitored areas with resuscitation attempted using AED. American journal of emergency medicine 2020;38(12):2524–30.

Raza A, Arslan A, Ali Z, Patel R. How long should we run the code? survival analysis based on location and duration of cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest. Journal of community hospital internal medicine perspectives 2021;11(2):206–11.

National Institute of Emergency Medicine. EMS operation rates for critically ill emergency patients nationwide during 2021–2022 [Internet]. [cited 2024 Mar 20]. Available from: https://ws.niems.go.th/KPI57/2557/kpireportcontinue01.aspx (in Thai)

Yaemwan N, Sromanee J. Final research report on the situation and factors affecting the implementation and management of pre-hospital emergency medical services by provincial administrative organizations in Thailand. Bangkok: National Institute of Emergency Medicine 2023. p. 46–7. (in Thai)

Lott C, Truhlar A, Alfonzo A, Barelli A, Gonzalez-Salvado V, Hinkelbein J, et al. European resuscitation council guidelines 2021: cardiac arrest in special circumstances. Resuscitation 2021;161:152–219.

Vahatalo JH, Huikuri HV, Holmstrom LTA, Kentta TV, Haukilahti MAE, Pakanen L, et al. Association of silent myocardial infarction and sudden cardiac death. JAMA cardiology 2019;4(8):796–802.

Vahatalo J, Holmstrom L, Pakanen L, Kaikkonen K, Perkiomaki J, Huikuri H, et al. Coronary artery disease as the cause of sudden cardiac death among victims <50 years of age. The American Journal of Cardiology 2021;147:33-8.

De Gaspari M, Rizzo S, Thiene G, Basso C. Causes of sudden death. European Heart Journal Supplements. 2023;25:16–20.

Levitt CV, Boone K, Tran QK, Pourmand A. Application of technology in cardiopulmonary resuscitation, a narrative review. Journal of Clinical Medicine. 2023;12(23):7383.

Olasveengen TM, Semeraro F. Basic life support and systems saving lives. Current opinion in critical care 2021;27(6):617–22.

Wiratchai N. Lecture materials on accurate and modern methods for determining sample size. in: research zone project organized by the research Learning Center. Bangkok: National Research Council of Thailand (NRCT); 2012 Jan 26. (in Thai)

Ratnayake A, Nakahara S, Bagaria D, De Silva SL, Llaneta A, Pattanarattanamolee R, et al. Focused research in emergency medical systems in Asia: A necessity for trauma system advancement. Emergency and Critical Care Medicine 2022;2(2):87–93.

Holmström L, Reinier K, Toft L, Halperin H, Salvucci A, Jui J, Chugh SS. Out-of-hospital cardiac arrest with onset witnessed by emergency medical services: Implications for improvement in overall survival. Resuscitation. 2022;175:19–27.

Limsuriyakan W, Lorwanich P. Factors associated with patients delivered through Phra Nakhon Si Ayutthaya Hospital’s emergency medical system dying within 24 hours. TUH Journal online [Internet]. 2022 [cited 2025 Mar 8];7(2):31–40. Available from: https://he02.tci-thaijo.org/index.php/TUHJ/article/view/256903/176621 (in Thai)

Chayawuttinpong T. Factor associated with the return of spontaneous circulation of out-hospital cardiac arrest at emergency department, Kumpawapi Hospital Udonthani. Udonthani hospital medical journal [Internet]. 2022 [cited 2025 Mar 8];30(1):58-67. Available from: https://he02.tci-thaijo.org/index.php/udhhosmj/article/view/257556 (in Thai)

American Heart Association. Highlights of the 2020 American Heart Association Guidelines for CPR and ECC [Internet]. Dallas, Texas: American Heart Association; 2020 [cited 2025 Jun 8]. Available from: https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf

Sasang N, Chusak T, Samee A. Effect of the resuscitation training program on knowledge and skills and perceived self-efficacy of resuscitation village health volunteers in Khlong Chik Subdistrict, Bang Pra-in District, Phra Nakhon Si Ayutthaya Province. Journal of the Royal Thai Army Nurses 2020;21(3):283–93. (in Thai)

Eastin C, Karim S, Hawthorn C, Webb MH, Waheed MA, Buford A, et al. Mandated 30-minute scene time interval correlates with improved return of spontaneous circulation at emergency department arrival: a before and after study. The Journal of Emergency Medicine 2019;57(4):527–34.