Cardiac arrests outside hospital

BMJ 1998;316:1031-1032 ( 4 April )

Editorials

Cardiac arrests outside hospital

Survival could be improved by better public awareness of symptoms

General practice pp 1060, 1065

The first 150 words of the full text of this article appear below.

Twenty five years after the original epidemiological studies ¹ ² two thirds of all patients with coronary artery diseasestill die before reaching hospital (p 1065).³ These patientshave no opportunity to benefit from the advances in hospital treatmentof acute myocardial infarction, such as thrombolysis, that havedramatically reduced mortality in hospital. It is particularlysobering to see in the study by Norris et al that among patientsaged under 55 who die from cardiac arrest, 91% do so outside hospital,whereas the hospital mortality from acute myocardial infarctionin this age group is only 3%.³ The hospital mortality for olderpatients is proportionally higher, but two thirds of these patientsalso die before reaching hospital. Is it possible to save moreof these patients who die outside hospital?

Several studies, including that by Norris et al,³ show that half these patients who die outside hospital have an unwitnessedcardiac arrest and are . . . [Full text of this article]

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