Post on 18-Feb-2021
2018 Cardiac Arrest Summary and Outcomes
2018
COX, MATT
OFFICE OF THE MEDICAL DIRECTOR 1417 N Lansing Ave Tulsa, OK 74106
Page 1 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%
Page 2 of 20
*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
Page 3 of 20
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
Page 4 of 20
1271
1382
1323
1451
1423
1387
1150
1200
1250
1300
1350
1400
1450
1500
2013 2014 2015 2016 2017 2018
ANNUAL RESUSCITATIONS INITIATED
Page 5 of 20
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
Page 6 of 20
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
Page 7 of 20
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
Page 8 of 20
*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
Page 9 of 20
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
Page 10 of 20
*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
Page 11 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
Page 12 of 20
*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
Page 13 of 20
*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
Page 14 of 20
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
Page 15 of 20
*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
Page 16 of 20
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
CPC 1 CPC 2 CPC 3 CPC 4
Page 17 of 20
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
Page 18 of 20
Initial Pulseless Rhythm Survival 2018
10(2%)
634(98%)
Asystole Survival
Survival Non-Survival
N= 644
35(8%)
427(92%)
PEA
Survival Non-Survival
N= 462
8(16%)
41(84%)
AED Non-Shockable
Survival Non-Survival
N= 49
37(19%)
153(81%)
Ventricular Fibrillation
Survival Non-Survival
N= 190
5(45%)
6(55%)
Ventricular TachycardiaPulesless
Survival Non-Survival
N= 11
13(42%)
18(58%)
AED Shockable
Survival Non-Survival
N= 31
Page 19 of 20
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
CPC 1 CPC 2 CPC 3 CPC 4
Page 20 of 20
Survival Rates, Cardiac Arrest Witnessed By 2018
26(22%)
91(78%)
Bystander Witnessed
Survival Non-Survival
N= 117
26(13%
177(87%)
EMS/FD Witnessed
Survival Non-Survival
N= 203
16(7%)
230(93%)
Family Member Witnessed
Survival Non-Survival
N= 246
6(13%)
42(87%)
Healthcare Provider Witnessed
Survival Non-Survival
N= 48
34(4%)
739(96%)
Not Witnessed
Survival Non-Survival
N= 773