Resuscitation highlights in 2012

An analysis of a nationwide registry in South Korea showed that oisonings were responsible for 4.4% of 20, 536 out-of-hospital ardiac arrest (OHCA) cases of non-cardiac aetiology.1 Poisons ncluded insecticides (15.5%); herbicides (13.2%); unknown pestiides (19.9%); non-pesticide drugs (16.8%); and unknown poisons 6%). The survival to admission rate was 22.5% for insecticides, .2% for herbicides, 16.2% for unknown pesticides, 16.7% for nonesticides and 11.3% for the unknown poisoning cases. The survival o discharge rates was 9.9% for insecticides, 0.0% for herbicides, 2.1% or unknown pesticides, 3.3% for non-pesticides and 3.2% for the nknown group. Cardiac arrest from a non-shockable rhythm or non-cardiac ause comprises a substantial proportion of those who survive to ospital discharge. In a study of 1001 OHCA patients who were esuscitated and discharged alive, 313/1001 (31%) had presented ith a non-shockable rhythm and 210/1001 (21%) with nonardiac aetiology.2 Five-year survival was 43% for non-shockable hythms compared to 73% for shockable rhythms, and 45% for on-cardiac aetiology compared to 69% for cardiac aetiology p < 0.001). It is unclear how often resuscitation is futile when applied to ndividuals who experience OHCA in nursing homes. Of 2350 cariac arrests in such facilities in Melbourne, Australia from 2000 to 009, bystander CPR had been performed in 66% and a shockable hythm was present in 7.6% of patients on arrival of paramedics.3 urvival was less than survival in those aged >70 years of age who ad an OHCA in their own homes (1.8% vs. 4.7%, p = 0.001). The uthors concluded that survival might be improved by basic life upport (BLS) training of nursing home staff and availability of utomated external defibrillators (AEDs). Based on the theoretical protective effect of sex hormones, there s considerable interest in whether age and/or female gender are ssociated with survival after OHCA. An analysis of data from 29 ities in the U.S. that participate in the Cardiac Arrest Registry to nhance Survival (CARES) program showed that although females f all ages were less likely to have a cardiac arrest in public, or one hat was witnessed or treatable with defibrillation, odds of survival ere higher in younger females.4