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- Paul Younger and Graham McClelland.
- North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne, UK.
- Emerg Med J. 2015 Jun 1;32(6):503.
BackgroundSurvival rates from out-of-hospital cardiac arrest (OHCA) vary, with figures from 2% to 12% reported nationally. Our ambulance service introduced a dedicated cardiac arrest response unit (CARU) as a trial in order to improve local patient outcomes by focussing training, extending the scope of practice and increasing exposure to cardiac arrests. CARU launched in January 2014 using a rapid response car staffed by senior paramedics responding to cardiac arrests within a 19 minute radius of their location. emermed;32/6/503-b/EMERMED2015204979TB1T1EMERMED2015204979TB1 CARU Service (CARU removed) 2012 OHCA Registry Cardiac arrests where resuscitation was attempted 54 705 1,853 ROSC (Sustained to hospital) 35.2% 25.8% 23.0% Survival to discharge (Based on latest available data) 13.0% 3.3% 7.0%MethodsThis work describes the development and impact of CARU during the initial six months (10/01/14 to 09/07/2014) of operations using prospectively collected data on all cases attended.ResultsCARU activated to 165 calls and attended 65% (n=107). 50% (n=54) of the cases attended were cardiac arrests where resuscitation was attempted. Return of Spontaneous Circulation (ROSC) was achieved during pre-hospital resuscitation in 52% (n=28) of cases. Patient outcomes are reported compared with service data for January to June 2014 inclusive and one year of historical data from the regional OHCA registry:ConclusionsBased on these figures CARU appears to have a positive impact on ROSC and a significant impact on survival to discharge rates compared with the rest of the service (p<0.01, Fisher's exact test). Further work is needed to explore how CARU delivers this impact and how the CARU model can be implemented beyond the trial setting in a sustainable fashion.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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