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Background: Adrenaline has long been proved to increase chance of ROSC in both animal and human studies. Therefore, American Heart Association state in current ACLS guidelines that it must be administered during CPR. However, benefit of adrenaline in pre-hospital settings is still controversial.
Objective: To determine the effect of pre-hospital adrenaline administration in out of hospital cardiac arrest patients.
Methods: Cross-sectional study by analyzing secondary data from National Institute of Emergency Medical Service of Thailand (NIEMS) between January to December 2012. Population include every patients with out-of-hospital cardiac arrest resuscitated by advance EMS team, Dataset of adrenaline administration, operation time and outcome of resuscitation before emergency room arrival were recorded and analyzed subsequently by univariate and multivariate logistic regression analysis.
Results: Total of 1,506 cardiac arrest had been report. Only 512 (64%) patients had complete data for analysis, 424 (82.8%) patients survived to ER. In univariate analysis endotracheal intubation, intravenous fluid, and adrenaline were statistical significantly improve survival to ER. In multivariate analysis only adrenaline and intravenous fluid improved survival to ER with OR 3.32 (95% CI, 1.74 - 6.33) and OR 0.93 (95% CI, 0.90 - 0.96), respectively.
Conclusions: Adrenaline administration significantly increased survival to ER in out of hospital cardiac arrest patients resuscitated by advance EMS team.
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