Mark Hobson
Journal of Paramedic Practice, Vol. 9, Iss. 7, 07 Jul 2017, pp 302 - 310

Background: Survival of prehospital cardiac arrest remains low and variable.
Angiography in cardiac arrest survivors shows a high incidence of ischaemic heart
disease and myocardial infarction (MI) which are treated at regional centres in the

Methods: A literature search was performed using the healthcare databases
Medline and CINAHL in order the answer the question: 'Which resuscitated
patients benefit from PPCI after out of hospital cardiac arrest?'. There was a
screening process to ensure precise relevance to the research question.

Findings: 163 articles were found using Medline and CINAHL. After screening, 11 articles
were reviewed in text. The evidence favours the intervention and demonstrates
increased survival rates when PPCI is available for patients with cardiac arrest
following an MI. The ECG is useful to predict coronary occlusion, but cannot rule
it out. Increased journey time to reach a regional PPCI centre appears unlikely
to impact negatively upon prognosis.

Conclusions: There are currently no randomised controlled trials answering this question and the evidence that is available is frequently influenced by selection bias. There is a need to identify
patients who will not benefit from the intervention so that a clinical decision rule can be developed to guide practice.

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