Jon Jui MD, MPH
Jan 11, 2016
Jon Jui MD, MPH
RSI (AMR data): January – October 2007
Success Total Percent
Medical 65 74 88 %
Trauma 25 32 78%
Total 90 106 85 %
RSI : Success by Primary Impression
Number Success PercentCardiac 8 8 100%
Neurologic
25 20 80%
Respiratory
24 22 92%
Toxicology
12 11 92%
Trauma 36 28 77%
Burns 1 1 100%
Total 106 90 85%
Cardiac Arrest (AMR data): January 1 – October 31, 2007
Treatment Number Percent
No resuscitation 156 26 %
Treated : Resuscitation Terminated
126 22 %
Transported 309 52 %
Total 591 100 %
Cardiac Arrest : ROSCROSC Number Percent
NO 301 70 %
YES 134 30 %
Total 435 100 %
Cardiac Arrest : EZIO vs ROSCROSC : YES
ROSC : NO
Total Percent
EZIO : YES
41 75 116 35 %
EZIO : NO
93 226 319 29 %
Total 134 231 365
ROC Cardiac Outcomes12/01/05 – 5/30/07 - Total Cases
Multnomah
All others
All 951 942
Treated 555 (58%) 576 (61%)
ROC Cardiac OutcomePortland ROC
2nd amongst all ROC sites in survival of cardiac arrest patients.
Guess who is number 1?
ROC Cardiac OutcomesLocation of Arrest
Multnomah
Others
Public 114 (20%) 90 (16%)
Private 441 (80%) 486 (84%)
Total 555 576
ROC Cardiac OutcomesWitness & Bystander CPR
Multnomah
Other
Bystander Witnessed
50% 48%
EMS 3.8% 3.3%
Bystander CPR
44% 48%
ROC Cardiac OutcomesPresenting Rhythm
Multnomah Other
VF or VT 174 (31%) 195 (33%)
PEA 130 (23%) 111 (19%)
Asystole 238 (43%) 257 (45%)
AED No shock
0 4 (0.7%)
Cannot determine
13 (2%) 9 (1.5%)
ROC Cardiac Outcomes Field ROSC
Multnomah
Others
Any Field ROSC
43% 33%
ROC Cardiac OutcomesTransported
Multnomah Others
Died at scene 208 (37%) 266 (46%)
Transported 347 (63%) 310 (54%)
ROC Cardiac OutcomesOutcome
Multnomah Others
Died at scene 208 (37%) 266 (46%)
Died in ED 197 (35%) 145 (25%)
Died after admission
80 (14%) 84 (15%)
DC Alive 62 (11.2%) 62 (10.7%)
Outcome unknown
8 (1.4%) 19 (3.3%)
Multnomah County EMS12 Lead ProceduresJanuary 1 – October 31, 2007
Patients ECG STEMI
4965 5812 156 (3%)
Multnomah County STEMI’s
12 Lead ECG : Scene Time YR 2005 vs Year 2006
12 Lead ECG : Scene TimeSTEMI vs NON STEMI 2006
EZ IOSuccessful by PatientSuccessful 159 93%
Unsuccessful
12 7%
Total 171
MCEMS : EZIO by AgencyNumber of procedures
Fire 58 (34%)
AMR 113 (66%)
Total 171
MCEMS: EZIO by IndicationCardiac Arrest 119 70%
Trauma Arrest 2 1%
Trauma System Entry (Mandatory)
9 5%
Respiratory 13 8%
Neurologic 8 5%
Toxicologic 6 4%
Shock (GI bleed)
4 2%
MCEMS Trauma System EntriesScene Times : All vs. RSI
2007 All 2007 RSI
Mean 14.34 18.11
Median 12.57 14.05
75% 17.41 19.59
MCEMS Trauma System EntriesRSI Scene Times 2006 vs 2007
2006 RSI Pt Side to Transport
2007 RSI Pt Side to Transport
Mean 20.29 18.11
Median 17.18 14.05
75% 25.51 19.59
Trauma Scene Time Impact of RSI : Conclusions
Dramatic decrease! 2006 5-7 minutes increase
2007 1-3 minutes increase