Out-of-hospital traumatic cardiac arrest: an underrecognized source of organ donors.

Whereas the gap between organ supply and demand remains a worldwide concern, resuscitation of out-of-hospital traumatic cardiac arrest (TCA) remains controversial. The aim of this study is to evaluate, in a prehospital medical care system, the number of organs transplanted from victims of out-of-hospital TCA. This is a descriptive study. Victims of TCA are collected in the out-of-hospital cardiac arrest registry of the French North Alpine Emergency Network from 2004 to 2008. In addition to the rates of admission and survival, brain-dead patients and the organ transplanted are described. Among the 540 resuscitated patients with suspected TCA, 79 were admitted to a hospital, 15 were discharged alive from the hospital, and 22 developed brain death. Nine of these became eventually organ donors, with 31 organs transplanted, all functional after 1 year. Out-of-hospital TCA should be resuscitated just as medical CA. With a steady prevalence in our network, 19% of admitted TCA survived to discharge, and 11% became organ donors. It is essential to raise awareness among rescue teams that out-of-hospital TCA are an organ source to consider seriously.

Impact of an emergency medical dispatch system on survival from out-of-hospital cardiac arrest: a population-based study.

BACKGROUND: In countries where a single public emergency telephone number is not in operation, different emergency telephone numbers corresponding to multiple dispatch centres (police, fire, emergency medical service) may create confusion for the population about the most appropriate service to call. In particular, out-of-hospital cardiac arrest (OHCA) requires a prompt and effective response. We compare two different dispatch systems on OHCA patient survival at 30 days in a national system with multiple emergency telephone numbers. METHODS: We conducted an observational retrospective study of 6871 patients aged 18 years or older with presumed OHCA of cardiac origin between 2005 and 2013 in three counties of the Northern French Alps region. One county had a single dispatch centre combining medical and fire emergencies, and two had multiple dispatch centres. Propensity score matching analyses were performed to compare patient survival at 30 days. RESULTS: A total of 2257 emergency calls for OHCA were managed by a single dispatch centre and 4614 by a multiple dispatch centre. A single dispatch centre was associated with an increase in survival (adjusted odds ratio [OR] for all patients: 1.7; 95 % confidence interval [CI] = 1.3-2.2; p <0.001; adjusted OR for propensity-matched patients: 2.0; 95 % CI = 1.2-3.4; p = 0.012). CONCLUSIONS: A single dispatch centre was associated with a markedly improved increase of survival among OHCA patients at 30 days in a system with several emergency telephone numbers.