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PREHOSPITAL GUIDELINE ADHERENCE
Most cardiac arrests occur in the out of hospital setting. A Finnish study (
) assessed the prehospital care after return of spontaneous circulation in the out of hospital setting. It found that only 40% of patients received care in accordance with established guidelines. Failure to follow guidelines correlated with a lower rate of survival to hospital discharge. The results emphasise that return of spontaneous circulation is really only the beginning in the management of these patients, and that what happens next is just as critical.
STEROIDS IN PREHOSPITAL ARREST
It is widely acknowledged that the stress hormones play a role during resuscitation. A pilot study in the
) examines the use of hydrocortisone in the resuscitation of non-traumatic out-of-hospital cardiac arrest patients. Administration of hydrocortisone during resuscitation was associated with an improvement in return of spontaneous circulation from 39% (placebo group) to 61% (steroid group). Disappointingly, it had no significant effect upon one and seven day survival rates, or the …