TY - JOUR T1 - Sophia JF - Emergency Medicine Journal JO - Emerg Med J SP - 522 LP - 522 VL - 24 IS - 7 AU - Tanya Baron AU - Jonathan Wyatt Y1 - 2007/07/01 UR - http://emj.bmj.com/content/24/7/522.abstract N2 - Most cardiac arrests occur in the out of hospital setting. A Finnish study ( Eur J Emerg Med2007;14:75–81OpenUrlCrossRefPubMedWeb of Science) 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. It is widely acknowledged that the stress hormones play a role during resuscitation. A pilot study in the American Journal of Emergency Medicine (2007;25:318–25OpenUrlCrossRefPubMedWeb of Science) 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 … ER -