Analysis of a 2-year-old resuscitation service

The results of attempted resuscitation of 561 patients with cardiac or respiratory arrest are reported. A one-way speech, multiple-call system, and two mobile resuscitation trolleys were used. Most of the patients were between 50 and 80 years of age. Threequarters of the patients presented with cardiac arrest which manifested as asystole almost twice as often as ventricular fibrillation. The commonest causes of arrest were acute myocardial infarction, unknown causes, cardiac failure, recent surgery, and respiratory arrest. Autopsies were obtained in one-third of patients who died. Most calls were between 10.00 hours and 22.00 hours and came from the medical wards. The initial method of assisted ventilation was by endotracheal tube and Ambu-bag in almost one-half of the patients, face mask and Ambu-bag in one-quarter and mouth-to-mouth or mouthto-nose in only one-tenth. A spontaneous electrocardiogram and/or pulse was restored in approximately one-third of patients, spontaneous breathing in 22%, and consciousness in 9%, and 18% returned to their pre-arrest status. Successful resuscitation was achieved in 25% but only 8% survived to leave hospital. Patients with respiratory arrest fared more than twice as well as those with cardiac arrest.The factors relating to successful resuscitation are discussed.