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Abstract WP477: Neuro-Cognitive Outcomes After Transitioning to Pit Crew Model for Out of Hospital Cardiac Arrest


 Introduction:
 Survival and neurological outcomes from the out of hospital cardiac arrest (OHCA) varies from one region to another depending on the different practices followed by the emergency personnel. Our study looked into neuro-cognitive outcomes post OHCA before and after adopting a pit crew model approach in one of the largest counties in Kansas.
 
 
 Methods:
 The data was collected by the emergency medical services (EMS) before transitioning (from 2010 - 2012) and after transitioning (from 2013-2016) to the pit crew approach. The patient demographics and resuscitation variables were similar and comparable including the emergency and fire department personnel. The primary outcomes were the average number of pauses >10 seconds and the cerebral performance post return of spontaneous circulation (ROSC)
 
 
 Results:
 The average number of CPR pause time > 10 seconds post pit crew model was 1 vs 5 (p=0.01). Cerebral performance post return of spontaneous circulation using pit crew approach with good cerebral performance was 56% vs 47% (p=0.2), moderate cerebral disability was 17% vs 23% (p=0.19), severe cerebral disability was 8% vs 11% (p=0.44) and in coma/vegetative state was 8% vs 16% (p=0.001).
 
 
 Conclusion:
 This focused model of high-quality CPR performance with the individualized assigned task has shown a declining trend in the rates of cerebral disability especially with moderate and severe cerebral performance including the patients in coma or vegetative state. More studies with better neuro-cognitive follow-up care after ROSC is needed to further establish the superiority of pit crew model approach.
