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Introduction: Recent data are not available on ongoing CPR for emergency services with an onboard physician. The aim of the present study was to identify factors associated with the decision to transport patients to hospital with ongoing CPR and examine their survival to hospital discharge with good neurological status. Methods: An observational study based on a registry of out-of-hospital cardiac arrests attended to by emergency services with an onboard physician. All OHCA cases occurring between the 1st of January and the 31st of December 2022 were included. Patients receiving ongoing CPR during transport to the hospital were compared with patients pronounced dead at the scene following arrival of the care team. The dependent variable was ongoing CPR during transport to the hospital. The main characteristics and the neurological status of patients surviving to discharge were described. Results: A total of 9321 cases were included, of which 350 (3.7%) were transported to hospital with ongoing CPR. Such patients were young (59.9 ± 20.1 years vs 64.6 ± 16.9 years; p

Este artículo valora la respuesta de los Servicios de Emergencias Médicas (SEM) en España ante la pandemia por SARS-Cov-2, su nivel de integración y las responsabilidades asumidas. Estudio descriptivo transversal de todas las Comunidades Autónomas del Estado Español. Recogida de datos realizada entre el 14 y el 30 de abril de 2020. Encuesta enviada a los miembros del Grupo de Investigación OSHCAR (Out-Of-Hospital Cardiac Arrest Registry). 48 preguntas. Variables cualitativas: mediana (Mdn) y rango intercuartilico (IQR). Recibidas respuestas de todos los SEM. Comité interdisciplinar en el 76% con reuniones de periodicidad variable. Plan de contingencia en 10 Centros Coordinadores de Urgencias (CCU).Refuerzo de plantillas en operadores (Mdn=13;IQR=21,25). Médicos (Mdn=5;IQR=6,91) y enfermeros (Mdn=5;IQR=27,08). Acceso a pruebas, 10 CCU a información, 6 solicitud directa y 5 por otros servicios. Nuevos teléfonos de información gestionados por los SEM directamente en 11. Interrogatorio telefónico para autodiagnóstico en 9 y consulta on line en 7. Todos los SEM disponían de unidades asistenciales exclusivas (1-84) para COVID (Mdn= 8;IQR=18,125).Medidas especificas para atención a la parada cardio-respiratoria en 13. Podemos concluir que los SEM han demostrado una gran capacidad de adaptación a situaciones nuevas y han sido esenciales como primera línea de contención en la pandemia.

Background: The aim of this study is to describe major trauma cases in Navarre and analyze differences based on mortality groups, sex, and mode of injury., Methods: Cross-sectional study of major traumas (severity =3) registered in Navarre between 2010 and 2019. We analyzed the type of trauma, intentionality, the mode of injury, and the affected anatomical area. The odds ratio for major trauma associated with different variables was calculated., Results: The study included 2,609 patients; mean age was 54.7 years (0-101) and 70.9% were male. A predominance of accidental (84%) / blunt (94.7%) major traumas was recorded, primarily resulting from falls (46.5%) and car accidents (18.4%). Women experienced more falls and pedestrian accidents, while men had more motorcycle, bicycle, knife/firearm accidents, and contusions. Most major traumas affected the head and thorax. Head trauma was significantly more common in deceased individuals and women, while thoracic trauma was more frequent in patients who died on-site and in men. Head injuries were caused by falls from low heights and firearms, whereas thoracic injuries resulted from car accidents and falls from height. The risk of major trauma decreased with age; deceased patients were between two and three times more likely to present lesions in all anatomical areas., Conclusions: Gender differences are observed in intentionality, type, and mode of injury. Head and thoracic injuries are potentially life-threatening and abdominal and extremity/pelvic ring injuries are associated with early deaths. This suggests that the extent and severity of these injuries complicate treatment and management.

Summary: Out-of-hospital cardiac arrest is a serious public health problem worldwide. The annual incidence is estimated at around 400 000 cases in Europe and the United States, and survival rates scarcely reach 10%. However, there is considerable variation between countries and even between regions that share a similar health care system within a single country. Information recorded by the Out-of-Hospital Spanish Cardiac Arrest Registry (OHSCAR) provides information on care provided by emergency ambulance services, final health outcomes after cardiac arrest cases (including variations), the possibility of organ donation, and the impact of the COVID-19 pandemic. This paper presents the OHSCAR report for Spanish emergency services for the year 2022.

Objectives: To examine gender-related differences in the management and survival of out-of-hospital cardiac arrest (OHCA) in Spain during 2 time series., Material and Methods: Analysis of data recorded in the prospective Spanish OHCA registry (OHSCAR in its Spanish acronym) for 2 time series (2013-2014 and 2017-2018). We included all 11 036 consecutive cases in which an emergency team intervened. The dependent variables were arrival at the hospital after return of spontaneous circulation, overall survival to discharge, and overall survival with good neurological outcomes. Sex was the independent variable. We report descriptive statistics, patient group comparisons, and changes over time., Results: Women were significantly older and less likely to experience an OHCA in a public place, receive automatic external defibrillation, have a shockable heart rhythm, and be attended by an ambulance team within 15 minutes. In addition, fewer women underwent percutaneous coronary interventions or received treatment for hypothermia on admission to the hospital. In 2013-2014 and 2017-2018, respectively, the likelihood of survival was lower for women than men on admission (odds ratio [OR], 0.52 vs OR, 0.61; P .001 and P = .009 in the 2 time series) and at discharge (OR, 0.69 vs 0.72 for men; P = .001 in both time series). Survival with good neurological outcomes was also less likely in women (OR, 0.50 vs 0.63; P .001 in both series)., Conclusion: The odds for survival and survival with good neurological outcomes were lower for women in nearly all patient groups in both time series. These findings suggest the need to adopt new approaches to address gender differences in OHCA.