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The authors have evaluated a total of 52,467 out-of-hospital cardiac arrests (OHCA). Of these, 900 were due to poisoning (poisoning-induced OHCA; POHCA). Diagnosis of poisoning had been confirmed on the basis of history taken from a neighbor or relatives, physical examination, and clinical signs and symptoms. I would like to ask few questions from the authors and also, I have a suggestion for them.
According to their information, few interventions were performed at field or during the pre-hospital transport. A total of 6 cases received pre-hospital advanced airway management and pre-hospital vascular access was done in only 2 cases. First, I would like to ask them what pre-hospital care is given by the EMS in their country. Does EMS just give ride to the ill patients to the hospital without performing any advanced life supports? It should be borne in mind that South Korea has been classified as a developed country and this certainly includes the health care system.
Second, what was the inter-rater agreement for the diagnosis of POHCA between the investigators? It seems that they should have mentioned this in their study.
I suggest the authors to reflect their results to the authorities of their country such as Ministry of Health and Welfare to develop the role of EMS (to perform advanced life support and antidotal therapy) in the management of the poisoned patients. Thanks for this interesting study.
Conflict of interest statement
None to declare.
Epidemiology and outcomes of poisoning-induced out-of-hospital cardiac arrest.