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Editorial| Volume 184, 109705, March 2023

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A burning issue in Resuscitation

  • Ziad Nehme
    Correspondence
    Corresponding author at: Centre for Research and Evaluation, Ambulance Victoria, 31 Joseph Street, Blackburn Norther, Victoria 3130 Australia.
    Affiliations
    Centre of Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia
    Department of Paramedicine, Monash University, Frankston, Victoria, Australia
    Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Victoria, Australia
    Search for articles by this author
  • Emily Nehme
    Affiliations
    Centre of Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia
    Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Victoria, Australia
    Search for articles by this author
      Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in the developed world.
      • Berdowski J.
      • Berg R.A.
      • Tijssen J.G.
      • Koster R.W.
      Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies.
      Although the vast majority of OHCA are of medical or cardiac aetiology, there is a growing population of OHCA patients whose pathogenesis is related to external causes, including overdose or poisoning, trauma, and asphyxiation.
      • Alqahtani S.
      • Nehme Z.
      • Williams B.
      • Bernard S.
      • Smith K.
      Changes in the incidence of out-of-hospital cardiac arrest: Differences between cardiac and non-cardiac aetiologies.
      • Lee S.Y.
      • Ro Y.S.
      • Park J.H.
      • Jeong J.
      • Song K.J.
      • Shin S.D.
      Trends of the incidence and clinical outcomes of suicide-related out-of-hospital cardiac arrest in Korea: A 10-year nationwide observational study.
      External causes of OHCA represent as many as one quarter of all OHCA cases, have a very low prospect of survival, and are associated with significant neurological sequelae in survivors.
      • Alqahtani S.
      • Nehme Z.
      • Williams B.
      • Bernard S.
      • Smith K.
      Changes in the incidence of out-of-hospital cardiac arrest: Differences between cardiac and non-cardiac aetiologies.
      • Lee S.Y.
      • Ro Y.S.
      • Park J.H.
      • Jeong J.
      • Song K.J.
      • Shin S.D.
      Trends of the incidence and clinical outcomes of suicide-related out-of-hospital cardiac arrest in Korea: A 10-year nationwide observational study.
      • Kitamura T.
      • Kiyohara K.
      • Sakai T.
      • et al.
      Epidemiology and outcome of adult out-of-hospital cardiac arrest of non-cardiac origin in Osaka: a population-based study.
      • Kuisma M.
      • Alaspaa A.
      Out-of-hospital cardiac arrests of non-cardiac origin.
      • Hess E.P.
      • Campbell R.L.
      • White R.D.
      Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin.
      • Kim S.J.
      • Shin S.D.
      • Lee E.J.
      • et al.
      Epidemiology and outcomes of out-of-hospital cardiac arrest according to suicide mechanism: a nationwide observation study.
      • Alqudah Z.
      • Nehme Z.
      • Williams B.
      • Oteir A.
      • Bernard S.
      • Smith K.
      Impact of temporal changes in the epidemiology and management of traumatic out-of-hospital cardiac arrest on survival outcomes.
      • Alqahtani S.
      • Nehme Z.
      • Williams B.
      • Bernard S.
      • Smith K.
      Long-term trends in the epidemiology of out-of-hospital cardiac arrest precipitated by suspected drug overdose.
      • Alqahtani S.
      • Nehme Z.
      • Williams B.
      • Bernard S.
      • Smith K.
      Temporal Trends in the Incidence, Characteristics, and Outcomes of Hanging-Related Out-of-Hospital Cardiac Arrest.
      However, there are a myriad of external causes of OHCA, making the interpretation and translation of evidence difficult when described under such umbrella terms. For instance, OHCA precipitated by trauma can have a range of mechanisms, including long falls, assaults, motor vehicle accidents, animal injury, shootings, and stabbings, among many others, all of which have distinct epidemiological profiles, prognostic factors and challenges in treatment and recovery.
      • Kitamura T.
      • Kiyohara K.
      • Sakai T.
      • et al.
      Epidemiology and outcome of adult out-of-hospital cardiac arrest of non-cardiac origin in Osaka: a population-based study.
      • Doan T.N.
      • Wilson D.
      • Rashford S.
      • Sims L.
      • Bosley E.
      Epidemiology, management and survival outcomes of adult out-of-hospital traumatic cardiac arrest due to blunt, penetrating or burn injury.
      • Beck B.
      • Bray J.E.
      • Cameron P.
      • et al.
      Predicting outcomes in traumatic out-of-hospital cardiac arrest: the relevance of Utstein factors.
      • Kim J.G.
      • Lee J.
      • Choi H.Y.
      • et al.
      Outcome analysis of traumatic out-of-hospital cardiac arrest patients according to the mechanism of injury: A nationwide observation study.
      • Deasy C.
      • Bray J.
      • Smith K.
      • et al.
      Traumatic out-of-hospital cardiac arrests in Melbourne.
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