• R Araújo, E Gomes, M Lopes, and M S Araújo.
• Intensive Care Unit (ICIP), Hospital Geral de Santo António, Porto, Portugal.
• Eur J Emerg Med. 1997 Jun 1; 4 (2): 81-6.

AbstractPortugal has many weak links in the so-called 'chain of survival' both in the pre-hospital and in-hospital setting. Apart from evaluating the performance of a newly implemented in-hospital cardiac arrest system, we assessed the correlation between different clinical variables and outcome after cardiopulmonary resuscitation (CPR). All resuscitation attempts during 1995 were registered using the form recommended by the European Resuscitation Council. One hundred and twenty-five patients either collapsing out-of-hospital (42; 33.6%) or having in-hospital cardiac arrest (83; 66.4%) were included in the study. The number of patients who experienced recovery of spontaneous circulation was 10 (23.8%) in the out-of-hospital group and 35 (42.2%) in the in-hospital one. Of all out-of-hospital patients, 11.9% were discharged from hospital compared with 22.8% of the in-hospital group. Asystole was the initial rhythm in a significant number of arrests. The average call-response interval of the in-hospital cardiac arrest team was under 3 min. The results from this series concur with other reported series. Although good standards of care were achieved, we are aware that this was only an isolated step in the implementation of the 'chain of survival' in our country. The authors conclude that there is an urgent need for a nationwide programme that improves the standards of care for these patients.

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