Evaluation of cardiac arrest patients in the emergency department with bispectral module device for cpr termination decision

OBJECTIVE: According to the AHA guidelines, it is difficult to predict irreversible brain damage or brain death during cardiopulmonary resuscitation (CPR). Failure to start resuscitation or discontinuation of life-sustaining treatment is ethically equal. There are termination criteria, the basic life support of which consists of 3 parameters. All three of these must be met in order to terminate basic life support. These are; the fact that the arrest patient was not witnessed by a medical worker or a rescuer, ROSC was not provided after 3 full rounds of CPR and OED analysis, and no OED shock was given. Our aim in this study is to determine the effectiveness of BIS in the termination of cardiopulmonary resuscitation. MATERIAL AND METHOD: This study was performed at the Emergency Medicine Department of Gaziantep University Faculty of Medicine. Patients who were brought to the emergency department as an arrest and had an arrest in the emergency department were connected to the BIS device booklet without interruption of resuscitation with the appropriate instructions. During the intervention of the patient 0.dk, 10.dk, 20.dk., 30.dk, 40.dk in other words, BIS values were taken every 10 minutes. As soon as the ROSC was provided and the "ex decision" was made, the BIS tracking was stopped. The study was completed in 5 months. In the study, the number determined after statistical power analysis was performed was found to be 20. 25 Patients with arrest were enrolled in the study. The study data were statistically evaluated using the SPSS 22.0 Windows version package program. RESULTS: The 25 patients participating in the study, 16 of them was Ex and 9 had ROSC. 64% of patients were brought to the Emergency department by ASH. 36% of them were witnessed and in-hospital diagnosed arrest. The first-time BIS values of the patients were found to be 33.48 (± 13.93), while the average BIS value at the time of Ex was 34.06 (±19.66), while the ROSC was found to be 36.56 (±23.7) DISCUSSION AND CONCLUSION: The decision to terminate resuscitative efforts in the hospital belongs to the treating physician and is made taking into account many factors. These factors are if there is an arrest with or without witnesses, CPR duration, first arrest rhythm, defibrillation time, concomitant diseases, pre-arrest condition, and whether there may be ROSC at some point during resuscitation.According to the data in our study, the benefit of using BIS in CPR termination has not been determined. KEYWORDS: Emergency Department, CPR, Arrest, ROSC, BIS