Lower chest compression fraction among patients with longer downtime and ROSC was not due to peri-shock pause
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Letter to the Editor
Sir, In our paper entitled “Lower chest compression fraction associated with ROSC in OHCA patients with longer downtimes”  we reported a significant, inverse relationship between chest compression fraction (CCF) and return of spontaneous circulation (ROSC); furthermore this relationship was shown to vary with downtime from onset of arrest to the provision of CPR by paramedics. We found specifically that in the group with a downtime of greater than 15 min, a lower CCF during the first three minutes of cardiopulmonary resuscitation (CPR) was significantly associated with ROSC. In this Letter to the Editor we present some additional data for pre-, post- and peri-shock pause  that was not included in our previously published work. The reason that it was not included was because there were few cases in our cohort that received a shock during the first three minutes of CPR quality data capture. However, we believe that presentation of this additional shock pause data aids in demonstrating that the significantly lower CCF observed among patients who achieved ROSC in the group with a downtime of greater than 15 min was not due to more time spent administering defibrillations.
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