Impact of Emergency Medical Service arrival time and initial arrest rhythm on return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest: The experience of the province of Lecce, Italy

Background: The reporting and analysing of data of out-of-hospital cardiac arrests encourages the quality improvement of the emergency medical services. For this reason, the establishment of a sufficiently large patient database is intended to allow analysis of resuscitation treatments for out-of-hospital cardiac arrests and performances of different emergency medical services. Aims: The aim of this study was to describe the demographics, characteristics, outcomes and determinant factors of survival for patients who suffered an out-of-hospital cardiac arrest. Methods: this was a retrospective study including all out-of-hospital cardiac arrest cases treated by the emergency medical service in the district of Udine (Italy) from 1 January 2010–31 December 2014. Results: A total of 1105 out-of-hospital cardiac arrest patients were attended by the emergency medical service. Of these, 489 (44.2%) underwent cardiopulmonary resuscitation, and return of spontaneous circulation was achieved in 142 patients (29%). There was a male predominance overall, and the main age was 72.6 years (standard deviation 17.9). Cardiopulmonary resuscitation before emergency medical service arrival was performed on 62 cases (44%) in the return of spontaneous circulation group, and on 115 cases (33%) in the no return of spontaneous circulation group ( p<0.024). Among the 142 cases of return of spontaneous circulation, 29 (5.9%) survived to hospital discharge. There was a smaller likelihood of return of spontaneous circulation when patients were female (odds ratio 0.61, 0.40–0.93). Patients who had an out-of-hospital cardiac arrest with an initial shockable rhythm (odds ratio 6.33, 3.86–10.39) or an age <60 years (odds ratio 2.91, 1.86–4.57) had a greater likelihood of return of spontaneous circulation. In addition, bystander cardiopulmonary resuscitation (odds ratio 1.56, 1.04–2.33) was associated with an increased chance of return of spontaneous circulation. Conclusion: The incidence of out-of-hospital cardiac arrest and survival rate lies within the known range. A wider database is necessary to achieve a better knowledge of out-of-hospital cardiac arrest and to drive future investments in the healthcare system.

Download Full-text

Association of Prehospital Advanced Airway Management by Physician or Emergency Medical Service Personnel with Return of Spontaneous Circulation After Out-of-Hospital Cardiac Arrest Due to Drowning

10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a1707 ◽

2021 ◽

Author(s):

T. Chinen ◽

T. Fukuda ◽

H. Sekiguchi ◽

A. Matusudaira ◽

H. Kaneshima ◽

...

Keyword(s):

Cardiac Arrest ◽

Airway Management ◽

Emergency Medical Service ◽

Medical Service ◽

Spontaneous Circulation ◽

Emergency Medical Service Personnel ◽

Return Of Spontaneous Circulation ◽

Service Personnel ◽

Advanced Airway ◽

Hospital Cardiac Arrest

Download Full-text

Saving the On-Scene Time for Out-of-Hospital Cardiac Arrest Patients: The Registered Nurses’ Role and Performance in Emergency Medical Service Teams

BioMed Research International ◽

10.1155/2017/5326962 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6

Author(s):

Ming-Wei Lin ◽

Che-Yu Wu ◽

Chih-Long Pan ◽

Zhong Tian ◽

Jyh-Horng Wen ◽

...

Keyword(s):

Cardiac Arrest ◽

Registered Nurses ◽

Emergency Medical Service ◽

Medical Service ◽

Statistical Significance ◽

Spontaneous Circulation ◽

Emergency Medical ◽

Nurses Role ◽

And Performance ◽

Hospital Cardiac Arrest

For out-of-hospital cardiac arrest (OHCA) patients, every second is vital for their life. Shortening the prehospital time is a challenge to emergency medical service (EMS) experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs) participating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247 cases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O), critical (NT-C), and noncritical (NT-NC) cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (T-CS), fracture fixation (T-F), and general trauma (T-G) cases. The average on-scene time of RN-attended cases showed a decrease of 21.05% in NT-O, 3.28% in NT-C, 0% in NT-NC, 18.44% in T-CS, 13.56% in T-F, and 3.46% in T-G compared to non-RN-attended. In NT-O and T-CS cases, the RNs’ attendance can notably save the on-scene time with a statistical significance (P=.016 and .017, resp.). Furthermore, the return of spontaneous circulation within two hours (ROSC2 h) rate in the NT-O cases was increased by 12.86%. Based on the findings, the role of RNs in the EMTs could save the golden time in the prehospital medical care in Taiwan.

Download Full-text