Emergency medical services employing intra-arrest transport less frequently for out-of-hospital cardiac arrest have higher survival and favorable neurological outcomes

Resuscitation ◽  
2021 ◽  
Author(s):  
Brian Grunau ◽  
Takahisa Kawano ◽  
Tom Rea ◽  
Masashi Okubo ◽  
Frank Scheuermeyer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Neurological Outcomes ◽  
Emergency Medical ◽  
Hospital Cardiac Arrest

scholarly journals Effect of Prehospital Epinephrine Use on Survival from Out-of-Hospital Cardiac Arrest and on Emergency Medical Services

2021 ◽  
Vol 11 (1) ◽  
pp. 190
Author(s):  
Song Yi Park ◽  
Daesung Lim ◽  
Seong Chun Kim ◽  
Ji Ho Ryu ◽  
Yong Hwan Kim ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Emergency Medical Services ◽  
Chest Compression ◽  
Response Times ◽  
Discharge Rate ◽  
Medical Services ◽  
Neurological Outcomes ◽  
Mechanical Chest Compression ◽  
Emergency Medical ◽  
Hospital Cardiac Arrest

This study was to identify the effect of epinephrine on the survival of out-of-hospital cardiac arrest (OHCA) patients and changes in prehospital emergency medical services (EMSs) after the introduction of prehospital epinephrine use by EMS providers. This was a retrospective observational study comparing two groups (epinephrine group and norepinephrine group). We used propensity score matching of the two groups and identified the association between outcome variables regarding survival and epinephrine use, controlling for confounding factors. The epinephrine group was 339 patients of a total 1943 study population. The survival-to-discharge rate and OR (95% CI) of the epinephrine group were 5.0% (p = 0.215) and 0.72 (0.43–1.21) in the total patient population and 4.7% (p = 0.699) and 1.15 (0.55–2.43) in the 1:1 propensity-matched population. The epinephrine group received more mechanical chest compression and had longer EMS response times and scene times than the norepinephrine group. Mechanical chest compression was a negative prognostic factor for survival to discharge and favorable neurological outcomes in the epinephrine group. The introduction of prehospital epinephrine use in OHCA patients yielded no evidence of improvement in survival to discharge and favorable neurological outcomes and adversely affected the practice of EMS providers, exacerbating the factors negatively associated with survival from OHCA.

scholarly journals Temperature and age–gender effects on out-of-hospital cardiac arrest cases

2018 ◽  
Vol 25 (2) ◽  
pp. 83-90
Author(s):  
Chien Tat Low ◽  
Poh Chin Lai ◽  
Paul Sai Shun Yeung ◽  
Axel Yuet Chung Siu ◽  
Kelvin Tak Yiu Leung ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hong Kong ◽  
Emergency Medical Services ◽  
Large Scale ◽  
Gender Effects ◽  
Medical Services ◽  
Curvilinear Relationship ◽  
Elderly Age ◽  
Emergency Medical ◽  
Hospital Cardiac Arrest

Introduction: Temperature is a key factor influencing the occurrence of out-of-hospital cardiac arrest, yet there is no equivalent study in Hong Kong. This study reports results involving a large-scale territory-wide investigation on the impacts of ambient temperature and age–gender differences on out-of-hospital cardiac arrest outcome in Hong Kong. Methods: This study included 25,467 out-of-hospital cardiac arrest cases treated by the Hong Kong Fire Services Department between December 2011 and November 2016 inclusive. Simple correlation and regression analyses were used to examine the relationships between out-of-hospital cardiac arrest cases and temperature, age and gender. Calendar charts were used to visualise temporal patterns of pre-hospital emergency medical services related to out-of-hospital cardiac arrest cases. Results: A strong negative curvilinear relationship was found between out-of-hospital cardiac arrest and daily temperature (r2 > 0.9) with prominent effects on elderly people aged ≥85 years. For each unit decrease in mean temperature in °C, there was a maximum of 5.6% increase in out-of-hospital cardiac arrest cases among all age groups and 7.3% increase in the ≥85 years elderly age group. Men were slightly more at risk of out-of-hospital cardiac arrest compared with women. The demand for out-of-hospital cardiac arrest–related emergency medical services was highest between 06:00 and 11:00 in the wintertime. Conclusion: This study provides the first local evidence linking weather and demographic effects with out-of-hospital cardiac arrest in Hong Kong. It offers empirical evidence to policymakers in support of strengthening existing emergency medical services to deal with the expected increase in out-of-hospital cardiac arrest in the wintertime and in regions with a large number of elderly population.

scholarly journals Management of EMS on-scene time during advanced life support in out-of-hospital cardiac arrest: a retrospective observational trial

2020 ◽  
Vol 9 (4_suppl) ◽  
pp. S82-S89
Author(s):  
Michael Poppe ◽  
Mario Krammel ◽  
Christian Clodi ◽  
Christoph Schriefl ◽  
Alexandra-Maria Warenits ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Life Support ◽  
Advanced Life Support ◽  
Spontaneous Circulation ◽  
Medical Services ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Emergency Medical ◽  
Hospital Cardiac Arrest

Objective Most western emergency medical services provide advanced life support in out-of-hospital cardiac arrest aiming for a return of spontaneous circulation at the scene. Little attention is given to prehospital time management in the case of out-of-hospital cardiac arrest with regard to early coronary angiography or to the start of extracorporeal cardiopulmonary resuscitation treatment within 60 minutes after out-of-hospital cardiac arrest onset. We investigated the emergency medical services on-scene time, defined as emergency medical services arrival at the scene until departure to the hospital, and its association with 30-day survival with favourable neurological outcome after out-of-hospital cardiac arrest. Methods All patients of over 18 years of age with non-traumatic, non-emergency medical services witnessed out-of-hospital cardiac arrest between July 2013 and August 2015 from the Vienna Cardiac Arrest Registry were included in this retrospective observational study. Results Out of 2149 out-of-hospital cardiac arrest patients, a total of 1687 (79%) patients were eligible for analyses. These patients were stratified into groups according to the on-scene time (<35 minutes, 35–45 minutes, 45–60 minutes, >60 minutes). Within short on-scene time groups, out-of-hospital cardiac arrest occurred more often in public and bystander cardiopulmonary resuscitation was more common (both P<0.001). Patients who did not achieve return of spontaneous circulation at the scene showed higher rates of 30-day survival with favourable neurological outcome with an on-scene time of less than 35 minutes (adjusted odds ratio 5.00, 95% confidence interval 1.39–17.96). Conclusion An emergency medical services on-scene time of less than 35 minutes was associated with higher rates of survival and favourable outcomes. It seems to be reasonable to develop time optimised advance life support protocols to minimise the on-scene time in view of further treatments such as early coronary angiography as part of post-resuscitation care or extracorporeal cardiopulmonary resuscitation in refractory out-of-hospital cardiac arrest.

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