scholarly journals Impact of the COVID-19 pandemic on emergency medical service response to out-of-hospital cardiac arrests in Taiwan: a retrospective observational study

2021 ◽  
pp. emermed-2020-210409
Author(s):  
Jiun-Hao Yu ◽  
Chien-Yu Liu ◽  
Wei-Kung Chen ◽  
Shao-Hua Yu ◽  
Fen-Wei Huang ◽  
...  
Keyword(s):  
Response Time ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Life Support ◽  
Advanced Life Support ◽  
Spontaneous Circulation ◽  
Automated External Defibrillators ◽  
Outbreak Period ◽  
Emergency Medical ◽  
Bystander Cardiopulmonary Resuscitation

BackgroundEmergency medical service (EMS) personnel have high COVID-19 risk during resuscitation. The resuscitation protocol for patients with out-of-hospital cardiac arrest (OHCA) was modified in response to the COVID-19 pandemic. However, how the adjustments in the EMS system affected patients with OHCA remains unclear.MethodsWe analysed data from the Taichung OHCA registry system. We compared OHCA outcomes and rescue records for 622 cases during the COVID-19 outbreak period (1 February to 30 April 2020) with those recorded for 570 cases during the same period in 2019.ResultsThe two periods did not differ significantly with respect to patient age, patient sex, the presence of witnesses or OHCA location. Bystander cardiopulmonary resuscitation and defibrillation with automated external defibrillators were more common in 2020 (52.81% vs 65.76%, p<0.001%, and 23.51% vs 31.67%, p=0.001, respectively). The EMS response time was longer during the COVID-19 pandemic (445.8±210.2 s in 2020 vs 389.7±201.8 s in 2019, p<0.001). The rate of prehospital return of spontaneous circulation was lower in 2020 (6.49% vs 2.57%, p=0.001); 2019 and 2020 had similar rates of survival discharge (5.96% vs 4.98%). However, significantly fewer cases had favourable neurological function in 2020 (4.21% vs 2.09%, p=0.035).ConclusionEMS response time for patients with OHCA was prolonged during the COVID-19 pandemic. Early advanced life support by EMS personnel remains crucial for patients with OHCA.

scholarly journals Emergency Medical Service in Rural Mountain Areas in Taiwan: A Nantou Mountain Areas Based Study

2014 ◽  
Vol 21 (6) ◽  
pp. 373-381 ◽  
Author(s):  
Sc Hung ◽  
Yh Li ◽  
Mc Chen ◽  
Sw Lai ◽  
Fc Sung ◽  
...  
Keyword(s):  
Response Time ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Life Support ◽  
Advanced Life Support ◽  
Patient Characteristics ◽  
Emergency Medical Technician ◽  
Mountain Areas ◽  
Emergency Medical ◽  
The Mean

Background This study explored the emergency medical service (EMS) in rural mountain areas in Taiwan to establish the public health policies in rural mountain areas. Methods This was a retrospective study. Based on mission records available at 3 EMS branches in Ren-Ai and Sinyi townships of Nantou County, we evaluated dispatched status, patient characteristics, and pre-hospital emergency managements. Results From January to June 2011, a total of 765 EMS were dispatched from these 3 mountain branches. Each dispatched EMS team was consisted of one official emergency medical technician (EMT) with EMT II certificate (100%), and one (88.0%) or two (11.2%) volunteers as EMT I personnel. Most of missions were conducted in the daytime and peaked during 10am to 12pm. Patients were characterised with more men and elderly and predominant with non-traumatic medical complains (55.0%). Approximately 38.7% EMS patients required the advanced life support. Of these 3 mountain EMS branches, the mean response time was 15.3±16.9 minutes, the mean management time on site was 6.1±6.9 minutes and the mean transport time was 38.0±15.9 minutes. The response time and transportation time of EMS in rural mountain areas were relatively longer than that in urban towns in Taiwan. Conclusions The rural EMS is under the challenges of providing appropriate and adequate medical care. Each EMS team should be equipped with adequate emergency care facilities and well trained personnel. (Hong Kong j.emerg.med. 2014;21:373-381)

scholarly journals Improving bystander defibrillation in out-of-hospital cardiac arrests at home

2020 ◽  
Vol 9 (4_suppl) ◽  
pp. S74-S81
Author(s):  
Lena Karlsson ◽  
Carolina M Hansen ◽  
Christina Vourakis ◽  
Christopher LF Sun ◽  
Shahzleen Rajan ◽  
...  
Keyword(s):  
Response Time ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Automated External Defibrillator ◽  
Automated External Defibrillators ◽  
Bystander Activation ◽  
Emergency Medical ◽  
Service Response Time ◽  
External Defibrillator ◽  
At Home

Aims: Most out-of-hospital cardiac arrests occur at home with dismal bystander defibrillation rates. We investigated automated external defibrillator coverage of home arrests, and the proportion potentially reachable with an automated external defibrillator before emergency medical service arrival according to different bystander activation strategies. Methods and results: Cardiac arrests in homes (private/nursing/senior homes) in Copenhagen, Denmark (2008–2016) and registered automated external defibrillators (2007–2016), were identified. Automated external defibrillator coverage (distance from arrest to automated external defibrillator) and accessibility at the time of arrest were examined according to route distance to nearest automated external defibrillator and emergency medical service response time. The proportion of arrests reachable with an automated external defibrillator by bystander was calculated using two-way (from patient to automated external defibrillator and back) and one-way (from automated external defibrillator to patient) potential activation strategies. Of 1879 home arrests, automated external defibrillator coverage ≤100 m was low (6.3%) and a two-way bystander could potentially only retrieve an accessible automated external defibrillator before emergency medical service in 31.1% ( n=37) of cases. If a bystander only needed to travel one-way to bring an automated external defibrillator (≤100 m, ≤250 m and ≤500 m), 45.4% ( n=54/119), 37.1% ( n=196/529) and 29.8% ( n=350/1174) could potentially be reached before the emergency medical service based on current automated external defibrillator accessibility. Conclusions: Few home arrests were reachable with an automated external defibrillator before emergency medical service if bystanders needed to travel from patient to automated external defibrillator and back. However, nearly one-third of arrests ≤500 m of an automated external defibrillator could be reached before emergency medical service arrival if the bystander only needed to travel one-way from the automated external defibrillator to the patient.

The Efficacy of Pediatric Advanced Life Support Training in Emergency Medical Service Providers

2009 ◽  
Vol 25 (8) ◽  
pp. 508-512 ◽  
Author(s):  
Troy W. Baker ◽  
Wilson King ◽  
Wendy Soto ◽  
Cindy Asher ◽  
Adrienne Stolfi ◽  
...  
Keyword(s):  
Emergency Medical Service ◽  
Medical Service ◽  
Life Support ◽  
Service Providers ◽  
Advanced Life Support ◽  
Emergency Medical

scholarly journals Prehospital Time of Suspected Stroke Patients Treated by Emergency Medical Service: A Nationwide Study in Thailand

2020 ◽  
Author(s):  
Phantakan Tansuwannarat ◽  
Pongsakorn Atiksawedparit ◽  
Arrug Wibulpolprasert ◽  
Natdanai Mankasetkit
Keyword(s):  
Emergency Medical Service ◽  
Medical Service ◽  
Life Support ◽  
Demographic Data ◽  
Advanced Life Support ◽  
National Database ◽  
Stroke Patients ◽  
Emergency Medical ◽  
Suspected Stroke ◽  
Prehospital Time

Abstract Background: This study was to study the prehospital time among suspected stroke patients who were transported by emergency medical service (EMS) system using national database. Methods: National EMS database across 77 provinces of Thailand among suspected stroke patients who were treated by EMS system between January 1, 2015 to December 31, 2018 was retrospectively analyzed. Demographic data (i.e., regions, shifts, levels of ambulance and distance to scene) and prehospital time (i.e., dispatch, activation, response, scene and transportation times) were extracted. Time parameters were also categorized according to guideline. Results: In total 53,536 subjects were included in analysis. Most of the subjects were transported during 06.00-18.00 and were in 10 kilometers from ambulance parking. Half of the subjects were treated by advanced life support (ALS) ambulance. Median total time was 29 minutes (IQR: 21, 39) which was mainly occupied for transporting patient from scene to hospital. Although most of subjects had dispatch and activation times ≤ 2 minutes, but only 48.3% had RT ≤ 8 minutes. However, 95% of service were at scene ≤ 15 minutes. ALS ambulance had the longer total time, compared to first responder and basic level (30 minutes versus 28 and 27 minutes). Conclusions: Prehospital time from EMS call to hospital was approximately 30 minutes among suspected stroke patients. This was mainly utilized for travelling from ambulance parking to scene and transporting patient from scene to hospital. Although only 48% of services had RT ≤ 8 minutes, but 95% of them had scene time ≤ 15 minutes.

scholarly journals Prehospital time of suspected stroke patients treated by emergency medical service: a nationwide study in Thailand

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Phantakan Tansuwannarat ◽  
Pongsakorn Atiksawedparit ◽  
Arrug Wibulpolprasert ◽  
Natdanai Mankasetkit
Keyword(s):  
Emergency Medical Service ◽  
Medical Service ◽  
Life Support ◽  
Demographic Data ◽  
National Database ◽  
Stroke Patients ◽  
Emergency Medical ◽  
Significant Difference ◽  
Suspected Stroke ◽  
Prehospital Time

Abstract Background This work was to study the prehospital time among suspected stroke patients who were transported by an emergency medical service (EMS) system using a national database. Methods National EMS database of suspected stroke patients who were treated by EMS system across 77 provinces of Thailand between January 1, 2015, and December 31, 2018, was retrospectively analyzed. Demographic data (i.e., regions, shifts, levels of ambulance, and distance to the scene) and prehospital time (i.e., dispatch, activation, response, scene, and transportation time) were extracted. Time parameters were also categorized according to the guidelines. Results Total 53,536 subjects were included in the analysis. Most of the subjects were transported during 06.00-18.00 (77.5%) and were 10 km from the ambulance parking (80.2%). Half of the subjects (50.1%) were served by advanced life support (ALS) ambulance. Median total time was 29 min (IQR 21, 39). There was a significant difference of median total time among ALS (30 min), basic (27 min), and first responder (28 min) ambulances, Holm P = 0.009. Although 91.7% and 88.3% of the subjects had dispatch time ≤ 1 min and activation time ≤ 2 min, only 48.3% had RT ≤ 8 min. However, 95% of the services were at the scene ≤ 15 min. Conclusion Prehospital time from EMS call to hospital was approximately 30 min which was mainly utilized for traveling from the ambulance parking to the scene and transporting patients from the scene to hospitals. Even though only 48% of the services had RT ≤ 8 min, 95% of them had the scene time ≤ 15 min.

Factors Influencing the Emergency Medical Service Response Time for Cardiovascular Disease in Guangzhou, China

2019 ◽  
Vol 39 (3) ◽  
pp. 463-471
Author(s):  
Xiao-qian Chen ◽  
Zi-feng Liu ◽  
Shi-kun Zhong ◽  
Xing-tang Niu ◽  
Yi-xiang Huang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Response Time ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Factors Influencing ◽  
Emergency Medical ◽  
Service Response Time

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.

Sign in / Sign up

Export Citation Format

Share Document