Kyoung Jun Song1, Sang Do Shin2, Chang Bae Park3, Joo Yeong Kim4, Do Kyun Kim5, Chu Hyun Kim6, So Young Ha7, Marcus Eng Hock Ong8, Bentley J Bobrow9, Bryan McNally10. 1. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: skciva@gmail.com. 2. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: shinsangdo@medimail.co.kr. 3. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: ipanema2@medimail.co.kr. 4. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: blj01he@gmail.com. 5. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: birdbeak@naver.com. 6. Department of Emergency Medicine, Inje University College of Medicine, Seoul, South Korea. Electronic address: juliannnn@hanmail.net. 7. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: redkid00@naver.com. 8. Department of Emergency Medicine, Singapore General Hospital, Singapore; Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore. Electronic address: marcus.ong.e.h@sgh.com.sg. 9. Bureau of EMS and Trauma System, Arizona Department of Health Services, Phoenix, AZ, United States; Department of Emergency Medicine, Maricopa Medical Center, University of Arizona College of Medicine, United States. Electronic address: Bentley.Bobrow@azdhs.gov. 10. Department of Emergency Medicine, Emory University School of Medicine, United States. Electronic address: mcnally.bryan@gmail.com.
Abstract
BACKGROUND: The goal of this study was to determine the effects of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-CPR) on outcomes of out-of-hospital cardiac arrest (OHCA). METHODS: All EMS in a metropolitan city with a population of 10 million are dispatched by a single, centralized, and physician-supervised center. Data on patients with adult OHCA with cardiac etiology were collected from the dispatch center registry and from EMS run sheets and hospital medical record review from 2009 to 2011. A standardized DA-CPR protocol (aligned with the 2010 AHA guidelines) we implemented as an intervention in January 2011. The end points were survival to discharge, good neurological outcome, and bystander CPR rate. Multivariate logistic analysis was used to compare between intervention group (2011) and historical control group (2009-2010). RESULTS: Of 8.144 eligible patients, bystander CPR was performed for the patients in 5.7% (148/2600) of cases in 2009, 6.7% (190/2857) in 2010, and 12.4% (334/2686) in 2011 (p<0.001). The survival to discharge rates was 7.1% (2009), 7.1% (2010), and 9.4% (2011) (p=0.001). Good neurological outcomes occurred in 2.1% (2009), 2.0% (2010), and 3.6% (2011) of cases (p<0.001). The adjusted ORs (95% CIs) for survival to discharge compared with 2009 were 1.33 (1.07-1.66) in 2011 and 1.12 (0.89-1.41) in 2010. The adjusted ORs (95% CIs) for good neurological outcomes were 1.67 (1.13-2.45) in 2011 and 1.13 (0.74-1.72) in 2010. CONCLUSIONS: An EMS intervention using the DA-CPR protocol was associated with a significant increase in bystander CPR and an improved survival and neurologic outcome after OHCA.
BACKGROUND: The goal of this study was to determine the effects of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-CPR) on outcomes of out-of-hospital cardiac arrest (OHCA). METHODS: All EMS in a metropolitan city with a population of 10 million are dispatched by a single, centralized, and physician-supervised center. Data on patients with adult OHCA with cardiac etiology were collected from the dispatch center registry and from EMS run sheets and hospital medical record review from 2009 to 2011. A standardized DA-CPR protocol (aligned with the 2010 AHA guidelines) we implemented as an intervention in January 2011. The end points were survival to discharge, good neurological outcome, and bystander CPR rate. Multivariate logistic analysis was used to compare between intervention group (2011) and historical control group (2009-2010). RESULTS: Of 8.144 eligible patients, bystander CPR was performed for the patients in 5.7% (148/2600) of cases in 2009, 6.7% (190/2857) in 2010, and 12.4% (334/2686) in 2011 (p<0.001). The survival to discharge rates was 7.1% (2009), 7.1% (2010), and 9.4% (2011) (p=0.001). Good neurological outcomes occurred in 2.1% (2009), 2.0% (2010), and 3.6% (2011) of cases (p<0.001). The adjusted ORs (95% CIs) for survival to discharge compared with 2009 were 1.33 (1.07-1.66) in 2011 and 1.12 (0.89-1.41) in 2010. The adjusted ORs (95% CIs) for good neurological outcomes were 1.67 (1.13-2.45) in 2011 and 1.13 (0.74-1.72) in 2010. CONCLUSIONS: An EMS intervention using the DA-CPR protocol was associated with a significant increase in bystander CPR and an improved survival and neurologic outcome after OHCA.
Authors: Tomas Nuño; Bentley J Bobrow; Karen A Rogge-Miller; Micah Panczyk; Terry Mullins; Wayne Tormala; Antonio Estrada; Samuel M Keim; Daniel W Spaite Journal: Resuscitation Date: 2017-03-23 Impact factor: 5.262
Authors: Pamela V C Hiltunen; Tom O Silfvast; T Helena Jäntti; Markku J Kuisma; Jouni O Kurola Journal: Eur J Emerg Med Date: 2015-08 Impact factor: 2.799
Authors: John Sutter; Micah Panczyk; Daniel W Spaite; Jose Maria E Ferrer; Jason Roosa; Christian Dameff; Blake Langlais; Ryan A Murphy; Bentley J Bobrow Journal: West J Emerg Med Date: 2015-10-20