Jen-Tang Sun1, Wen-Chu Chiang2, Ming-Ju Hsieh3, Edward Pei-Chuan Huang3, Wen-Shuo Yang4, Yu-Chun Chien4, Yao-Cheng Wang4, Bin-Chou Lee5, Shyh-Shyong Sim6, Kuang-Chao Tsai6, Matthew Huei-Ming Ma7, Lee-Wei Chen8. 1. Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Institute of Emergency and Critical Care Medicine, National Yang Ming University, Taipei City, Taiwan. 2. Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch C, Taiwan. Electronic address: drchiang.tw@gmail.com. 3. Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan. 4. The Emergency Medical Services(ambulance) Division, Taipei City Fire Department, Taiwan. 5. Department of Emergency Medicine, Taipei City Hospital, Chung-Shaw Branch, Taipei, Taiwan. 6. Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 7. Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch C, Taiwan. Electronic address: mattma.tw@gmail.com. 8. Institute of Emergency and Critical Care Medicine, National Yang Ming University, Taipei City, Taiwan; Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan. Electronic address: lwchen@vghks.gov.tw.
Abstract
AIM: The effect of the number and level of on-scene emergency medical technicians (EMTs) on the outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to test the association between the number and level of EMTs and the outcomes of patients with OHCA. METHODS: We analysed Utstein-based registry data on OHCA in Taipei from 2011 to 2015. The eligible patients were adults, aged ≥20 years, with non-traumatic OHCA who underwent resuscitation attempts. The exposures were the total number of EMTs or the EMT-Paramedic (EMT-P) ratio >50%. The outcome of interest was survival to discharge. RESULTS: During study period, total 8262 OHCA cases were included, of which 1085 (13.1%) were approached by crews with an EMT-P ratio >50%. While an increase in the number of EMTs on-scene was not associated with better chances of survival (adjusted odds ratio [aOR] 0.98, 95% confidence interval [CI] 0.89-1.08), an EMT-P ratio >50% was significantly associated with improved outcome (aOR 1.36, 95% CI 1.06-1.76). Subgroup analyses showed that EMT-P >50% significantly benefited survival in witnessed OHCA cases with non-shockable rhythm (aOR 1.69, 95% CI 1.01-2.58). Survival was the highest among cases seen by four EMTs with an EMT-P ratio >50% (aOR 2.54, 95% CI 1.43-4.50). CONCLUSION: An on-scene EMT-P ratio >50% was associated with improved survival to discharge of OHCA cases, especially in those with witnessed, non-shockable rhythm. The presence of four EMTs with an EMT-P ratio >50% at the scene of OHCA was associated with the best outcome.
AIM: The effect of the number and level of on-scene emergency medical technicians (EMTs) on the outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to test the association between the number and level of EMTs and the outcomes of patients with OHCA. METHODS: We analysed Utstein-based registry data on OHCA in Taipei from 2011 to 2015. The eligible patients were adults, aged ≥20 years, with non-traumatic OHCA who underwent resuscitation attempts. The exposures were the total number of EMTs or the EMT-Paramedic (EMT-P) ratio >50%. The outcome of interest was survival to discharge. RESULTS: During study period, total 8262 OHCA cases were included, of which 1085 (13.1%) were approached by crews with an EMT-P ratio >50%. While an increase in the number of EMTs on-scene was not associated with better chances of survival (adjusted odds ratio [aOR] 0.98, 95% confidence interval [CI] 0.89-1.08), an EMT-P ratio >50% was significantly associated with improved outcome (aOR 1.36, 95% CI 1.06-1.76). Subgroup analyses showed that EMT-P >50% significantly benefited survival in witnessed OHCA cases with non-shockable rhythm (aOR 1.69, 95% CI 1.01-2.58). Survival was the highest among cases seen by four EMTs with an EMT-P ratio >50% (aOR 2.54, 95% CI 1.43-4.50). CONCLUSION: An on-scene EMT-P ratio >50% was associated with improved survival to discharge of OHCA cases, especially in those with witnessed, non-shockable rhythm. The presence of four EMTs with an EMT-P ratio >50% at the scene of OHCA was associated with the best outcome.
Authors: Kichan Han; You Hwan Jo; Yu Jin Kim; Seung Min Park; Dong Keon Lee; Dong Won Kim; Kui Ja Lee; Hyo Ju Choi; Dong-Hyun Jang Journal: Emerg Med Int Date: 2022-03-17 Impact factor: 1.112
Authors: Pin-Hui Fang; Yu-Yuan Lin; Chien-Hsin Lu; Ching-Chi Lee; Chih-Hao Lin Journal: Int J Environ Res Public Health Date: 2020-03-16 Impact factor: 3.390