Jeong Ho Park1, Sang Do Shin2, Young Sun Ro3, Kyoung Jun Song4, Ki Jeong Hong5, Tae Han Kim6, Eui Jung Lee7, So Yeon Kong8. 1. Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea. Electronic address: timethe@gmail.com. 2. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Seoul National University College of Medicine, South Korea. Electronic address: sdshin@snu.ac.kr. 3. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea. Electronic address: Ro.youngsun@gmail.com. 4. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Seoul National University College of Medicine, South Korea. Electronic address: skciva@gmail.com. 5. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Seoul National University Hospital, South Korea. Electronic address: emkjhong@gmail.com. 6. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Seoul National University Hospital, South Korea. Electronic address: adoong2001@naver.com. 7. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Korea University Anam Hospital, South Korea. Electronic address: ironlyj@gmail.com. 8. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea. Electronic address: soyeon.kong@gmail.com.
Abstract
INTRODUCTION: The study aimed to determine the effect of community implementation of a bundles of cardiopulmonary resuscitation (CPR) programs on outcomes in out-of-hospital cardiac arrest (OHCA). METHODS: A before- and after-intervention study was performed in a metropolis. Emergency medical services (EMS)-treated adults and cardiac OHCAs were included. Three new CPR programs was implemented in January 2015: 1) a high-quality dispatcher-assisted CPR program (DACPR), 2) a multi-tier response (MTR) program using fire engines or basic life support vehicles, and 3) a feedback CPR (FCPR) program with professional recording and feedback of CPR process. The outcomes (cerebral performance category 1 or 2, good CPC) and survival to discharge) were compared between study period (2015-2016) and control period (2013-2014). RESULTS: Overall, 6201 and 6469 patients were included in the control period and the study period, respectively. During the post-intervention period, the proportion of OHCA patients who underwent three types of cardiopulmonary resuscitation programs increased significantly compared to those in the pre-intervention period. DACPR increased from 38.3% to 44.3%, MTR increased from 0.0% to 37.5%, and FCPR increased from 25.3% to 61.5%. (All p values <0.001). Good neurological recovery and survival to discharge were significantly increased from 5.4% to 6.8%, and from 9.6% to 10.9%. The adjusted odds ratio (95% confidence intervals) of the study period was 1.45 (1.12-1.87) for good CPC, and 1.31 (1.09-1.58) for survival to discharge. CONCLUSIONS: The citywide implementation of a bundle of UTIS CPR programs was associated with significantly better OHCA outcomes.
INTRODUCTION: The study aimed to determine the effect of community implementation of a bundles of cardiopulmonary resuscitation (CPR) programs on outcomes in out-of-hospital cardiac arrest (OHCA). METHODS: A before- and after-intervention study was performed in a metropolis. Emergency medical services (EMS)-treated adults and cardiac OHCAs were included. Three new CPR programs was implemented in January 2015: 1) a high-quality dispatcher-assisted CPR program (DACPR), 2) a multi-tier response (MTR) program using fire engines or basic life support vehicles, and 3) a feedback CPR (FCPR) program with professional recording and feedback of CPR process. The outcomes (cerebral performance category 1 or 2, good CPC) and survival to discharge) were compared between study period (2015-2016) and control period (2013-2014). RESULTS: Overall, 6201 and 6469 patients were included in the control period and the study period, respectively. During the post-intervention period, the proportion of OHCA patients who underwent three types of cardiopulmonary resuscitation programs increased significantly compared to those in the pre-intervention period. DACPR increased from 38.3% to 44.3%, MTR increased from 0.0% to 37.5%, and FCPR increased from 25.3% to 61.5%. (All p values <0.001). Good neurological recovery and survival to discharge were significantly increased from 5.4% to 6.8%, and from 9.6% to 10.9%. The adjusted odds ratio (95% confidence intervals) of the study period was 1.45 (1.12-1.87) for good CPC, and 1.31 (1.09-1.58) for survival to discharge. CONCLUSIONS: The citywide implementation of a bundle of UTIS CPR programs was associated with significantly better OHCA outcomes.