TY - JOUR
T1 - Impact of the number of on-scene emergency life-saving technicians and outcomes from out-of-hospital cardiac arrest in Osaka City
AU - Kajino, Kentaro
AU - Kitamura, Tetsuhisa
AU - Iwami, Taku
AU - Daya, Mohamud
AU - Ong, Marcus Eng Hock
AU - Nishiyama, Chika
AU - Sakai, Tomohiko
AU - Tanigawa-Sugihara, Kayo
AU - Hayashida, Sumito
AU - Nishiuchi, Tatsuya
AU - Hayashi, Yasuyuki
AU - Hiraide, Atsushi
AU - Shimazu, Takeshi
N1 - Funding Information:
This work was supported by a grant from the Fire Disaster Management Agency (for studies concerning a strategy for applying the results of the Utstein report to the improvement of emergency service).
PY - 2014/1
Y1 - 2014/1
N2 - Backgrounds: In Japan, ambulance staffing for cardiac arrest responses consists of a 3-person unit with at least one emergency life-saving technician (ELST). Recently, the number of ELSTs on ambulances has increased since it is believed that this improves the quality of on-scene care leading to better outcomes from out-of-hospital cardiac arrest (OHCA). The objective of this study was to evaluate the association between the number of on-scene ELSTs and OHCA outcome. Methods: This was a prospective cohort study of all bystander-witnessed OHCA patients aged ≥18. years in Osaka City from January 2005 to December 2007 using on an Utstein-style database. The primary outcome measure was one-month survival with favorable neurological outcome defined as a cerebral performance category ≤2. Multivariable logistic regression model were used to assess the contribution of the number of on-scene ELSTs to the outcome after adjusting for confounders. Results: Of the 2408 bystander-witnessed OHCA patients, one ELST group was present in 639 (26.5%), two ELST were present in 1357 (56.4%), and three ELST group in 412 (17.1%). The three ELST group had a significantly higher rate of one-month survival with favorable neurological outcome compared with the one ELST group (8.0% versus 4.5%, adjusted OR 2.26, 95% CI 1.27-4.04), while the two ELST group did not (5.4% versus 4.5%, adjusted OR 1.34, 95% CI 0.82-2.19). Conclusions: Compared with the one on-scene ELST group, the three on-scene ELST group was associated with the improved one-month survival with favorable neurological outcome from OHCA in Osaka City.
AB - Backgrounds: In Japan, ambulance staffing for cardiac arrest responses consists of a 3-person unit with at least one emergency life-saving technician (ELST). Recently, the number of ELSTs on ambulances has increased since it is believed that this improves the quality of on-scene care leading to better outcomes from out-of-hospital cardiac arrest (OHCA). The objective of this study was to evaluate the association between the number of on-scene ELSTs and OHCA outcome. Methods: This was a prospective cohort study of all bystander-witnessed OHCA patients aged ≥18. years in Osaka City from January 2005 to December 2007 using on an Utstein-style database. The primary outcome measure was one-month survival with favorable neurological outcome defined as a cerebral performance category ≤2. Multivariable logistic regression model were used to assess the contribution of the number of on-scene ELSTs to the outcome after adjusting for confounders. Results: Of the 2408 bystander-witnessed OHCA patients, one ELST group was present in 639 (26.5%), two ELST were present in 1357 (56.4%), and three ELST group in 412 (17.1%). The three ELST group had a significantly higher rate of one-month survival with favorable neurological outcome compared with the one ELST group (8.0% versus 4.5%, adjusted OR 2.26, 95% CI 1.27-4.04), while the two ELST group did not (5.4% versus 4.5%, adjusted OR 1.34, 95% CI 0.82-2.19). Conclusions: Compared with the one on-scene ELST group, the three on-scene ELST group was associated with the improved one-month survival with favorable neurological outcome from OHCA in Osaka City.
KW - Advanced life support
KW - Cardiopulmonary resuscitation
KW - Emergency life-saving technicians
KW - Emergency medical services
KW - Out-of-hospital cardiac arrest
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U2 - 10.1016/j.resuscitation.2013.09.002
DO - 10.1016/j.resuscitation.2013.09.002
M3 - Article
C2 - 24036196
AN - SCOPUS:84891155228
SN - 0300-9572
VL - 85
SP - 59
EP - 64
JO - Resuscitation
JF - Resuscitation
IS - 1
ER -