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Prehospital advanced cardiac life support by EMT with a smartphone-based direct medical control for nursing home cardiac arrest

Title
Prehospital advanced cardiac life support by EMT with a smartphone-based direct medical control for nursing home cardiac arrest
Author
김창선
Keywords
Out-of-hospital cardiac arrest; Epinephrine; Advanced cardiac life support; Administration; Intravenous; Emergency medical system
Issue Date
2019-04
Publisher
W B SAUNDERS CO-ELSEVIER INC
Citation
AMERICAN JOURNAL OF EMERGENCY MEDICINE, v. 37, NO 4, Page. 585-589
Abstract
Objective: To compare the survival to discharge between nursing home (NH) cardiac arrest patients receiving smartphone-based advanced cardiac life support (SALS) and basic life support (BLS). Methods: The SALS registry includes data on cardiac arrest from 7 urban and suburban areas in Korea between July 2015 and December 2016. We include adult patients (>18) with out-of-hospital cardiac arrest (OHCA) of medical causes and EMS attended and dispatched in. SALS is an advanced field resuscitation including drug administration by paramedics with video communication-based direct medical direction. Prehospital resuscitation method was key exposure (SALS, BLS). The primary outcome was survival to discharge. Results: A total of 616 consecutive out-of-hospital cardiopulmonary resuscitation cases in NHs were recorded, and 199 (32.3%) underwent SALS. Among the NH arrest patients, the survival discharge rate was a little higher in the SALS group than the BLS group (4.0% vs 1.7%), but the difference was not significant (P = 0.078). Survival discharge with good neurologic outcome rates was 0.5% in the SALS group and 1.0% in the BLS group (P = 0.119). On the other hand, in the non-NH group, all outcome measures significantly improved when SALS was performed compared to BLS alone (survival discharge rate: 10.0% vs 7.3%, P = 0.001; good neurologic outcome: 6.8% vs 3.3%, P < 0.001). Conclusions: As a result of providing prehospital ACLS with direct medical intervention through remote video calls to paramedics, the survival to discharge rate and that with good neurologic outcome (CPC 1, 2) of non-NH patients significantly improved, however those of NH patients were not significantly increased. (C) 2018 Elsevier Inc. All rights reserved.
URI
https://www.sciencedirect.com/science/article/pii/S0735675718304959?via%3Dihubhttps://repository.hanyang.ac.kr/handle/20.500.11754/110999
ISSN
0735-6757; 1532-8171
DOI
10.1016/j.ajem.2018.06.031
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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