Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study

Objective The Korean National Fire Agency conducted a pilot project examining Advanced Life Support (ALS) protocols, including epinephrine administration, to improve survival among patients suffering out-of-hospital cardiac arrest (OHCA). In this study, we aimed to evaluate the effects of the Korean...

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Main Authors: Seung Hyo Lee, Won Pyo Hong, Young Su Kim, Jeseong Park, Hyouk Jae Lim
Format: Article
Language:English
Published: The Korean Society of Emergency Medicine 2024-09-01
Series:Clinical and Experimental Emergency Medicine
Subjects:
Online Access:http://www.ceemjournal.org/upload/pdf/ceem-23-177.pdf
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author Seung Hyo Lee
Won Pyo Hong
Young Su Kim
Jeseong Park
Hyouk Jae Lim
author_facet Seung Hyo Lee
Won Pyo Hong
Young Su Kim
Jeseong Park
Hyouk Jae Lim
author_sort Seung Hyo Lee
collection DOAJ
description Objective The Korean National Fire Agency conducted a pilot project examining Advanced Life Support (ALS) protocols, including epinephrine administration, to improve survival among patients suffering out-of-hospital cardiac arrest (OHCA). In this study, we aimed to evaluate the effects of the Korean National Fire Agency ALS protocol on prehospital return of spontaneous circulation (ROSC) in patients with OHCA. Methods This study included patients with adult-presumed cardiac arrest between January and December 2020. The main factor of interest was ambulance type according to ALS protocol, which was divided into dedicated ALS ambulance (DA), smartphone-based ALS ambulance (SALS), and non-DA, and the main analysis factor was prehospital ROSC. Multivariable logistic regression analysis was performed. Results During the study period, a total of 18,031 adult patients with OHCA was treated by the emergency medical services, including 7,520 DAs (41.71%), 2,622 SALSs (14.54%), and 7,889 non-DAs (43.75%). The prehospital ROSC rate of the DA group (13.19%) was higher than those of the non-DA group (7.91%) and the SALS group (11.17%, P<0.01). Compared with that of the DA group, the adjusted odds ratios (95% confidence interval) for prehospital ROSC were 0.97 (0.82–1.15) in the SALS group and 0.57 (0.50–0.65) in the non-DA group. Conclusion ALS protocol intervention was associated with prehospital ROSC rates. Therefore, continuous efforts to promote systemic implementation of the ALS protocol to improve OHCA outcomes are necessary.
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spelling doaj-art-5d3083c840984533b9d268e7730a2be32024-11-19T00:09:27ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252024-09-0111327628510.15441/ceem.23.177548Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational studySeung Hyo Lee0Won Pyo Hong1Young Su Kim2Jeseong Park3Hyouk Jae Lim4 119 EMS Division, National Fire Agency 119, Sejong, Korea Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea 119 EMS Division, National Fire Agency 119, Sejong, Korea 119 EMS Division, National Fire Agency 119, Sejong, Korea Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, KoreaObjective The Korean National Fire Agency conducted a pilot project examining Advanced Life Support (ALS) protocols, including epinephrine administration, to improve survival among patients suffering out-of-hospital cardiac arrest (OHCA). In this study, we aimed to evaluate the effects of the Korean National Fire Agency ALS protocol on prehospital return of spontaneous circulation (ROSC) in patients with OHCA. Methods This study included patients with adult-presumed cardiac arrest between January and December 2020. The main factor of interest was ambulance type according to ALS protocol, which was divided into dedicated ALS ambulance (DA), smartphone-based ALS ambulance (SALS), and non-DA, and the main analysis factor was prehospital ROSC. Multivariable logistic regression analysis was performed. Results During the study period, a total of 18,031 adult patients with OHCA was treated by the emergency medical services, including 7,520 DAs (41.71%), 2,622 SALSs (14.54%), and 7,889 non-DAs (43.75%). The prehospital ROSC rate of the DA group (13.19%) was higher than those of the non-DA group (7.91%) and the SALS group (11.17%, P<0.01). Compared with that of the DA group, the adjusted odds ratios (95% confidence interval) for prehospital ROSC were 0.97 (0.82–1.15) in the SALS group and 0.57 (0.50–0.65) in the non-DA group. Conclusion ALS protocol intervention was associated with prehospital ROSC rates. Therefore, continuous efforts to promote systemic implementation of the ALS protocol to improve OHCA outcomes are necessary.http://www.ceemjournal.org/upload/pdf/ceem-23-177.pdfadvanced cardiac life supportout-of-hospital cardiac arrestemergency medical servicesreturn of spontaneous circulationepinephrine
spellingShingle Seung Hyo Lee
Won Pyo Hong
Young Su Kim
Jeseong Park
Hyouk Jae Lim
Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
Clinical and Experimental Emergency Medicine
advanced cardiac life support
out-of-hospital cardiac arrest
emergency medical services
return of spontaneous circulation
epinephrine
title Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
title_full Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
title_fullStr Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
title_full_unstemmed Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
title_short Dual-dispatch protocols and return of spontaneous circulation in patients with out-of-hospital cardiac arrest: a nationwide observational study
title_sort dual dispatch protocols and return of spontaneous circulation in patients with out of hospital cardiac arrest a nationwide observational study
topic advanced cardiac life support
out-of-hospital cardiac arrest
emergency medical services
return of spontaneous circulation
epinephrine
url http://www.ceemjournal.org/upload/pdf/ceem-23-177.pdf
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