Application of a Dual-Dispatch System for Out-of-Hospital Cardiac Arrest Patients: Will More Hands Save More Lives?

Kim, Jung Ho; Ryoo, Hyun Wook; Kim, Jong Yeon; Ahn, Jae Yun; Moon, Sungbae; Lee, Dong Eun; Mun, You Ho

doi:10.3346/jkms.2019.34.e141

Cited by 6 publications

(15 citation statements)

References 24 publications

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“…This study employed a before-and-after observational design using the Daegu Emergency Medical Service Registry, which is a prospective citywide OHCA registry that retrieves data from the emergency medical service (EMS) run sheet, dispatcher CPR registry, and hospital medical records according to the Utstein style guidelines. 5 The study period spanned 2 months, starting from February 18, 2020, when the first COVID-19 case was detected in Daegu. The control period spanned from February 18, 2019 to April 17, 2019.…”

Section: Study Design and Settingmentioning

confidence: 99%

Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study

et al. 2021

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Objective This study aimed to compare the outcomes of adult out-of-hospital cardiac arrest (OHCA) before and after the coronavirus disease 2019 (COVID-19) outbreak in a large metropolitan city.Methods This before-and-after observational study used a prospective citywide OHCA registry. Adult patients with emergency medical service-treated OHCA, with presumed cardiac etiology, pre-and post-COVID-19 outbreak were enrolled. The study period spanned 2 months, starting from February 18, 2020. The control period was 2 months from February 18, 2019. The primary and secondary outcomes were good neurologic outcome and survival to hospital discharge, respectively. The association between the COVID-19 outbreak and OHCA outcomes was assessed using multivariable logistic regression analysis. ResultsThis study analyzed 297 OHCA patients (control period, 145; study period, 152). The bystander cardiopulmonary resuscitation rates were 64.8% and 60.5% during the control and study periods, respectively. Response and on-scene times increased by 2 minutes, supraglottic airway use increased by 35.6%, and mechanical chest compression device use increased by 13% post-COVID-19 outbreak. Good neurologic outcome was significantly lower during the study period in overall OHCAs (adjusted odds ratio, 0.23; 95% confidence interval, 0.05-0.98) and in witnessed OHCAs (adjusted odds ratio, 0.14; 95% confidence interval, 0.02-0.90). No significant difference was found in the survival to hospital discharge of OHCA patients between the two periods. ConclusionDuring the COVID-19 pandemic, the response and on-scene times were longer, and good neurologic outcome was significantly lower than that in the control period.

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Section: Study Design and Settingmentioning

confidence: 99%

Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study

et al. 2021

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“…As a result of previous EMS interventions, the rates of dual-dispatch responses and advanced airway management gradually increased. The effect of the dual-dispatch system and advanced airway management on the improvement in outcomes after OHCA is unclear [ 7 , 15 – 17 ]. However, we expected positive effects by increasing the rapid success rate of prehospital advanced airway management and well-coordinated team approach in prehospital EMS.…”

Section: Discussionmentioning

confidence: 99%

“…The community intervention division, in partnership with the Daegu Metropolitan Office of Education and local public health centers, helped to set up the CPR education curriculum in the local schools and public health centers [ 5 ]. For prehospital EMS-level intervention, a dual-dispatch system was started to reduce response time and to increase the number of EMTs attending an OHCA [ 7 ]. The EMS intervention division, comprising the EMS medical directors, regularly provided a team CPR training program to enable a well-coordinated team approach, with predefined roles for each EMT.…”

Section: Methodsmentioning

confidence: 99%

“…The EMS intervention division, comprising the EMS medical directors, regularly provided a team CPR training program to enable a well-coordinated team approach, with predefined roles for each EMT. Based on the regional OHCA registry [Daegu Emergency Medical Services Registry (DEMSRe)] [ 7 ]. We provided feedback on prehospital activities of EMTs and conducted quality-control meetings quarterly.…”

Section: Methodsmentioning

confidence: 99%

“…Each prehospital EMS team comprises 2 or 3 EMTs, including a level 1 EMT (similar to EMT-intermediate level in the EMS of the United States) as the top-level ambulance crew, a level 2 EMT (similar to EMT-basic), and a driver. Both scopes of practice are limited to the basic life support level, as has been mentioned in previous studies [6][7][8]. Since the start of the dual-dispatch system in 2015, two ambulances or one ambulance with one fire engine could be dispatched for OHCA patients.…”

Section: Study Settingmentioning

confidence: 99%

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Effect of citywide enhancement of the chain of survival on good neurologic outcomes after out-of-hospital cardiac arrest from 2008 to 2017

et al. 2020

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Improving outcomes after out-of-hospital cardiac arrests (OHCAs) requires an integrated approach by strengthening the chain of survival and emergency care systems. This study aimed to identify the change in outcomes over a decade and effect of citywide intervention on good neurologic outcomes after OHCAs in Daegu. This is a before- and after-intervention study to examine the association between the citywide intervention to improve the chain of survival and outcomes after OHCA. The primary outcome was a good neurologic outcome, defined as a cerebral performance category score of 1 or 2. After dividing into 3 phases according to the citywide intervention, the trends in outcomes after OHCA by primary electrocardiogram rhythm were assessed. Logistic regression analysis was used to analyze the association between the phases and outcomes. Overall, 6203 patients with OHCA were eligible. For 10 years (2008–2017), the rate of survival to discharge and the good neurologic outcomes increased from 2.6% to 8.7% and from 1.5% to 6.6%, respectively. Especially for patients with an initial shockable rhythm, these changes in outcomes were more pronounced (survival to discharge: 23.3% in 2008 to 55.0% in 2017, good neurologic outcomes: 13.3% to 46.0%). Compared with phase 1, the adjusted odds ratio (AOR) and 95% confidence intervals (CI) for good neurologic outcomes was 1.20 (95% CI: 0.78–1.85) for phase 2 and 1.64 (1.09–2.46) for phase 3. For patients with an initial shockable rhythm, the AOR for good neurologic outcomes was 3.76 (1.88–7.52) for phase 2 and 5.51 (2.77–10.98) for phase 3. Citywide improvement was observed in the good neurologic outcomes after OHCAs of medical origin, and the citywide intervention was significantly associated with better outcomes, particularly in those with initial shockable rhythm.

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QRS complex characteristics and patient outcomes in out-of-hospital pulseless electrical activity cardiac arrest

et al. 2020

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BackgroundPulseless electrical activity (PEA) is increasingly observed in out-of-hospital cardiac arrest (OHCA), but outcomes are still poor. We aimed to assess the relationship between QRS characteristics and outcomes of patients with OHCA with initial PEA (OHCA-P).MethodsThis prospective observational study included patients aged at least 18 years who developed OHCA-P between 1 January 2016 and 31 December 2018, and were enrolled in the Daegu Emergency Medical Services registry, South Korea. We performed multivariable logistic regression analyses to identify the associations between QRS characteristics and OHCA-P outcomes, in which QRS complexes were considered separately (model 1) and simultaneously (model 2). The primary outcome was survival to hospital discharge and the secondary outcome was a favourable neurological outcome.ResultsOf the 3659 patients with OHCA, 576 were enrolled (median age 73 years; 334 men). A higher QRS amplitude was associated with survival to hospital discharge and a favourable neurological outcome in model 1 (adjusted OR (aOR) 1.077 and 1.106, respectively; 95% CI 1.021 to 0.136 and 1.029 to 1.190, respectively) and model 2 (aOR 1.084 and 1.123, respectively; 95% CI 1.026 to 1.145 and 1.036 to 1.216, respectively). A QRS width of <120 ms was associated with survival to hospital discharge and a favourable neurological outcome in model 1 (aOR 3.371 and 4.634, respectively; 95% CI 1.633 to 6.960 and 1.562 to 13.144, respectively) and model 2 (aOR 3.213 and 5.103, respectively; 95% CI 1.568 to 6.584 and 1.682 to 15.482, respectively). Survival to hospital discharge and neurological outcome were not associated with QRS frequency.ConclusionOHCA-P outcomes were better when the initial QRS complex showed a higher amplitude or narrower width.

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Application of a Dual-Dispatch System for Out-of-Hospital Cardiac Arrest Patients: Will More Hands Save More Lives?

Cited by 6 publications

References 24 publications

Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study

Impact of the COVID-19 outbreak on adult out-of-hospital cardiac arrest outcomes in Daegu, South Korea: an observational study

Effect of citywide enhancement of the chain of survival on good neurologic outcomes after out-of-hospital cardiac arrest from 2008 to 2017

QRS complex characteristics and patient outcomes in out-of-hospital pulseless electrical activity cardiac arrest

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