Can the full range of paramedic skills improve survival from out of hospital cardiac arrests?

Mitchell, R G; Guly, U.M.; Rainer, Timothy Hudson; Robertson, Colin E.

doi:10.1136/emj.14.5.274

Cited by 23 publications

(6 citation statements)

References 6 publications

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“…9 The large number of cases included in this study, as well as the analytical adjustment for paramedic vehicle response time, strengthens our confidence that this finding may be true. Forty-six percent of the patients (69/150) who were intubated within 12 minutes of collapse survived, compared with 23% (124/553) of the patients intubated after 13 minutes or more.…”

Section: Discussionsupporting

confidence: 60%

TIME TOINTUBATION ANDSURVIVAL INPREHOSPITALCARDIACARREST

Shy¹,

Rea²,

Becker³

et al. 2004

Prehospital Emergency Care

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Section: Discussionsupporting

confidence: 60%

TIME TOINTUBATION ANDSURVIVAL INPREHOSPITALCARDIACARREST

Shy¹,

Rea²,

Becker³

et al. 2004

Prehospital Emergency Care

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“…Yet there is no recent study that audits how theoretical and practical course knowledge is applied at the scene of an accident. Current studies look mainly at very specific details (e. g. resuscitation) in rescue and are mainly interested in end points such as patient survival (i. e. [6,16]) or the on-scene data include diagnoses made by physicians as well as by paramedics [15]. The practical content of paramedic training for ski patrols needs regular assessment, because injury patterns are changing faster than the national curriculum.…”

Section: Introductionmentioning

confidence: 99%

Qualified Rescue by Ski Patrols - Safety for the Skier

Küpper

Steffgen²,

Gore³

et al. 2002

Int J Sports Med

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This study aims to determine whether the training of ski-patrol teams is still adequate in view of a marked change in injury patterns. All accidents which occurred during two winter seasons (n = 579, 583 patients) in the Oberwallis ski area in Switzerland are analysed retrospectively. As the analysis of the accidents' data are similar to other studies and first aid training is standardised throughout Switzerland, the results of this study can be viewed as representative for other areas of Switzerland. The generally high level of training is reflected by the accuracy of "on-scene" diagnoses: 77.5 % were "correct", 12 % "mainly correct". In the remainder, the most frequent problems were underestimation or failure of recognition of multiple injuries (n = 25), head injury (n = 10), injuries to the trunk (n = 9) and to the spine (n = 7). Special emphasis on these topics during the training of ski patrols should result in the further improvement in on-scene first aid and rescue.

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“…[2][3][4][5] However, a number of studies have demonstrated that ACLS-skilled paramedics improve the likelihood of patients arriving at hospital with a spontaneous pulse. [6][7][8] The largest and most recent study of the effect of ACLS-skilled paramedics in the treatment of OHCA has been the third phase of the Ontario Prehospital Advanced Life Support study, which examined the incremental effect of ACLS in an emergency medical services (EMS) system with an optimised rapid defibrillation programme.…”

mentioning

confidence: 99%

Impact of advanced cardiac life support-skilled paramedics on survival from out-of-hospital cardiac arrest in a statewide emergency medical service

Woodall¹,

McCarthy

Johnston

et al. 2007

Emergency Medicine Journal

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Background: Prehospital research has found little evidence in support of advanced cardiac life support (ACLS) for out-of-hospital cardiac arrest. However, these studies generally examine city-based emergency medical services (EMS) systems. The training and experience of ACLS-skilled paramedics differs internationally, and this may also contribute to negative findings. Additionally, the frequency of negative outcome in out-of-hospital cardiac arrest suggests that it is difficult to establish sufficient numbers to detect an effect. Purpose: To examine the effect of ACLS on cardiac arrest in Queensland, Australia. Queensland has a population of 3.8 million and an area of over 1.7 million km 2 , and is served by a statewide EMS system, which deploys resources using a two-tier model. Advanced treatments such as intubation and cardioactive drug administration are provided by extensively trained intensive care paramedics. Methods: An observational, retrospective design was used to examine all cases of cardiac arrest attended by the Queensland Ambulance Service from January 2000 to December 2002. Logistic regression was used to examine the effect of the presence of an intensive care paramedic on survival to hospital discharge, adjusting for age, sex, initial rhythm, the presence of a witness and bystander cardiopulmonary resuscitation. Results: The presence of an intensive care paramedic had a significant effect on survival (OR = 1.43, 95% CI = 1.02 to 1.99). Conclusions: Highly trained ACLS-skilled paramedics provide added survival benefit in EMS systems not optimised for early defibrillation. The reasons for this benefit are multifactorial, but may be the result of greater skill level and more informed use of the full range of prehospital interventions.

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Can the full range of paramedic skills improve survival from out of hospital cardiac arrests?

Abstract: Objective-To examine the effect of full implementation of advanced skills by ambulance personnel on the outcome from out of hospital cardiac arrest.

Cited by 23 publications

References 6 publications

TIME TOINTUBATION ANDSURVIVAL INPREHOSPITALCARDIACARREST

TIME TOINTUBATION ANDSURVIVAL INPREHOSPITALCARDIACARREST

Qualified Rescue by Ski Patrols - Safety for the Skier

Impact of advanced cardiac life support-skilled paramedics on survival from out-of-hospital cardiac arrest in a statewide emergency medical service

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