Impact of different medical direction policies on prehospital advanced airway management for out-of hospital cardiac arrest patients: A retrospective cohort study

Hongo, Takashi; Yumoto, Tetsuya; Naito, Hiromichi; Mikane, Takeshi; Nakao, Atsunori

doi:10.1016/j.resplu.2022.100210

Cited by 1 publication

(2 citation statements)

References 33 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The AAM rate among nontraumatic OHCA patients varies widely in Japan, 26 and AAM use depends on a number of factors including transfer time, patient characteristics, EMS personnel skill, and physicians' discretion in charge region‐specific online medical control. 27 Thus, the standard clinical criteria of AAM in Japan is not entirely established and could vary from region to region. Furthermore, treatments allowed for ELST differ in different regions/countries.…”

Section: Discussionmentioning

confidence: 99%

“…Japan's unique prehospital delivery system should be taken into account when adapting our results for other countries. The AAM rate among nontraumatic OHCA patients varies widely in Japan, 26 and AAM use depends on a number of factors including transfer time, patient characteristics, EMS personnel skill, and physicians' discretion in charge region‐specific online medical control 27 . Thus, the standard clinical criteria of AAM in Japan is not entirely established and could vary from region to region.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prehospital advanced airway management of emergency medical service‐witnessed traumatic out‐of‐hospital cardiac arrest patients: analysis of nationwide trauma registry

Nishimura

Suga

Nakao

et al. 2022

Acute Medicine & Surgery

Self Cite

View full text Add to dashboard Cite

Aim Survival of traumatic out‐of‐hospital cardiac arrest (OHCA) is poor. Early use of advanced airway management (AAM) techniques, including endotracheal intubation and supraglottic devices, are expected to contribute to the improved survival of these patients. The aim of this study was to determine whether prehospital use of AAM improves the outcomes for emergency medical service (EMS)‐witnessed traumatic OHCA. Methods A nationwide retrospective study was carried out. Trauma patients with EMS‐witnessed cardiac arrest who received cardiopulmonary resuscitation during transport were included. Patients younger than 16 years and those with missing data were excluded. We compared two groups using propensity score matching. The primary outcome was survival to discharge. The secondary outcome was return of spontaneous circulation (ROSC) on hospital arrival. A logistic regression model was used to calculate odds ratios (OR) and confidence intervals (CI). Results After propensity score matching, 1,346 patients were enrolled (AAM 673 versus non‐AAM 673). Forty‐four AAM cases (6.5%) and 39 non‐AAM cases (5.8%) survived. Logistic regression analysis did not show a contribution of AAM for survival to discharge (AAM 44/673 (6.5%), non‐AAM 39/673 (5.8%); OR 1.12; 95% CI, 0.70–1.76; P = 0.64). However, AAM improved ROSC on admission (AAM 141/673 (21.0%), non‐AAM 77/673 (11.4%); OR 2.05; 95% CI, 1.51–2.78; P < 0.001). This tendency was consistent throughout our subgroup analysis categorized by body region of the severe injury (head trauma, torso trauma, and extremity/spine trauma). Conclusions Prehospital AAM among EMS‐witnessed traumatic OHCA patients was not associated with survival to discharge; however, ROSC on hospital admission improved for the AAM patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%