Prehospital anaesthesia by a physician and paramedic critical care team in Southwest England

Vopelius-Feldt, Johannes von; Benger, Jonathan

doi:10.1097/mej.0b013e32835b08b7

“…17,23 In addition, prehospital critical care providers often have the support of advanced clinical governance structures with regular case reviews and quality improvement projects, which might not be available to the cohort of ALS providers. 34 Finally, prehospital critical care providers potentially have more freedom to select destination hospitals, such as cardiac or trauma centres, as appropriate for each patient. 17 All of these aspects make it possible that prehospital providers can achieve better outcomes for an individual patient following OHCA.…”

Section: Discussionmentioning

confidence: 99%

33 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

Vopelius-Feldt

¹

2017

View full text Add to dashboard Cite

“…The service is delivered using a combination of helicopter transport (provided by the Great Western Air Ambulance charity) and fast response road vehicles covering the GWAS territory. 23 To undertake pre-hospital work, prehospital physicians complete a training programme with specified competencies and mentored practice, coupled with theoretical and simulation training. CCPs are experienced paramedics who have completed a university-based theory and practical training course with mentoring and supervised experience, followed by the successful completion of a comprehensive qualifying assessment.…”

Section: Great Western Air Ambulance (Gwaa) Critical Care Teammentioning

confidence: 99%

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest

Vopelius-Feldt

¹

,

Coulter

²

,

Benger

³

2015

Self Cite

View full text Add to dashboard Cite

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest. Resuscitation, 96. pp. 290-295. ISSN 0300-9572 Available from: http://eprints.uwe.ac.uk/29457We recommend you cite the published version. The publisher's URL is: http://dx.doi.org/10.1016/j.resuscitation.2015.08.020Refereed: Yes (no note) Disclaimer UWE has obtained warranties from all depositors as to their title in the material deposited and as to their right to deposit such material. UWE makes no representation or warranties of commercial utility, title, or fitness for a particular purpose or any other warranty, express or implied in respect of any material deposited. UWE makes no representation that the use of the materials will not infringe any patent, copyright, trademark or other property or proprietary rights. UWE accepts no liability for any infringement of intellectual property rights in any material deposited but will remove such material from public view pending investigation in the event of an allegation of any such infringement. PLEASE SCROLL DOWN FOR TEXT.The Impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest 1 THE IMPACT OF A PRE-HOSPITAL CRITICAL CARE TEAM ON SURVIVAL FROM OUT-OF- WORD COUNT, REFERENCES, FIGURES AND TABLES Abstract: 233Manuscript: 3045 ABSTRACT AimTo assess the impact of a pre-hospital critical care team (CCT) on survival from out-ofhospital cardiac arrest (OHCA). MethodsWe undertook a retrospective observational study, comparing OHCA patients attended by advanced life support (ALS) paramedics with OHCA patients attended by ALS paramedics and a CCT between April 2011 and April 2013 in a single ambulance service in Southwest England. We used multiple logistic regression to control for an anticipated imbalance of prognostic factors between the groups. The primary outcome was survival to hospital discharge. All data were collected independently of the research. Results1851 cases of OHCA were included in the analysis, of which 1686 received ALS paramedic treatment and 165 were attended by both ALS paramedics and a CCT. Unadjusted rates of survival to hospital discharge were significantly higher in the CCT group, compared to the ALS paramedic group (15.8% and 6.5%, respectively, p < 0.001). After adjustment using multiple logistic regression, the effect of CCT treatment was no longer statistically significant (OR 1.54, 95% CI 0.89 to 2.67, p = 0.13). Subgroup analysis of OHCA with first monitored rhythm of ventricular fibrillation or pulseless ventricular tachycardia showed similar results. ConclusionPre-hospital critical care for OHCA was not associated with significantly improved rates of survival to hospital discharge. These results are in keeping with previously published studies.Further research with a larger sample size is required to determine whether CCTs can improve outcome in OHCA.The Impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest 3

show abstract

“…The service is delivered using a combination of helicopter transport (provided by the Great Western Air Ambulance charity) and fast response road vehicles covering the GWAS territory. 23 To undertake pre-hospital work, prehospital physicians complete a training programme with specified competencies and helicopter. 12 A detailed analysis of the competences of GWAS and GWAA pre-hospital providers has been published previously.…”

Section: Great Western Air Ambulance (Gwaa) Critical Care Teammentioning

confidence: 99%

The impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest

Vopelius-Feldt

¹

,

Coulter

²

,

Benger

³

2015

Self Cite

View full text Add to dashboard Cite

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest. Resuscitation, 96. pp. 290-295. ISSN 0300-9572 Available from: http://eprints.uwe.ac.uk/29457We recommend you cite the published version. The publisher's URL is: http://dx.doi.org/10.1016/j.resuscitation.2015.08.020Refereed: Yes (no note) Disclaimer UWE has obtained warranties from all depositors as to their title in the material deposited and as to their right to deposit such material. UWE makes no representation or warranties of commercial utility, title, or fitness for a particular purpose or any other warranty, express or implied in respect of any material deposited. UWE makes no representation that the use of the materials will not infringe any patent, copyright, trademark or other property or proprietary rights. UWE accepts no liability for any infringement of intellectual property rights in any material deposited but will remove such material from public view pending investigation in the event of an allegation of any such infringement. PLEASE SCROLL DOWN FOR TEXT.The Impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest 1 THE IMPACT OF A PRE-HOSPITAL CRITICAL CARE TEAM ON SURVIVAL FROM OUT-OF- WORD COUNT, REFERENCES, FIGURES AND TABLES Abstract: 233Manuscript: 3045 ABSTRACT AimTo assess the impact of a pre-hospital critical care team (CCT) on survival from out-ofhospital cardiac arrest (OHCA). MethodsWe undertook a retrospective observational study, comparing OHCA patients attended by advanced life support (ALS) paramedics with OHCA patients attended by ALS paramedics and a CCT between April 2011 and April 2013 in a single ambulance service in Southwest England. We used multiple logistic regression to control for an anticipated imbalance of prognostic factors between the groups. The primary outcome was survival to hospital discharge. All data were collected independently of the research. Results1851 cases of OHCA were included in the analysis, of which 1686 received ALS paramedic treatment and 165 were attended by both ALS paramedics and a CCT. Unadjusted rates of survival to hospital discharge were significantly higher in the CCT group, compared to the ALS paramedic group (15.8% and 6.5%, respectively, p < 0.001). After adjustment using multiple logistic regression, the effect of CCT treatment was no longer statistically significant (OR 1.54, 95% CI 0.89 to 2.67, p = 0.13). Subgroup analysis of OHCA with first monitored rhythm of ventricular fibrillation or pulseless ventricular tachycardia showed similar results. ConclusionPre-hospital critical care for OHCA was not associated with significantly improved rates of survival to hospital discharge. These results are in keeping with previously published studies.Further research with a larger sample size is required to determine whether CCTs can improve outcome in OHCA.The Impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest 3

show abstract

Prehospital anaesthesia by a physician and paramedic critical care team in Southwest England

Cited by 43 publications

References 23 publications

33 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

33 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest

The impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest

Contact Info

Product

Resources

About