Cover Image
QR Code

Paramedic Out-of-hospital Cardiac Arrest Case Volume Is a Predictor of Return of Spontaneous Circulation.

Introduction: Many factors contribute to the survival of out-of-hospital cardiac arrest (OHCA). One such factor is the quality of resuscitation efforts, which in turn may be a function of OHCA case volume. However, few studies have investigated the OHCA case volume-survival relationship. Consequentl...

Full description

Published in:Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Vol. 19; no. 4; pp. 654 - 660
Main Authors: Tuttle, Jenna E., Hubble, Michael W.
Format: research tables/charts Journal Article
Published: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Jul2018
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130509862&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 130509862
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        1936900X
        8B61
      jtl: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
      issn: 1936900X
      maglogo: N
    pubinfo:
      dt: Jul2018
      vid: 19
      iid: 4
      pid: 29816
      pub: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
      place: Orange, California
    artinfo:
      ui:
        130509862
        130509862
        130509862
        10.5811/westjem.2018.3.37051
        130509862
      ppf: 654
      ppct: 6
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Paramedic Out-of-hospital Cardiac Arrest Case Volume Is a Predictor of Return of Spontaneous Circulation.
      aug:
        au:
          Tuttle, Jenna E.
          Hubble, Michael W.
        affil: Western Carolina University, School of Health Sciences, Emergency Medical Care Program, Cullowhee, North Carolina
      sug:
        subj:
          Emergency Medical Technicians
          Heart Arrest Therapy
          Prehospital Care North Carolina
          Recovery
          Human
          North Carolina
          Retrospective Design
          Adult
          Suffering
          Logistic Regression
          Odds Ratio
          Confounding Variable
          Age Factors
          Sex Factors
          Male
          Female
          White Persons
          Resuscitation, Cardiopulmonary
          Time Factors
          Meetings
          Patient Attitudes
          Bystander CPR
          Adult: 19-44 years
          Male
          Female
      ab: Introduction: Many factors contribute to the survival of out-of-hospital cardiac arrest (OHCA). One such factor is the quality of resuscitation efforts, which in turn may be a function of OHCA case volume. However, few studies have investigated the OHCA case volume-survival relationship. Consequently, we sought to develop a model describing the likelihood of return of spontaneous circulation (ROSC) as a function of paramedic cumulative OHCA experience. Methods: We conducted a statewide retrospective study of cardiac arrest using the North Carolina Prehospital Care Reporting System. Adult patients suffering a witnessed, non-traumatic cardiac arrest between January 2012 and June 2014 were included. Using logistic regression, we calculated an adjusted odds ratio (OR) for the influence of the preceding five-year paramedic OHCA case volume on ROSC while controlling for the potentially confounding variables identified a priori as patient age, gender, and non-Caucasian race; shockable presenting rhythm; layperson/first responder cardiopulmonary resuscitation (CPR); and emergency medical services (EMS) response time. Results: Of the 6,405 patients meeting inclusion criteria, 3,155 (49.3%) experienced ROSC. ROSC was more likely among patients treated by paramedics with = 15 OHCA experiences during the preceding five years (OR [1.21], p<0.01). ROSC was also more likely among patients with shockable initial rhythms (OR [2.35], p<0.01) and who received layperson/first responder CPR (OR [1.77], p<0.01). Increasing patient age (OR [0.996], p=0.02), male gender (OR [0.742], p<0.01), and increasing EMS response time (OR [0.954], p<0.01) were associated with a decreased likelihood of ROSC. Non-Caucasian race was not an independent predictor of ROSC. Conclusion: We found that a paramedic five-year OHCA case volume of = 15 is significantly associated with ROSC. Further study is needed to determine the specific actions of these more experienced paramedics who are responsible for the increased likelihood of ROSC, as well as the influence of case volume on the longer-term outcome measures of hospital discharge and neurological function.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N