https://scholars.lib.ntu.edu.tw/handle/123456789/560371
標題: | The effect of the number and level of emergency medical technicians on patient outcomes following out of hospital cardiac arrest in Taipei | 作者: | Sun J.-T. WEN-CHU CHIANG MING-JU HSIEH EDWARD PEI-CHUAN HUANG Yang W.-S. Chien Y.-C. Wang Y.-C. Lee B.-C. Sim S.-S. Tsai K.-C. MATTHEW HUEI-MING MA Chen L.-W. |
公開日期: | 2018 | 卷: | 122 | 起(迄)頁: | 48-53 | 來源出版物: | Resuscitation | 摘要: | Aim The effect of the number and level of on-scene emergency medical technicians (EMTs) on the outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to test the association between the number and level of EMTs and the outcomes of patients with OHCA. Methods We analysed Utstein-based registry data on OHCA in Taipei from 2011 to 2015. The eligible patients were adults, aged ?20 years, with non-traumatic OHCA who underwent resuscitation attempts. The exposures were the total number of EMTs or the EMT-Paramedic (EMT-P) ratio >50%. The outcome of interest was survival to discharge. Results During study period, total 8262 OHCA cases were included, of which 1085 (13.1%) were approached by crews with an EMT-P ratio >50%. While an increase in the number of EMTs on-scene was not associated with better chances of survival (adjusted odds ratio [aOR] 0.98, 95% confidence interval [CI] 0.89–1.08), an EMT-P ratio >50% was significantly associated with improved outcome (aOR 1.36, 95% CI 1.06–1.76). Subgroup analyses showed that EMT-P >50% significantly benefited survival in witnessed OHCA cases with non-shockable rhythm (aOR 1.69, 95% CI 1.01–2.58). Survival was the highest among cases seen by four EMTs with an EMT-P ratio >50% (aOR 2.54, 95% CI 1.43–4.50). Conclusion An on-scene EMT-P ratio >50% was associated with improved survival to discharge of OHCA cases, especially in those with witnessed, non-shockable rhythm. The presence of four EMTs with an EMT-P ratio >50% at the scene of OHCA was associated with the best outcome. ? 2017 |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/560371 | ISSN: | 0300-9572 | DOI: | 10.1016/j.resuscitation.2017.11.048 | SDG/關鍵字: | adult; aged; Article; cohort analysis; confidence interval; female; hospital discharge; human; major clinical study; male; odds ratio; out of hospital cardiac arrest; priority journal; register; rescue personnel; retrospective study; survival; Taiwan; treatment outcome; emergency health service; epidemiology; middle aged; mortality; nonparametric test; organization and management; out of hospital cardiac arrest; outcome assessment; procedures; rescue personnel; resuscitation; statistics and numerical data; Taiwan; very elderly; Aged; Aged, 80 and over; Cardiopulmonary Resuscitation; Emergency Medical Services; Emergency Medical Technicians; Female; Humans; Male; Middle Aged; Odds Ratio; Out-of-Hospital Cardiac Arrest; Outcome Assessment (Health Care); Registries; Retrospective Studies; Statistics, Nonparametric; Taiwan |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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