首页|Effects of Smart Advanced Life Support protocol implementation including CPR coaching during out-of-hospital cardiac arrest

Effects of Smart Advanced Life Support protocol implementation including CPR coaching during out-of-hospital cardiac arrest

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  • NSTL
  • Elsevier
? 2022 Elsevier Inc.Purpose: The aim of this study was to compare out-of-hospital cardiac arrest (OHCA) outcomes before and after implementation of Smart Advanced Life Support (SALS) protocol incorporating changes in cardiopulmonary resuscitation (CPR) assistance and coaching by physicians via real-time video calls. Methods: A prospective before-and-after multi-regional observational study was conducted between January 2014 and December 2018. In January 2016, emergency medical service (EMS) providers adopted an integrated CPR coaching by physicians via real-time video call via SALS to treat patients with OHCA focusing on high-quality cardiopulmonary resuscitation. Propensity score matching was performed to match patients. Patients' outcomes using conventional protocol were then compared with those of patients using the SALS protocol. Results: Among 26,349 OHCA cases, 2351 patients and 7261 patients were enrolled during the pre-intervention and the post-intervention periods, respectively. Multivariate analysis showed that SALS was independently associated with favorable neurological outcomes [odds ratio (OR): 2.20; 95% confidence interval (CI): 1.62–2.99]. A total of 2096 patients were propensity score-matched and the two groups were well balanced. In the matched cohort, the use of SALS protocol was still associated with increased prehospital return of spontaneous circulation (ROSC) (OR: 3.83, 95% CI: 2.80–5.26), survival to discharge (OR: 1.68; 95% CI: 1.20–2.34), and favorable neurological outcomes (OR: 1.83; 95% CI: 1.19–2.82). Conclusion: A multidisciplinary SALS protocol for the resuscitation of patients with OHCA was associated with increased prehospital ROSC, survival to discharge, and good neurologic outcomes compared with traditional resuscitation protocol.

Advanced cardiac life supportEmergency medical dispatchOut-of-hospital cardiac arrest

Kim G.W.、Moon H.J.、Lim H.、Kim Y.J.、Lee C.A.、Park Y.J.、Lee K.M.、Woo J.H.、Cho J.S.、Jeong W.J.、Choi H.J.、Kim C.S.、Choi I.K.、Heo N.H.、Park J.S.、Lee Y.H.、Park S.M.、Jeong D.K.

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Department of Emergency Medicine College of Medicine Soonchunhyang University

Department of Emergency Medicine Seoul National University Bundang Hospital

Department of Emergency Medicine Hallym University Dongtan Sacred Heart Hospital

Department of Emergency Medicine Chosun University Hospital

Department of Emergency Medicine Myongji Hospital Koyang

Department of Emergency Medicine Gachon University Gil medical center

Department of Emergency Medicine St. Vincent's Hospital Catholic University of Korea

Department of Emergency Medicine Dankook University Hospital

Department of Emergency Medicine Hanyang University Guri Hospital

Department of Emergency Medicine Cheonan Chungmu Hospital

Clinical Trial Center Soonchunhyang University Cheonan Hospital

Department of Emergency Medicine College of Medicine Chungnam National University

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2022

10.1016/j.ajem.2022.03.050

The American journal of emergency medicine

The American journal of emergency medicine

ISSN：0735-6757
年,卷(期)：2022.56
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