Mortality in OHCA during resuscitation by rescue teams without a doctor
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a condition that requires immediate intervention by a medical emergency team. CPR is usually based on current scientific guidelines. In Poland, medical response teams are divided into specialist emergency medical services with a doctor (S-EMS) a...
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| Format: | Article |
| Language: | English |
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Towarzystwo Pomocy Doraźnej
2019-12-01
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| Series: | Critical Care Innovations |
| Subjects: | |
| Online Access: | https://www.irdim.net/cci/2(4)1-10.html |
| _version_ | 1818385363057508352 |
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| author | Paweł Szymczuk |
| author_facet | Paweł Szymczuk |
| author_sort | Paweł Szymczuk |
| collection | DOAJ |
| description | INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a condition that requires immediate intervention by a medical emergency team. CPR is usually based on current scientific guidelines. In Poland, medical response teams are divided into specialist emergency medical services with a doctor (S-EMS) and basic emergency medical services with a paramedic or emergency nurse (B-EMS). The aim of the study is to assess the differences in resuscitation management between two types of teams and to determine the mortality rate for each of them. MATERIAL AND METHODS: The study covered 75 emergency ambulance interventions performed in 2017 in central Poland, out of which calls directly to OHCA were selected. The patient's profile, resuscitation and mortality rate were analyzed, taking into account the division into types of emergence response teams. Mann-Whitney U test, chi-squared and Spearman-rho correlation were applied. All results at p<0.05 were deemed significant. RESULTS: The emergency teams were sent 54 times directly to OHCA (n=28; B-EMS vs. n=26; S-EMS). There were no significant differences between the teams in terms of arrival (Mann-Whitney U test: Z=0.43; p=0.668), nor between the profile of the patient. B-EMS more frequently applied fluid therapy (Spearman-rho =0.312; p=0.022). More often resuscitation was discontinued in medical teams than in B-EMS (46.2% vs. 22.2%). There was a statistically significant correlation between the type of the emergency response team and the outcome of resuscitation (x2=10.6834, p=0.001). Comparable often (52.6% vs. 47.4%), the doctor helping the B-EMS pronounced death and undertook transport to hospital. CONCLUSIONS: There are few differences in resuscitation performed by S-EMS and B-EMS. Teams accompanied by a doctor called upon to assist B-EMS with resuscitation do not increase the chance of ROSC (return of spontaneous circulation). New systemic and legal solutions should be considered, taking into account the qualifications of paramedics. |
| first_indexed | 2024-12-14T03:36:58Z |
| format | Article |
| id | doaj.art-5435104723c4475a96abb34741cdbc0d |
| institution | Directory Open Access Journal |
| issn | 2545-2533 2545-2533 |
| language | English |
| last_indexed | 2024-12-14T03:36:58Z |
| publishDate | 2019-12-01 |
| publisher | Towarzystwo Pomocy Doraźnej |
| record_format | Article |
| series | Critical Care Innovations |
| spelling | doaj.art-5435104723c4475a96abb34741cdbc0d2022-12-21T23:18:35ZengTowarzystwo Pomocy DoraźnejCritical Care Innovations2545-25332545-25332019-12-012411010.32114/CCI.2019.2.4.1.10Mortality in OHCA during resuscitation by rescue teams without a doctorPaweł Szymczuk0https://orcid.org/0000-0002-4773-6491Voivodship Ambulance Station and Sanitary Transport "Meditrans", Warsaw, PolandINTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a condition that requires immediate intervention by a medical emergency team. CPR is usually based on current scientific guidelines. In Poland, medical response teams are divided into specialist emergency medical services with a doctor (S-EMS) and basic emergency medical services with a paramedic or emergency nurse (B-EMS). The aim of the study is to assess the differences in resuscitation management between two types of teams and to determine the mortality rate for each of them. MATERIAL AND METHODS: The study covered 75 emergency ambulance interventions performed in 2017 in central Poland, out of which calls directly to OHCA were selected. The patient's profile, resuscitation and mortality rate were analyzed, taking into account the division into types of emergence response teams. Mann-Whitney U test, chi-squared and Spearman-rho correlation were applied. All results at p<0.05 were deemed significant. RESULTS: The emergency teams were sent 54 times directly to OHCA (n=28; B-EMS vs. n=26; S-EMS). There were no significant differences between the teams in terms of arrival (Mann-Whitney U test: Z=0.43; p=0.668), nor between the profile of the patient. B-EMS more frequently applied fluid therapy (Spearman-rho =0.312; p=0.022). More often resuscitation was discontinued in medical teams than in B-EMS (46.2% vs. 22.2%). There was a statistically significant correlation between the type of the emergency response team and the outcome of resuscitation (x2=10.6834, p=0.001). Comparable often (52.6% vs. 47.4%), the doctor helping the B-EMS pronounced death and undertook transport to hospital. CONCLUSIONS: There are few differences in resuscitation performed by S-EMS and B-EMS. Teams accompanied by a doctor called upon to assist B-EMS with resuscitation do not increase the chance of ROSC (return of spontaneous circulation). New systemic and legal solutions should be considered, taking into account the qualifications of paramedics.https://www.irdim.net/cci/2(4)1-10.htmlemsparamedicohcaroscresuscitation |
| spellingShingle | Paweł Szymczuk Mortality in OHCA during resuscitation by rescue teams without a doctor Critical Care Innovations ems paramedic ohca rosc resuscitation |
| title | Mortality in OHCA during resuscitation by rescue teams without a doctor |
| title_full | Mortality in OHCA during resuscitation by rescue teams without a doctor |
| title_fullStr | Mortality in OHCA during resuscitation by rescue teams without a doctor |
| title_full_unstemmed | Mortality in OHCA during resuscitation by rescue teams without a doctor |
| title_short | Mortality in OHCA during resuscitation by rescue teams without a doctor |
| title_sort | mortality in ohca during resuscitation by rescue teams without a doctor |
| topic | ems paramedic ohca rosc resuscitation |
| url | https://www.irdim.net/cci/2(4)1-10.html |
| work_keys_str_mv | AT pawełszymczuk mortalityinohcaduringresuscitationbyrescueteamswithoutadoctor |