Variations in Cardiac Arrest Regionalization in California
Introduction: The development of cardiac arrest centers and regionalization of systems of care may improve survival of patients with out-of-hospital cardiac arrest (OHCA). This survey of the local EMS agencies (LEMSA) in California was intended to determine current practices regarding the treatment...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2018-02-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/6t0549pv |
| _version_ | 1818908045796704256 |
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| author | Brian L. Chang Mary P. Mercer Nichole Bosson Karl A. Sporer |
| author_facet | Brian L. Chang Mary P. Mercer Nichole Bosson Karl A. Sporer |
| author_sort | Brian L. Chang |
| collection | DOAJ |
| description | Introduction: The development of cardiac arrest centers and regionalization of systems of care may improve survival of patients with out-of-hospital cardiac arrest (OHCA). This survey of the local EMS agencies (LEMSA) in California was intended to determine current practices regarding the treatment and routing of OHCA patients and the extent to which EMS systems have regionalized OHCA care across California. Methods: We surveyed all of the 33 LEMSA in California regarding the treatment and routing of OHCA patients according to the current recommendations for OHCA management. Results: Two counties, representing 29% of the California population, have formally regionalized cardiac arrest care. Twenty of the remaining LEMSA have specific regionalization protocols to direct all OHCA patients with return of spontaneous circulation to designated percutaneous coronary intervention (PCI)-capable hospitals, representing another 36% of the population. There is large variation in LEMSA ability to influence inhospital care. Only 14 agencies (36%), representing 44% of the population, have access to hospital outcome data, including survival to hospital discharge and cerebral performance category scores. Conclusion: Regionalized care of OHCA is established in two of 33 California LEMSA, providing access to approximately one-third of California residents. Many other LEMSA direct OHCA patients to PCI-capable hospitals for primary PCI and targeted temperature management, but there is limited regional coordination and system quality improvement. Only one-third of LEMSA have access to hospital data for patient outcomes. |
| first_indexed | 2024-12-19T22:04:47Z |
| format | Article |
| id | doaj.art-55d5f67cddbb48bbb5ea4c768adcf267 |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-12-19T22:04:47Z |
| publishDate | 2018-02-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-55d5f67cddbb48bbb5ea4c768adcf2672022-12-21T20:04:03ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182018-02-0119210.5811/westjem.2017.10.34869wjem-19-259Variations in Cardiac Arrest Regionalization in CaliforniaBrian L. Chang0Mary P. Mercer1Nichole Bosson2Karl A. Sporer3University of California San Francisco School of Medicine, Department of Emergency Medicine, San Francisco, CaliforniaUniversity of California San Francisco School of Medicine, Department of Emergency Medicine, San Francisco, CaliforniaLos Angeles County Emergency Medical Service Agency, Los Angeles, CaliforniaUniversity of California San Francisco School of Medicine, Department of Emergency Medicine, San Francisco, CaliforniaIntroduction: The development of cardiac arrest centers and regionalization of systems of care may improve survival of patients with out-of-hospital cardiac arrest (OHCA). This survey of the local EMS agencies (LEMSA) in California was intended to determine current practices regarding the treatment and routing of OHCA patients and the extent to which EMS systems have regionalized OHCA care across California. Methods: We surveyed all of the 33 LEMSA in California regarding the treatment and routing of OHCA patients according to the current recommendations for OHCA management. Results: Two counties, representing 29% of the California population, have formally regionalized cardiac arrest care. Twenty of the remaining LEMSA have specific regionalization protocols to direct all OHCA patients with return of spontaneous circulation to designated percutaneous coronary intervention (PCI)-capable hospitals, representing another 36% of the population. There is large variation in LEMSA ability to influence inhospital care. Only 14 agencies (36%), representing 44% of the population, have access to hospital outcome data, including survival to hospital discharge and cerebral performance category scores. Conclusion: Regionalized care of OHCA is established in two of 33 California LEMSA, providing access to approximately one-third of California residents. Many other LEMSA direct OHCA patients to PCI-capable hospitals for primary PCI and targeted temperature management, but there is limited regional coordination and system quality improvement. Only one-third of LEMSA have access to hospital data for patient outcomes.https://escholarship.org/uc/item/6t0549pv |
| spellingShingle | Brian L. Chang Mary P. Mercer Nichole Bosson Karl A. Sporer Variations in Cardiac Arrest Regionalization in California Western Journal of Emergency Medicine |
| title | Variations in Cardiac Arrest Regionalization in California |
| title_full | Variations in Cardiac Arrest Regionalization in California |
| title_fullStr | Variations in Cardiac Arrest Regionalization in California |
| title_full_unstemmed | Variations in Cardiac Arrest Regionalization in California |
| title_short | Variations in Cardiac Arrest Regionalization in California |
| title_sort | variations in cardiac arrest regionalization in california |
| url | https://escholarship.org/uc/item/6t0549pv |
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