Effect of timing of advanced life support on out-of-hospital cardiac arrests at home in Japan

被引:1
作者
Morioka, Daigo [1 ,2 ,5 ]
Sagisaka, Ryo [2 ,4 ]
Nakagawa, Koshi [3 ]
Takahashi, Hiroyuki [2 ]
Tanaka, Hideharu [2 ]
机构
[1] Meiji Univ Integrat Med, Fac Emergency Med Sci, Sch Hlth Sci & Med Care, Kyoto, Japan
[2] Kokushikan Univ, Grad Sch Emergency Med Syst, Tokyo, Japan
[3] Chuo Univ, Fac Sci & Engn, Dept Integrated Sci & Engn Sustainable Soc, Tokyo, Japan
[4] Kokushikan Univ, Res Inst Disaster Management & Emergency Med Syst, Tokyo, Japan
[5] Meiji Univ Integrat Med, 6-1 Honoda Hinotani, Kyoto 6290301, Japan
关键词
Out -of -hospital cardiac arrests; Advanced life support; Emergency medical services; Endotracheal intubation; Adrenaline administration; CARDIOPULMONARY-RESUSCITATION QUALITY; INTRAVENOUS ACCESS; AIRWAY MANAGEMENT; TIME; FAILURE; SCENE; INTERVENTIONS; TRANSPORT; SURVIVAL; CPR;
D O I
10.1016/j.ajem.2024.05.021
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Aim: In cases of out-of-hospital cardiac arrests (OHCA) occurring at home, Japanese emergency medical services personnel decide whether to provide treatment on the scene or during transport based on their judgment. This study aimed to evaluate the association between the timing of advanced life support (ALS) (i.e., endotracheal intubation [ETI] or adrenaline administration) for OHCA at home and prognosis. Method: This retrospective cohort study used data from the Japan Utstein Registry and emergency transport data collected from patients who underwent pre-hospital ETI (n = 6806) and received adrenaline (n = 22,636) between 2016 and 2019. The timing of ETI or adrenaline administration was determined as "on the scene" or "in the ambulance." Multiple logistic regression analysis was used to estimate the association among the timing of ALS implementation, pre-hospital return of spontaneous circulation (ROSC), and survival at 1 month. Result: ETI on the scene was significantly positively associated with pre-hospital ROSC (adjusted odds ratio [AOR], 1.81; 95% confidence interval [CI], 1.57-2.09) and survival at 1 month (AOR, 1.81; 95% CI, 1.47-2.23). Adrenaline administration on the scene was significantly positively associated with pre-hospital ROSC (AOR, 2.51; 95% CI, 2.33-2.70) and survival at 1 month (AOR, 2.13; 95% CI, 1.89-2.40). Conclusion: Our analysis suggests performing ALS on the scene was associated with pre-hospital ROSC and survival at 1 month. Further efforts are needed to increase the rate of ALS implementation on the scene by emergency life-saving technicians. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
引用
收藏
页码:94 / 100
页数:7
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