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

被引：13

作者：

Kim, Gi Woon ^{[1
]}

Moon, Hyung Jun ^{[1
,13
]}

Lim, Hoon ^{[1
,13
]}

Kim, Yu Jin ^{[2
]}

Lee, Choung Ah. ^{[3
]}

Park, Yong Jin ^{[4
]}

Lee, Kyoung Mi ^{[5
]}

Woo, Jae Hyug ^{[6
]}

Cho, Jin Seong ^{[6
]}

Jeong, Won Jung ^{[7
]}

Choi, Hyuk Joong ^{[8
]}

Kim, Chang Sun ^{[8
]}

Choi, Han Joo ^{[9
]}

Choi, Il Kug ^{[10
]}

Heo, Nam Hun ^{[11
]}

Park, Jung Soo ^{[12
]}

Lee, Young Hwan ^{[1
]}

Park, Seung Min ^{[2
]}

Jeong, Dong Kil ^{[1
]}

机构：

[1] Soonchunhyang Univ, Coll Med, Dept Emergency Med, Asan, South Korea

[2] Seoul Natl Univ, Bundang Hosp, Dept Emergency Med, Seongnam, South Korea

[3] Hallym Univ, Dongtan Sacred Heart Hosp, Dept Emergency Med, Chunchon, South Korea

[4] Chosun Univ Hosp, Dept Emergency Med, Gwangju, South Korea

[5] Myongji Hosp, Dept Emergency Med, Koyang, South Korea

[6] Gachon Univ, Gil Med Ctr, Dept Emergency Med, Seongnam, South Korea

[7] Catholic Univ Korea, St Vincents Hosp, Dept Emergency Med, Suwon, South Korea

[8] Hanyang Univ, Guri Hosp, Dept Emergency Med, Seoul, South Korea

[9] Dankook Univ Hosp, Dept Emergency Med, Cheonan, South Korea

[10] Cheonan Chungmu Hosp, Dept Emergency Med, Cheonan, South Korea

[11] Soonchunhyang Univ, Cheonan Hosp, Clin Trial Ctr, Asan, South Korea

[12] Chungnam Natl Univ, Coll Med, Dept Emergency Med, Daejeon, South Korea

[13] Emergency Care Ctr, 30,Suncheonhyang 6 Gil, Cheonan 31151, Chungcheongnam, South Korea

来源：

AMERICAN JOURNAL OF EMERGENCY MEDICINE | 2022年 / 56卷

关键词：

Out-of -hospital cardiac arrest; Advanced cardiac life support; Emergency medical dispatch; CARDIOPULMONARY-RESUSCITATION QUALITY; TIME AUDIOVISUAL FEEDBACK; COMATOSE SURVIVORS; PATIENT SURVIVAL; OUTCOMES; ASSOCIATION; GUIDELINES; CARE; EPIDEMIOLOGY; STATEMENT;

D O I：

10.1016/j.ajem.2022.03.050

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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 re-suscitation (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 asso-ciated 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 neuro-logical 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 in-creased prehospital ROSC, survival to discharge, and good neurologic outcomes compared with traditional resus-citation protocol. (c) 2022 Elsevier Inc. All rights reserved.

引用

页码：211 / 217

页数：7

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