Abstract 223: Impact of the Number of On-Scene Emergency Lifesaving Technicians and Outcomes from Out-of-Hospital Cardiac Arrests
Introduction: In Japan, ambulance staffing for cardiac arrest responses consists of a 3-person unit with at least one emergency life saving technician (ELST). ELST's are trained in advanced airway techniques and can administer epinephrine with medial control approval. Recently, the number of ELST's on ambulances has increased since it is believed that this staffing model improves the quality of on-scene care leading to improved patient outcome.
Purpose: The aim of this study was to evaluate the relationship between the number of ELSTs on scene and outcomes from OHCA.
Materials and methods: This was a prospective cohort study including all persons aged >=18 years suffering OHCA witnessed by bystanders in Osaka City, Japan from January 2005 through December 2007. All data were collected using an Utstein-style database. Odds ratio of the number of ELSTs on scene for neurologically favorable one-month survival (CPC ≤ 2) were calculated using multiple logistic regression adjusting for the following confounding variables; gender, age, bystander CPR, location, epinephrine, advanced airway, EMS scene time, etiology, and first rhythm.
Results: Of the 2430 witnessed OHCA patients, one ELST group was present in 644, two ELST group were present in 1370, and three ELST group in 416.The proportion of neurologically favorable one month survival was 4.3% in the one ELST, 5.1% in the two ELST, and 7.7% in the three ELST group. Compared with the one ELST group, the three ELST group had a significantly greater odds ratio for CPC ≤ 2 after adjustment for confounding variables.
Conclusion: Increasing number of ELSTs on scene was associated with improved outcomes from OHCA in Osaka.
- © 2011 by American Heart Association, Inc.