Abstract 18139: Neurological Favorable Outcome Associated EMS Compliance With On-Scene Resuscitation Time Protocol
Introduction: Korean national emergency care protocol for EMS providers recommends minimum of 5 minutes of on-scene resuscitation before transport to hospital in cases of OHCA (Out-of-Hospital Cardiac Arrest).
Hypothesis: We compared survival outcome of OHCA patients according to STI (scene time interval)-protocol compliance of EMS.
Methods: EMS assessed and treated adult OHCAs with presumed cardiac etiology during 2 year period were analyzed. Noncompliance was defined as hospital transport with STI less than 6 minutes without return of spontaneous circulation (ROSC) on scene. Propensity score for compliance with protocol was calculated and based on the calculated propensity score, 1:1 matching was performed between compliance and non-compliance group. Univariate analysis as well as multivariable logistic model was used to evaluate effect of compliance to survival outcome.
Results: Among total of 28,100 OHCAs, EMS transported 7,026 (25.0%) cardiac arrest without achieving ROSC on scene with STI less than 6 minutes. 6,854 cases in each group were matched using propensity score matching. Overall survival to discharge rate did not differ in both groups (4.6% for compliance group vs. 4.5 for non-compliance group, p=0.78). Adjusted odds ratio of compliance for survival to discharge were 1.12 (95%CI 0.92 - 1.36). More patients with favorable neurological outcome was shown in compliance group (2.5% vs. 1.7%, p<0.01) and adjusted odds ratio was 1.91 (95% CI 1.42 - 2.59)
Conclusions: Although survival to discharge rate did not differ for patient with EMS non-compliance with STI protocol, lesser patients survived with favorable neurological outcomes when EMS did not stay for sufficient time on scene in OHCA before transport.
Author Disclosures: J. Park: None. T. Kim: None. S. Shin: None. K. Hong: None. G. Park: None. Y. Ro: None. K. Song: None. Y. Park: None. K. Lee: None. E. Lee: None.
- © 2016 by American Heart Association, Inc.