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Impacts of Emergency Medical Technician Configurations on Outcomes of Patients with Out-Of-Hospital Cardiac Arrest

Author

Listed:
  • Pin-Hui Fang

    (Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan)

  • Yu-Yuan Lin

    (Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan)

  • Chien-Hsin Lu

    (Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan)

  • Ching-Chi Lee

    (Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
    Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan 71101, Taiwan
    Department of Adult Critical Care Medicine, Tainan Sin-Lau Hospital, Tainan 70142, Taiwan)

  • Chih-Hao Lin

    (Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan)

Abstract

Paramedics can provide advanced life support (ALS) for patients with out-of-hospital cardiac arrest (OHCA). However, the impact of emergency medical technician (EMT) configuration on their outcomes remains debated. A three-year cohort study consisted of non-traumatic OHCA adults transported by ALS teams was retrospectively conducted in Tainan City using an Utstein-style population database. The EMT-paramedic (EMT-P) ratio was defined as the EMT-P proportion out of all on-scene EMTs. Among the 1357 eligible cases, the median (interquartile range) number of on-scene EMTs and the EMT-P ratio were 2 (2–2) persons and 50% (50–100%), respectively. The multivariate analysis identified five independent predictors of sustained return of spontaneous circulation (ROSC): younger adults, witnessed cardiac arrest, prehospital ROSC, prehospital defibrillation, and comorbid diabetes mellitus. After adjustment, every 10% increase in the EMT-P ratio was on average associated with an 8% increased chance (adjusted odds ratio [aOR], 1.08; p < 0.01) of sustained ROSC and a 12% increase change (aOR, 1.12; p = 0.048) of favorable neurologic status at discharge. However, increased number of on-scene EMTs was not linked to better outcomes. For nontraumatic OHCA adults, an increase in the on-scene EMT-P ratio resulted in a higher proportion of improved patient outcomes.

Suggested Citation

  • Pin-Hui Fang & Yu-Yuan Lin & Chien-Hsin Lu & Ching-Chi Lee & Chih-Hao Lin, 2020. "Impacts of Emergency Medical Technician Configurations on Outcomes of Patients with Out-Of-Hospital Cardiac Arrest," IJERPH, MDPI, vol. 17(6), pages 1-12, March.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:6:p:1930-:d:332991
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    Citations

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    Cited by:

    1. Han-Chun Huang & Tsung-Yu Lee & Cheng-Han Tsai & Yao-Sing Su & Yi-Rong Chen & Ya-Ni Yeh & Chi-Feng Hsu & Ming-Jen Tsai, 2021. "Effect of Temporal Difference on Clinical Outcomes of Patients with Out-of-Hospital Cardiac Arrest: A Retrospective Study from an Urban City of Taiwan," IJERPH, MDPI, vol. 18(21), pages 1-14, October.
    2. Ching-Fang Tzeng & Chien-Hsin Lu & Chih-Hao Lin, 2021. "Community Socioeconomic Status and Dispatcher-Assisted Cardiopulmonary Resuscitation for Patients with Out-of-Hospital Cardiac Arrest," IJERPH, MDPI, vol. 18(3), pages 1-11, January.

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