Effects of Smart Advanced Life Support protocol implementation including CPR coaching during out-of-hospital cardiac arrest
- Abstract
- 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 resuscitation (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 associated 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 neurological 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 increased prehospital ROSC, survival to discharge, and good neurologic outcomes compared with traditional resuscitation protocol.
- All Author(s)
- G. W. Kim
; H. J. Moon
; H. Lim
; Y. J. Kim
; C. A. Lee
; Y. J. Park
; K. M. Lee
; J. H. Woo
; J. S. Cho
; W. J. Jeong
; H. J. Choi
; C. S. Kim
; I. K. Choi
; N. H. Heo
; J. S. Park
; Y. H. Lee
; S. M. Park
; D. K. Jeong
- Issued Date
- 2022
- Type
- Article
- Keyword
- Out-of-hospital cardiac arrest; Advanced cardiac life support; Emergency medical dispatch
- Publisher
- Elsevier
- ISSN
- 0735-6757
- Citation Title
- The American Journal of Emergency Medicine
- Citation Volume
- 56
- Citation Start Page
- 211
- Citation End Page
- 217
- Language(ISO)
- eng
- DOI
- 10.1016/j.ajem.2022.03.050
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/1181
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