Application of a Dual-Dispatch System for Out-of-Hospital Cardiac Arrest Patients: Will More Hands Save More Lives?
10.3346/jkms.2019.34.e141
- Author:
Jung Ho KIM
1
;
Hyun Wook RYOO
;
Jong Yeon KIM
;
Jae Yun AHN
;
Sungbae MOON
;
Dong Eun LEE
;
You Ho MUN
Author Information
1. Department of Emergency Medicine, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.
- Publication Type:Original Article
- Keywords:
Basic Life Support;
Cardiac Arrest;
Emergency Medical Services
- MeSH:
Cardiopulmonary Resuscitation;
Daegu;
Emergency Medical Services;
Hand;
Heart Arrest;
Humans;
Korea;
Logistic Models;
Observational Study;
Odds Ratio;
Out-of-Hospital Cardiac Arrest;
Prospective Studies
- From:Journal of Korean Medical Science
2019;34(34):e141-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Recovery after out-of-hospital cardiac arrest (OHCA) is difficult, and emergency medical services (EMS) systems apply various strategies to improve outcomes. Multi-dispatch is one means of providing high-quality cardiopulmonary resuscitation (CPR), but no definitive best-operation guidelines are available. We assessed the effects of a basic life support (BLS)-based dual-dispatch system for OHCA. METHODS: This prospective observational study of 898 enrolled OHCA patients, conducted in Daegu, Korea from March 1, 2015 to June 30, 2016, involved patients > 18 years old with suspected cardiac etiology OHCA. In Daegu, EMS started a BLS-based dual-dispatch system in March 2015, for cases of cardiac arrest recognition by a dispatch center. We assessed the association between dual-dispatch and OHCA outcomes using multivariate logistic regressions. We also analyzed the effect of dual-dispatch according to the stratified on-scene time. RESULTS: Of 898 OHCA patients (median, 69.0 years; 65.5% men), dual-dispatch was applied in 480 (53.5%) patients. There was no difference between the single-dispatch group (SDG) and the dual-dispatch group (DDG) in survival at discharge and neurological outcomes (survival discharge, P = 0.176; neurological outcomes, P = 0.345). In the case of less than 10 minutes of on-scene time, the adjusted odds ratio was 1.749 (95% confidence interval [CI], 0.490–6.246) for survival discharge and 6.058 (95% CI, 1.346–27.277) for favorable neurological outcomes in the DDG compared with the SDG. CONCLUSION: Dual-dispatch was not associated with better OHCA outcomes for the entire study population, but showed favorable neurological outcomes when the on-scene time was less than 10 minutes.
