Advanced life support versus basic life support in the pre-hospital setting: A meta-analysis

Bakalos, Georgios; Mamali, M.; Komninos, Christos; Koukou, E.; Tsantilas, A.; Tzima, S.; Rosenberg, T.

doi:10.1016/j.resuscitation.2011.04.006

Cited by 73 publications

(44 citation statements)

References 36 publications

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“…Moreover, the time spent on scene was higher for ALS than for BLS providers (18.5 min vs 13.5 min, respectively; p=0.005)38; this can affect mortality. In a study by Bakalos et al 39 in 2011, ALS care was not associated with increased survival. The authors retrieved data from nine trials including 16 857 patients who met their inclusion criteria 11 40–47.…”

Section: Discussionmentioning

confidence: 92%

“…The authors retrieved data from nine trials including 16 857 patients who met their inclusion criteria 11 40–47. ALS care in patients with trauma was shown to reduce the probability of survival to hospital discharge by almost 10% when compared with BLS care (pooled OR 0.892, 95% CI 0.775 to 1.026) 39. However, this study included only few CTs of sufficient quality and strength that examined the survival of patients with trauma that were published at the time.…”

Section: Discussionmentioning

confidence: 99%

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Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis

et al. 2017

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IntroductionAdvanced life support (ALS) is thought to be associated with improved survival in prehospital trauma care when compared with basic life support (BLS). However, evidence on the benefits of prehospital ALS for patients with trauma is controversial. Therefore, we aim to clarify if ALS improves mortality in patients with trauma when compared with BLS by conducting a systematic review and meta-analysis of the recent literature.Methods and analysisWe will perform searches in PubMed, Embase and the Cochrane Central Register of Controlled Trials for published observational studies, controlled before-and-after studies, randomised controlled trials and other controlled trials conducted in humans and published until March 2017. We will screen search results, assess study selection, extract data and assess the risk of bias in duplicate; disagreements will be resolved through discussions. Data from clinically homogeneous studies will be pooled using a random-effects meta-analysis, heterogeneity of effects will be assessed using the χ2 test of homogeneity, and any observed heterogeneity will be quantified using the I2 statistic. Last, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of the evidence.Ethics and disseminationOur study does not require ethical approval as it is based on findings of previously published articles. Results will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences and publications for patient information.Trial registration numberPROSPERO (International Prospective Register of Systematic Reviews) registration number CRD42017054389.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis

et al. 2017

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“…6,7 Research examining ALS as a concept, rather than its individual components, has produced conflicting results. 2,8,9 Despite this lack of evidence, ALS has become the standard of care for OHCA in most modern EMS. 10 A number of further interventions, drugs and treatment modifications have been trialled, but have failed to improve outcomes consistently.…”

Section: Introductionmentioning

confidence: 99%

33 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

Vopelius-Feldt

2017

Emerg Med J

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“…There is some evidence that advanced life support (ALS), which includes interventions such as tracheal intubation and intravenous drug administration, can improve outcomes further. 9,10 ALS is now the standard of pre-hospital care for OHCA in most advanced EMS. 3 In addition to ALS providers, many EMS have also established targeted dispatch of physicians and/or specialised critical care paramedics to OHCA; a concept referred to as pre-hospital critical care.…”

Section: Introductionmentioning

confidence: 99%

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest

2015

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The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest. Resuscitation, 96. pp. 290-295. ISSN 0300-9572 Available from: http://eprints.uwe.ac.uk/29457We recommend you cite the published version. The publisher's URL is: http://dx.doi.org/10.1016/j.resuscitation.2015.08.020Refereed: Yes (no note) Disclaimer UWE has obtained warranties from all depositors as to their title in the material deposited and as to their right to deposit such material. UWE makes no representation or warranties of commercial utility, title, or fitness for a particular purpose or any other warranty, express or implied in respect of any material deposited. UWE makes no representation that the use of the materials will not infringe any patent, copyright, trademark or other property or proprietary rights. UWE accepts no liability for any infringement of intellectual property rights in any material deposited but will remove such material from public view pending investigation in the event of an allegation of any such infringement. PLEASE SCROLL DOWN FOR TEXT.The Impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest 1 THE IMPACT OF A PRE-HOSPITAL CRITICAL CARE TEAM ON SURVIVAL FROM OUT-OF- WORD COUNT, REFERENCES, FIGURES AND TABLES Abstract: 233Manuscript: 3045 ABSTRACT AimTo assess the impact of a pre-hospital critical care team (CCT) on survival from out-ofhospital cardiac arrest (OHCA). MethodsWe undertook a retrospective observational study, comparing OHCA patients attended by advanced life support (ALS) paramedics with OHCA patients attended by ALS paramedics and a CCT between April 2011 and April 2013 in a single ambulance service in Southwest England. We used multiple logistic regression to control for an anticipated imbalance of prognostic factors between the groups. The primary outcome was survival to hospital discharge. All data were collected independently of the research. Results1851 cases of OHCA were included in the analysis, of which 1686 received ALS paramedic treatment and 165 were attended by both ALS paramedics and a CCT. Unadjusted rates of survival to hospital discharge were significantly higher in the CCT group, compared to the ALS paramedic group (15.8% and 6.5%, respectively, p < 0.001). After adjustment using multiple logistic regression, the effect of CCT treatment was no longer statistically significant (OR 1.54, 95% CI 0.89 to 2.67, p = 0.13). Subgroup analysis of OHCA with first monitored rhythm of ventricular fibrillation or pulseless ventricular tachycardia showed similar results. ConclusionPre-hospital critical care for OHCA was not associated with significantly improved rates of survival to hospital discharge. These results are in keeping with previously published studies.Further research with a larger sample size is required to determine whether CCTs can improve outcome in OHCA.The Impact of a pre-hospital critical care team on survival from out of hospital cardiac arrest 3

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Advanced life support versus basic life support in the pre-hospital setting: A meta-analysis

Cited by 73 publications

References 36 publications

Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis

Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis

33 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest

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