Comparison of Results From a Cardiac Ambulance Manned by Medical or Non-Medical Personnel

Hampton, J. R.; Dowling, Monica; Nicholas, Colin

doi:10.1097/00132586-197804000-00053

Cited by 5 publications

(5 citation statements)

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“…The preponderance of evidence finds no difference with physicians present in either survival of the event (LOE 6, good/supporting; LOE 6, poor/supporting) or survival to discharge (LOE 6, good/supporting), (LOE 6, fair/neutral),, (LOE 6, good/neutral), (LOE 6, poor/neutral) . There are, in fact, a few studies that report worse outcome when physicians are present (LOE 6, poor/neutral), (LOE 6, poor/opposing), (LOE 6, fair/opposing, respectively) …”

Section: Evidence Summarymentioning

confidence: 99%

RECOVERevidence and knowledge gap analysis on veterinaryCPR. Part 2: Preparedness and prevention

McMichael

Herring

Fletcher

et al. 2012

J Vet Emergen Crit Care

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Objective -To systematically examine the evidence on the effect of prevention and preparedness measures on outcomes in veterinary cardiopulmonary resuscitation and to determine knowledge gaps. Design -Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Relevant questions were answered on a worksheet template and reviewed by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) prevention and preparedness domain members, by the RECOVER committee, and opened for comments by veterinary professionals for 3 months. Setting -Academia, referral practice, and general practice. Results -Nine worksheets were prepared to determine the extent to which preparation of the environment (charts, visual aids, etc) and personnel (training, debriefing, etc) are beneficial in improving return of spontaneous circulation. Conclusions -Of the questions evaluated, only the association between anesthesia-related cardiopulmonary arrest and better outcomes was supported by strong evidence. There is some evidence from the human literature that the use of cognitive aids, standardized didactic, and hands-on training with high-fidelity simulators, team and leadership training, and post-cardiac arrest debriefing improve adherence to cardiopulmonary resuscitation guidelines and, in some cases, patient outcomes. Veterinary studies investigating these issues are lacking, and development of initial guidelines is a crucial first step. Crit Care 2012; 22(S1): 13-25) (J Vet Emerg

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Section: Evidence Summarymentioning

confidence: 99%

RECOVERevidence and knowledge gap analysis on veterinaryCPR. Part 2: Preparedness and prevention

McMichael

Herring

Fletcher

et al. 2012

J Vet Emergen Crit Care

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show abstract

“…When compared within individual systems, 4 studies suggested improved survival to hospital discharge when physicians were part of the resuscitation team (LOE 2 313,314 ; LOE 3 315,316 ) and 10 studies suggested no difference in survival of the event (LOE 2) 307,313 or survival to hospital discharge (LOE 2). 307,315,[317][318][319][320][321][322][323] One study found lower survival of the event when physicians were part of the resuscitation team (LOE 2). 323 Studies indirectly comparing resuscitation outcomes between physician-staffed and other systems are difficult to interpret because of the heterogeneity among systems, independent of physician-staffing (LOE 5).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 12: Education, Implementation, and Teams

Mancini¹,

Soar²,

Bhanji³

et al. 2010

Circulation

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“…The presence of a physician before hospital arrival is believed to lead to effective cardiopulmonary resuscitation (CPR) for patients with out-of-hospital cardiac arrest (OHCA) [1] – [3] . Several studies have described ambulance crews staffed with a physician including cardiac ambulance crews [4] , helicopter ambulance teams [5] and physician-manned ambulance (PMA) teams comprised of two paramedics and an anesthesiologist [6] . However, findings concerning whether the presence of a physician before hospital arrival leads to improved patient outcome during CPR are mixed.…”

Section: Introductionmentioning

confidence: 99%

Physician Presence in an Ambulance Car Is Associated with Increased Survival in Out-of-Hospital Cardiac Arrest: A Prospective Cohort Analysis

et al. 2014

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The presence of a physician seems to be beneficial for pre-hospital cardiopulmonary resuscitation (CPR) of patients with out-of-hospital cardiac arrest. However, the effectiveness of a physician's presence during CPR before hospital arrival has not been established. We conducted a prospective, non-randomized, observational study using national data from out-of-hospital cardiac arrests between 2005 and 2010 in Japan. We performed a propensity analysis and examined the association between a physician's presence during an ambulance car ride and short- and long-term survival from out-of-hospital cardiac arrest. Specifically, a full non-parsimonious logistic regression model was fitted with the physician presence in the ambulance as the dependent variable; the independent variables included all study variables except for endpoint variables plus dummy variables for the 47 prefectures in Japan (i.e., 46 variables). In total, 619,928 out-of-hospital cardiac arrest cases that met the inclusion criteria were analyzed. Among propensity-matched patients, a positive association was observed between a physician's presence during an ambulance car ride and return of spontaneous circulation (ROSC) before hospital arrival, 1-month survival, and 1-month survival with minimal neurological or physical impairment (ROSC: OR = 1.84, 95% CI 1.63–2.07, p = 0.00 in adjusted for propensity and all covariates); 1-month survival: OR = 1.29, 95% CI 1.04–1.61, p = 0.02 in adjusted for propensity and all covariates); cerebral performance category (1 or 2): OR = 1.54, 95% CI 1.03–2.29, p = 0.04 in adjusted for propensity and all covariates); and overall performance category (1 or 2): OR = 1.50, 95% CI 1.01–2.24, p = 0.05 in adjusted for propensity and all covariates). A prospective observational study using national data from out-of-hospital cardiac arrests shows that a physician's presence during an ambulance car ride was independently associated with increased short- and long-term survival.

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Comparison of Results From a Cardiac Ambulance Manned by Medical or Non-Medical Personnel

Cited by 5 publications

References 0 publications

RECOVERevidence and knowledge gap analysis on veterinaryCPR. Part 2: Preparedness and prevention

RECOVERevidence and knowledge gap analysis on veterinaryCPR. Part 2: Preparedness and prevention

Part 12: Education, Implementation, and Teams

Physician Presence in an Ambulance Car Is Associated with Increased Survival in Out-of-Hospital Cardiac Arrest: A Prospective Cohort Analysis

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