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

Hampton, John R.; Dowling, Mary; Nicholas, Colin

doi:10.1016/s0140-6736(77)91384-8

Cited by 43 publications

(2 citation statements)

References 8 publications

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“…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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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 department's reluctance was in part based on clinical trials in Nottingham of one of the "mobile coronary care units" that at that time were considered to be the appropriate means of transport for patients with heart attacks. [2][3][4] The department subsequently, however, recommended advanced training for ambulance crews, and the official training scheme being tried consists ofan eight week course (half of it residential) in which the skills of defibrillation, endotracheal intubation, intravenous infusion, and drug administration are taught.56 The Nottingham mobile unit was considered to be insufficiently effective and was taken out of service in 1976. We subsequently developed a simple training scheme, with the aim of making a defibrillator part of the standard equipment in all ambulances handling emergency cases and training their crews in its use.…”

Section: Introductionmentioning

confidence: 99%

Advanced training for ambulance crews: implications from 403 consecutive patients with cardiac arrest managed by crews with simple training.

Rowley

Mounser

Garner

et al. 1987

BMJ

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Sixty seven ambulance staff in Nottinghamshire completed a simple extended training programme in managing cardiac arrest and using a defibrillator. This enabled around one third of the ambulance emergency shifts to be manned by such a crew, with a defibrillator as part of their standard equipment. Forty four of 403 consecutive patients who suffered cardiac arrest in the community were managed by these crews and survived to leave hospital.The training programme does not include endotracheal intubation, intravenous infusion, or drug administration. The new official advanced training course for ambulance crews, which includes these skills, is inappropriate in its methods and may delay widespread introduction of emergency ambulances equipped with defibrillators.

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Effectiveness of Advanced Paramedics in a Mobile Coronary Care System

Lewis¹

1979

JAMA

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The mobilized coronary care system in Columbus, Ohio, began with operation of a single vehicle with a physician in attendance. Currently, advanced emergency medical technician-paramedics work without direct physician supervision. When both experiences are compared, the results indicate that advanced emergency medical technician-paramedics working independently perform as well as physician counterparts.

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

Cited by 43 publications

References 8 publications

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

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

Advanced training for ambulance crews: implications from 403 consecutive patients with cardiac arrest managed by crews with simple training.

Effectiveness of Advanced Paramedics in a Mobile Coronary Care System

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