Paramedic exposure to out-of-hospital cardiac arrest is rare and declining in Victoria, Australia

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Abstract

Background and objective Paramedic exposure to out-of-hospital cardiac arrest (OHCA) may be an important factor in skill maintenance and quality of care. We aimed to describe the annual exposure rates of paramedics in the state of Victoria, Australia. Methodology We linked data from the Victorian Ambulance Cardiac Arrest Registry (VACAR) and Ambulance Victoria s employment dataset for 2003?2012. Paramedics were `exposed? to an OHCA if they attended a case where resuscitation was attempted. Individual rates were calculated for average annual exposure (number of OHCA exposures for each paramedic/years employed in study period) and the average number of days between exposures (total paramedic-days in study/total number of exposures in study). Results Over 10-years, there were 49,116 OHCAs and 5673 paramedics employed. Resuscitation was attempted in 44 of OHCAs. The typical `exposure? of paramedics was 1.4 (IQR = 0.0?3.0) OHCAs per year. Mean annual OHCA exposure declined from 2.8 in 2003 to 2.1 in 2012 (p = 0.007). Exposure was significantly less in those: employed part-time (p <0.001); in rural areas (p <0.001); and with lower qualifications (p <0.001). Annual exposure to paediatric and traumatic OHCAs was particularly low. It would take paramedics an average of 163 days to be exposed to an OHCA and up to 12.5 years for paediatric OHCAs, which occur relatively rarely. Conclusions Exposure of individual paramedics to resuscitation is low and has decreased over time. This highlights the importance of supplementing paramedic exposure with other methods, such as simulation, to maintain resuscitation skills particularly in those with low exposure and for rare case types.
Original languageEnglish
Pages (from-to)93 - 98
Number of pages6
JournalResuscitation
Volume89
DOIs
Publication statusPublished - 2015

Cite this

@article{9583eb45d0734dbbadc3f3594494c41f,
title = "Paramedic exposure to out-of-hospital cardiac arrest is rare and declining in Victoria, Australia",
abstract = "Background and objective Paramedic exposure to out-of-hospital cardiac arrest (OHCA) may be an important factor in skill maintenance and quality of care. We aimed to describe the annual exposure rates of paramedics in the state of Victoria, Australia. Methodology We linked data from the Victorian Ambulance Cardiac Arrest Registry (VACAR) and Ambulance Victoria s employment dataset for 2003?2012. Paramedics were `exposed? to an OHCA if they attended a case where resuscitation was attempted. Individual rates were calculated for average annual exposure (number of OHCA exposures for each paramedic/years employed in study period) and the average number of days between exposures (total paramedic-days in study/total number of exposures in study). Results Over 10-years, there were 49,116 OHCAs and 5673 paramedics employed. Resuscitation was attempted in 44 of OHCAs. The typical `exposure? of paramedics was 1.4 (IQR = 0.0?3.0) OHCAs per year. Mean annual OHCA exposure declined from 2.8 in 2003 to 2.1 in 2012 (p = 0.007). Exposure was significantly less in those: employed part-time (p <0.001); in rural areas (p <0.001); and with lower qualifications (p <0.001). Annual exposure to paediatric and traumatic OHCAs was particularly low. It would take paramedics an average of 163 days to be exposed to an OHCA and up to 12.5 years for paediatric OHCAs, which occur relatively rarely. Conclusions Exposure of individual paramedics to resuscitation is low and has decreased over time. This highlights the importance of supplementing paramedic exposure with other methods, such as simulation, to maintain resuscitation skills particularly in those with low exposure and for rare case types.",
author = "Dyson, {Kylie Louise} and Bray, {Janet Elizabeth} and Smith, {Karen Louise} and Bernard, {Stephen Anthony} and Straney, {Lahn David John} and Finn, {Judith C}",
year = "2015",
doi = "10.1016/j.resuscitation.2015.01.023",
language = "English",
volume = "89",
pages = "93 -- 98",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier",

}

TY - JOUR

T1 - Paramedic exposure to out-of-hospital cardiac arrest is rare and declining in Victoria, Australia

AU - Dyson, Kylie Louise

AU - Bray, Janet Elizabeth

AU - Smith, Karen Louise

AU - Bernard, Stephen Anthony

AU - Straney, Lahn David John

AU - Finn, Judith C

PY - 2015

Y1 - 2015

N2 - Background and objective Paramedic exposure to out-of-hospital cardiac arrest (OHCA) may be an important factor in skill maintenance and quality of care. We aimed to describe the annual exposure rates of paramedics in the state of Victoria, Australia. Methodology We linked data from the Victorian Ambulance Cardiac Arrest Registry (VACAR) and Ambulance Victoria s employment dataset for 2003?2012. Paramedics were `exposed? to an OHCA if they attended a case where resuscitation was attempted. Individual rates were calculated for average annual exposure (number of OHCA exposures for each paramedic/years employed in study period) and the average number of days between exposures (total paramedic-days in study/total number of exposures in study). Results Over 10-years, there were 49,116 OHCAs and 5673 paramedics employed. Resuscitation was attempted in 44 of OHCAs. The typical `exposure? of paramedics was 1.4 (IQR = 0.0?3.0) OHCAs per year. Mean annual OHCA exposure declined from 2.8 in 2003 to 2.1 in 2012 (p = 0.007). Exposure was significantly less in those: employed part-time (p <0.001); in rural areas (p <0.001); and with lower qualifications (p <0.001). Annual exposure to paediatric and traumatic OHCAs was particularly low. It would take paramedics an average of 163 days to be exposed to an OHCA and up to 12.5 years for paediatric OHCAs, which occur relatively rarely. Conclusions Exposure of individual paramedics to resuscitation is low and has decreased over time. This highlights the importance of supplementing paramedic exposure with other methods, such as simulation, to maintain resuscitation skills particularly in those with low exposure and for rare case types.

AB - Background and objective Paramedic exposure to out-of-hospital cardiac arrest (OHCA) may be an important factor in skill maintenance and quality of care. We aimed to describe the annual exposure rates of paramedics in the state of Victoria, Australia. Methodology We linked data from the Victorian Ambulance Cardiac Arrest Registry (VACAR) and Ambulance Victoria s employment dataset for 2003?2012. Paramedics were `exposed? to an OHCA if they attended a case where resuscitation was attempted. Individual rates were calculated for average annual exposure (number of OHCA exposures for each paramedic/years employed in study period) and the average number of days between exposures (total paramedic-days in study/total number of exposures in study). Results Over 10-years, there were 49,116 OHCAs and 5673 paramedics employed. Resuscitation was attempted in 44 of OHCAs. The typical `exposure? of paramedics was 1.4 (IQR = 0.0?3.0) OHCAs per year. Mean annual OHCA exposure declined from 2.8 in 2003 to 2.1 in 2012 (p = 0.007). Exposure was significantly less in those: employed part-time (p <0.001); in rural areas (p <0.001); and with lower qualifications (p <0.001). Annual exposure to paediatric and traumatic OHCAs was particularly low. It would take paramedics an average of 163 days to be exposed to an OHCA and up to 12.5 years for paediatric OHCAs, which occur relatively rarely. Conclusions Exposure of individual paramedics to resuscitation is low and has decreased over time. This highlights the importance of supplementing paramedic exposure with other methods, such as simulation, to maintain resuscitation skills particularly in those with low exposure and for rare case types.

UR - http://www.sciencedirect.com.ezproxy.lib.monash.edu.au/science/article/pii/S0300957215000416#

U2 - 10.1016/j.resuscitation.2015.01.023

DO - 10.1016/j.resuscitation.2015.01.023

M3 - Article

VL - 89

SP - 93

EP - 98

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -