Paramedic Exposure to Out-of-Hospital Cardiac Arrest Resuscitation Is Associated with Patient Survival

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Abstract

Background-Although out-of-hospital cardiac arrest (OHCA) is a major public health problem, individual paramedics are rarely exposed to these cases. In this study, we examined whether previous paramedic exposure to OHCA resuscitation is associated with patient survival. Methods and Results-For the period 2003 to 2012, we linked data from the Victorian Ambulance Cardiac Arrest Registry to Ambulance Victoria's employment data set. We defined exposure as the number of times a paramedic attended an OHCA where resuscitation was attempted in the 3 years preceding each case. Using a multivariable model adjusting for known predictors of survival, we measured the association between paramedic OHCA exposure and patient survival to hospital discharge. During the study period, there were 4151 paramedics employed and 48 291 OHCAs (44% with resuscitation attempted). The median exposure of all paramedics was 2 (interquartile range 1-3) OHCAs/year. Eleven percent of paramedics were not exposed to any OHCA cases. Increased paramedic exposure was associated with reduced odds of attempted resuscitation (P6 to 11 (12%, adjusted odds ratio 1.26, 95% confidence interval 1.04-1.54), >11 to 17 (14%, adjusted odds ratio 1.29, 95% confidence interval 1.04-1.59), and >17 exposures (17%, adjusted odds ratio 1.50, 95% confidence interval 1.22-1.86). Paramedic years of experience were not associated with survival. Conclusions-Patient survival after OHCA significantly increases with the number of OHCAs that paramedics have previously treated.

Original languageEnglish
Pages (from-to)154-160
Number of pages7
JournalCirculation: Cardiovascular Quality and Outcomes
Volume9
Issue number2
DOIs
Publication statusPublished - 1 Mar 2016

Keywords

  • emergency medical services
  • employment
  • heart arrest
  • resuscitation
  • survival

Cite this

@article{621060c4773f4214a3cdfe91b96cd15b,
title = "Paramedic Exposure to Out-of-Hospital Cardiac Arrest Resuscitation Is Associated with Patient Survival",
abstract = "Background-Although out-of-hospital cardiac arrest (OHCA) is a major public health problem, individual paramedics are rarely exposed to these cases. In this study, we examined whether previous paramedic exposure to OHCA resuscitation is associated with patient survival. Methods and Results-For the period 2003 to 2012, we linked data from the Victorian Ambulance Cardiac Arrest Registry to Ambulance Victoria's employment data set. We defined exposure as the number of times a paramedic attended an OHCA where resuscitation was attempted in the 3 years preceding each case. Using a multivariable model adjusting for known predictors of survival, we measured the association between paramedic OHCA exposure and patient survival to hospital discharge. During the study period, there were 4151 paramedics employed and 48 291 OHCAs (44{\%} with resuscitation attempted). The median exposure of all paramedics was 2 (interquartile range 1-3) OHCAs/year. Eleven percent of paramedics were not exposed to any OHCA cases. Increased paramedic exposure was associated with reduced odds of attempted resuscitation (P6 to 11 (12{\%}, adjusted odds ratio 1.26, 95{\%} confidence interval 1.04-1.54), >11 to 17 (14{\%}, adjusted odds ratio 1.29, 95{\%} confidence interval 1.04-1.59), and >17 exposures (17{\%}, adjusted odds ratio 1.50, 95{\%} confidence interval 1.22-1.86). Paramedic years of experience were not associated with survival. Conclusions-Patient survival after OHCA significantly increases with the number of OHCAs that paramedics have previously treated.",
keywords = "emergency medical services, employment, heart arrest, resuscitation, survival",
author = "Kylie Dyson and Bray, {Janet E.} and Karen Smith and Stephen Bernard and Lahn Straney and Judith Finn",
year = "2016",
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doi = "10.1161/CIRCOUTCOMES.115.002317",
language = "English",
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T1 - Paramedic Exposure to Out-of-Hospital Cardiac Arrest Resuscitation Is Associated with Patient Survival

AU - Dyson, Kylie

AU - Bray, Janet E.

AU - Smith, Karen

AU - Bernard, Stephen

AU - Straney, Lahn

AU - Finn, Judith

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background-Although out-of-hospital cardiac arrest (OHCA) is a major public health problem, individual paramedics are rarely exposed to these cases. In this study, we examined whether previous paramedic exposure to OHCA resuscitation is associated with patient survival. Methods and Results-For the period 2003 to 2012, we linked data from the Victorian Ambulance Cardiac Arrest Registry to Ambulance Victoria's employment data set. We defined exposure as the number of times a paramedic attended an OHCA where resuscitation was attempted in the 3 years preceding each case. Using a multivariable model adjusting for known predictors of survival, we measured the association between paramedic OHCA exposure and patient survival to hospital discharge. During the study period, there were 4151 paramedics employed and 48 291 OHCAs (44% with resuscitation attempted). The median exposure of all paramedics was 2 (interquartile range 1-3) OHCAs/year. Eleven percent of paramedics were not exposed to any OHCA cases. Increased paramedic exposure was associated with reduced odds of attempted resuscitation (P6 to 11 (12%, adjusted odds ratio 1.26, 95% confidence interval 1.04-1.54), >11 to 17 (14%, adjusted odds ratio 1.29, 95% confidence interval 1.04-1.59), and >17 exposures (17%, adjusted odds ratio 1.50, 95% confidence interval 1.22-1.86). Paramedic years of experience were not associated with survival. Conclusions-Patient survival after OHCA significantly increases with the number of OHCAs that paramedics have previously treated.

AB - Background-Although out-of-hospital cardiac arrest (OHCA) is a major public health problem, individual paramedics are rarely exposed to these cases. In this study, we examined whether previous paramedic exposure to OHCA resuscitation is associated with patient survival. Methods and Results-For the period 2003 to 2012, we linked data from the Victorian Ambulance Cardiac Arrest Registry to Ambulance Victoria's employment data set. We defined exposure as the number of times a paramedic attended an OHCA where resuscitation was attempted in the 3 years preceding each case. Using a multivariable model adjusting for known predictors of survival, we measured the association between paramedic OHCA exposure and patient survival to hospital discharge. During the study period, there were 4151 paramedics employed and 48 291 OHCAs (44% with resuscitation attempted). The median exposure of all paramedics was 2 (interquartile range 1-3) OHCAs/year. Eleven percent of paramedics were not exposed to any OHCA cases. Increased paramedic exposure was associated with reduced odds of attempted resuscitation (P6 to 11 (12%, adjusted odds ratio 1.26, 95% confidence interval 1.04-1.54), >11 to 17 (14%, adjusted odds ratio 1.29, 95% confidence interval 1.04-1.59), and >17 exposures (17%, adjusted odds ratio 1.50, 95% confidence interval 1.22-1.86). Paramedic years of experience were not associated with survival. Conclusions-Patient survival after OHCA significantly increases with the number of OHCAs that paramedics have previously treated.

KW - emergency medical services

KW - employment

KW - heart arrest

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