J Med Assoc Thai 2021; 104 (9):1488-96

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Factors Associated with Successful Resuscitation during Out-of-Hospital Cardiac Arrest Performed By Surgico Medical Ambulance and Rescue Team (S.M.A.R.T), Division of Emergency Medical Service and Disaster, Faculty of Medicine Vajira Hospital, Navamindrad
Huabbangyang T Mail, Soion T , Promdee A , Nguanjinda K , Chamchan A , Chaisorn R , Thaitan D , Tudchomuang N , Mahayodsanan T , Klaiangthong R

Objective: To explore factors associated with successful on-scene cardiac resuscitation and to identify the number of patients with return of spontaneous circulation (ROSC).

Materials and Methods: The present study was a retrospective descriptive study. Data were collected from the Surgico Medical Ambulance and Rescue Team at the Emergency Medicine Service and Disaster Division, Navamindradhiraj University. Data were recorded by using the overall operation reports of the Bangkok Emergency Medical Service Centre (Erawan Centre) about advanced life support. The reports used the code followed by the Emergency Medical Triage Protocol and Criteria Based Dispatch (CBD), CBD6 Red1, or followed by Response Code (RC) RC6 Red1, between May 2019 and April 2020.

Results: Two hundred seventy-three patients with out-of-hospital cardiac arrest (OHCA) were included in the present study. Seventy (25.6%) patients were successfully on-scene resuscitated, of which, 65.7% were male patients with an average age of 57.87 (standard deviation [SD] 21.6) years. However, 203 (74.4%) patients that received appropriated advanced resuscitation (non-ROSC) died on scene. Among patients in the successful resuscitation group and those in the deceased group, 65.7% and 61.6% were male, respectively (p=0.537). The mean age was 57.87 (SD 21.6) years and 65.8 (SD 20.21) years, respectively (p=0.006). In the multivariate analysis controlled for confounders, a significant association (p<0.05) was found between successful pre-hospital cardiac resuscitation on scene with the following four factors, traumatic cardiac arrest (adjusted odds ratio [OR] 4.18, 95% confidence interval [CI] 1.60 to 10.93, p=0.004), response time within eight minutes (adjusted OR 2.07, 95% CI 1.03 to 4.14, p=0.041), initial electrocardiogram with ventricular fibrillation (adjusted OR 2.63, 95% CI 1.13 to 6.12, p=0.025, and pulseless electrical activity (adjusted OR 2.89, 95% CI 1.26 to 6.64, p=0.012), and administration of resuscitation drug with epinephrine (adjusted OR 13.62, 95% CI 4.72 to 39.31, p<0.001).

Conclusion: In the present study, four factors were found to have a significant association with successful prehospital cardiac resuscitation on scene. Based on the knowledge discovered, these factors will develop on-scene CPR guidelines for the care of patients with OHCA for the authors’ emergency medical service personals.

Keywords: Success; Resuscitation; Prehospital cardiac arrest

DOI: doi.org/10.35755/jmedassocthai.2021.09.12759

Received 23 March 2021 | Revised 11 June 2021 | Accepted 15 June 2021

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