Yorifuji, Takashi Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap
Tahara, Yoshio National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine
Yonemoto, Naohiro National Center of Neurology and Psychiatry
Nonogi, Hiroshi Shizuoka General Hospital, Intensive Care Center
Nagao, Ken Nihon University Hospital, Cardiovascular Center
Ikeda, Takanori Toho University Faculty of Medicine, Department of Cardiovascular Medicine
Sato, Naoki Kawaguchi Cardiovascular and Respiratory Hospital, Cardiovascular Medicine
Tsutsui, Hiroyuki Kyushu University Faculty of Medical Sciences, Department of Cardiovascular Medicine
Background Emergency life-saving technicians (ELSTs) are specially trained prehospital medical providers believed to provide better care than basic emergency medical technicians (BEMTs). ELSTs are certified to perform techniques such as administration of advanced airways or adrenaline and are considered to have more knowledge; nevertheless, ELSTs’ effectiveness over BEMTs regarding out-of-hospital cardiac arrest (OHCA) remains unclear. We investigated whether the presence of an ELST improves OHCA patient outcomes. Methods In a retrospective study of adult OHCA patients treated in Japan from 2011 to 2015, we compared two OHCA patient groups: patients transported with at least one ELST and patients transported by only BEMTs. The primary outcome measure was one-month favorable neurological outcomes, defined as Cerebral Performance Category ≤ 2. A multivariable logistic regression model was used to calculate odds ratios (ORs) and their confidence intervals (CIs) to evaluate the effect of ELSTs. Results Included were 552,337 OHCA patients, with 538,222 patients in the ELST group and 14,115 in the BEMT group. The ELST group had a significantly higher odds of favorable neurological outcomes (2.5% vs. 2.1%, adjusted OR 1.39, 95% CI 1.17–1.66), one-month survival (4.9% vs. 4.1%, adjusted OR 1.37, 95% CI 1.22–1.54), and return of spontaneous circulation (8.1% vs. 5.1%, adjusted OR 1.90, 95% CI 1.72–2.11) compared with the BEMT group. However, ELSTs’ limited procedure range (adrenaline administration or advanced airway management) did not promote favorable neurological outcomes. Conclusions Compared with the BEMT group, transport by the ELST group was associated with better neurological outcomes in OHCA.
Emergency medical services
Advanced life support
This fulltext is available in May 2021.