Effects of Smart Advanced Life Support protocol implementation including CPR coaching during out-of-hospital cardiac arrest
- Authors
- Kim, Gi Woon; Moon, Hyung Jun; Lim, Hoon; Kim, Yu Jin; Lee, Choung Ah; Park, Yong Jin; Lee, Kyoung Mi; Woo, Jae Hyug; Cho, Jin Seong; Jeong, Won Jung; Choi, Hyuk Joong; Kim, Chang Sun; Choi, Han Joo; Choi, Il Kug; Heo, Nam Hun; Park, Jung Soo; Lee, Young Hwan; Park, Seung Min; Jeong, Dong Kil
- Issue Date
- Jun-2022
- Publisher
- W B SAUNDERS CO-ELSEVIER INC
- Keywords
- Advanced cardiac life support; Emergency medical dispatch; Out-of-hospital cardiac arrest
- Citation
- American Journal of Emergency Medicine, v.56, pp.211 - 217
- Journal Title
- American Journal of Emergency Medicine
- Volume
- 56
- Start Page
- 211
- End Page
- 217
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/84806
- DOI
- 10.1016/j.ajem.2022.03.050
- ISSN
- 0735-6757
- Abstract
- Purpose: The aim of this study was to compare out-of-hospital cardiac arrest (OHCA) outcomes before and after implementation of Smart Advanced Life Support (SALS) protocol incorporating changes in cardiopulmonary resuscitation (CPR) assistance and coaching by physicians via real-time video calls. Methods: A prospective before-and-after multi-regional observational study was conducted between January 2014 and December 2018. In January 2016, emergency medical service (EMS) providers adopted an integrated CPR coaching by physicians via real-time video call via SALS to treat patients with OHCA focusing on high-quality cardiopulmonary resuscitation. Propensity score matching was performed to match patients. Patients' outcomes using conventional protocol were then compared with those of patients using the SALS protocol. Results: Among 26,349 OHCA cases, 2351 patients and 7261 patients were enrolled during the pre-intervention and the post-intervention periods, respectively. Multivariate analysis showed that SALS was independently associated with favorable neurological outcomes [odds ratio (OR): 2.20; 95% confidence interval (CI): 1.62–2.99]. A total of 2096 patients were propensity score-matched and the two groups were well balanced. In the matched cohort, the use of SALS protocol was still associated with increased prehospital return of spontaneous circulation (ROSC) (OR: 3.83, 95% CI: 2.80–5.26), survival to discharge (OR: 1.68; 95% CI: 1.20–2.34), and favorable neurological outcomes (OR: 1.83; 95% CI: 1.19–2.82). Conclusion: A multidisciplinary SALS protocol for the resuscitation of patients with OHCA was associated with increased prehospital ROSC, survival to discharge, and good neurologic outcomes compared with traditional resuscitation protocol. © 2022 Elsevier Inc.
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