• Resuscitation · Jan 2014

    Impact of the number of on-scene emergency life-saving technicians and outcomes from out-of-hospital cardiac arrest in Osaka City.

    • Kentaro Kajino, Tetsuhisa Kitamura, Taku Iwami, Mohamud Daya, Marcus Eng Hock Ong, Chika Nishiyama, Tomohiko Sakai, Kayo Tanigawa-Sugihara, Sumito Hayashida, Tatsuya Nishiuchi, Yasuyuki Hayashi, Atsushi Hiraide, and Takeshi Shimazu.
    • Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamada-Oka, Suita City, Osaka 565-0871, Japan. Electronic address: kajihanapu@yahoo.co.jp.
    • Resuscitation. 2014 Jan 1;85(1):59-64.

    BackgroundsIn Japan, ambulance staffing for cardiac arrest responses consists of a 3-person unit with at least one emergency life-saving technician (ELST). Recently, the number of ELSTs on ambulances has increased since it is believed that this improves the quality of on-scene care leading to better outcomes from out-of-hospital cardiac arrest (OHCA). The objective of this study was to evaluate the association between the number of on-scene ELSTs and OHCA outcome.MethodsThis was a prospective cohort study of all bystander-witnessed OHCA patients aged ≥ 18 years in Osaka City from January 2005 to December 2007 using on an Utstein-style database. The primary outcome measure was one-month survival with favorable neurological outcome defined as a cerebral performance category ≤ 2. Multivariable logistic regression model were used to assess the contribution of the number of on-scene ELSTs to the outcome after adjusting for confounders.ResultsOf the 2408 bystander-witnessed OHCA patients, one ELST group was present in 639 (26.5%), two ELST were present in 1357 (56.4%), and three ELST group in 412 (17.1%). The three ELST group had a significantly higher rate of one-month survival with favorable neurological outcome compared with the one ELST group (8.0% versus 4.5%, adjusted OR 2.26, 95% CI 1.27-4.04), while the two ELST group did not (5.4% versus 4.5%, adjusted OR 1.34, 95% CI 0.82-2.19).ConclusionsCompared with the one on-scene ELST group, the three on-scene ELST group was associated with the improved one-month survival with favorable neurological outcome from OHCA in Osaka City.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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