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  • Prehosp Emerg Care · Oct 2013

    Recommendations on ambulance cardiopulmonary resuscitation in basic life support systems.

    • Marcus Eng Hock Ong, Sang Do Shin, Soon Swee Sung, Hideharu Tanaka, Matthew Huei-Ming, Kyoung Jun Song, Tatsuya Nishiuchi, Benjamin Sieu-Hon Leong, Sarah Abdul Karim, Chih-Hao Lin, Hyun Wook Ryoo, Hyun Ho Ryu, Taku Iwami, Kentaro Kajino, Patrick Chow-In Ko, Kyung Won Lee, Nathida Sumetchotimaytha, Robert Swor, Brent Myers, Kevin Mackey, Bryan McNally, and Asian EMS Council.
    • Department of Emergency Medicine, Singapore General Hospital, Singapore.
    • Prehosp Emerg Care. 2013 Oct 1;17(4):491-500.

    AimCardiopulmonary resuscitation (CPR) during ambulance transport can be a safety risk for providers and can affect CPR quality. In many Asian countries with basic life support (BLS) systems, patients experiencing out-of-hospital cardiac arrest (OHCA) are routinely transported in ambulances in which CPR is performed. This paper aims to make recommendations on best practices for CPR during ambulance transport in BLS systems.MethodsA panel consisting of 20 experts (including 4 North Americans) in emergency medical services (EMS) and resuscitation science was selected, and met over two days. We performed a literature review and selected 33 candidate issues in five core areas. Using Delphi methodology, the issues were classified into dichotomous (yes/no), multiple choice, and ranking questions. Primary consensus between experts was reached when there was more than 70% agreement. Questions with 60-69% agreement were made more specific and were submitted for a second round of voting.ResultsThe panel agreed upon 24 consensus statements with more than 70% agreement (2 rounds of voting). The recommendations cover the following: length of time on the scene; advanced airway at the scene; CPR prior to transport; rhythm analysis and defibrillation during transport; prehospital interventions; field termination of resuscitation (TOR); consent for TOR; destination hospital; transport protocol; number of staff members; restraint systems; mechanical CPR; turning off of the engine for rhythm analysis; alternative CPR; and feedback for CPR quality.ConclusionRecommendations for CPR during ambulance transport were developed using the Delphi method. These recommendations should be validated in clinical settings.

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