Background
Prehospital treatment of out-of-hospital cardiac arrest
Prehospital critical care for OHCA
Economic considerations regarding prehospital treatment of OHCA
Publications | Intervention | Incremental cost: Effectiveness $/Life saved |
---|---|---|
Ornato (1988) Jackobsson (1987) | Basic life support providers | $2,800–12,900 |
Hallstrom (1981) Nichol (1998) Jermyn (2000) Forrer (2002) Nichol (2003) | Defibrillation (pre-hospital provider and/or lay responders) | $7,800–$190,000 |
Nichol (1996) | Reducing EMS response time for OHCA | $262,700–$1,134,400 |
Urban (1981) Valenzuela (1990) | Advanced cardiac life support providers | $91,900–$181,000 |
Aims and objectives
Methods
Research sites
Inclusion/ exclusion criteria
Data collection
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▪ Medical identifying number
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▪ Date and time
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▪ Location (public place, private location or nursing home)
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▪ Postcode of event (district level)
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▪ Age-group and gender of patient
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▪ Do Not Attempt Resuscitation order in place
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▪ EMS chest compressions
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▪ Witnessed event
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▪ Bystander CPR
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▪ Public access defibrillator used by bystander
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▪ Suspected cause
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▪ First EMS resource response time
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▪ First recorded cardiac rhythm
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▪ ROSC on arrival at hospital
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▪ Receiving hospital (if transported to hospital)
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▪ Survival to hospital discharge
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▪ Medical identifying number
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▪ Stand down prior to arrival at patient
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▪ CCT requested by ALS ambulance crew on scene
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▪ CCT members: Critical care paramedic and/or doctor
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▪ CCT response time
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▪ Interventions delivered during cardiac arrest
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▪ Interventions delivered after return of spontaneous circulation (ROSC)
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▪ Transport decisions and modalities
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▪ Provider decision to not provide full critical care in patient’s best interest