Factors affecting good prognosis for out-of-hospital cardiac arrest patients in interhospital helicopter transport in rural area

Shin, Ho Min; Lee, Yoonsuk; Jung, Woo Jin; Cha, Yong Sung; Cha, Kyoung-Chul; Kim, Hyun; Lee, Kang Hyun; Hwang, Sung Oh; Kim, Oh Hyun

J Korean Soc Emerg Med > Volume 34(5); 2023 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2023;34(5): 394-402.

Factors affecting good prognosis for out-of-hospital cardiac arrest patients in interhospital helicopter transport in rural area

Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Correspondence

Oh Hyun Kim ,Tel: 033-741-0114, Fax: 033-742-3030, Email: ohkim@yonsei.ac.kr,

Received: September 14, 2022; Revised: October 23, 2022 Accepted: October 26, 2022. Published online: October 31, 2023.

ABSTRACT

Objective:
Out-of-hospital cardiac arrest (OHCA) is a common cause of death and serious neurological morbidity. Efforts to reduce the mortality due to OHCA focus on the “chain of survival.” The survival rates of OHCA patients are known to be related to prehospital conditions.
Method:
Helicopter emergency medical services (HEMS) provide a variety of procedures, such as cardiopulmonary resuscitation (CPR) and other advanced interventions that may improve the prognosis of OHCA patients. HEMS can respond quickly to long-distance or difficult-to-access places. This study attempted to investigate the characteristics of OHCA patients who had utilized inter-hospital air transport. The study was an observational cohort study using prospective data from a single suburban tertiary care hospital over a period of 7 years. The study data were analyzed using the SPSS version 28 software.
Results:
In the survival group, the cause was more cardiac-related than in the death group (54% vs. 23.4%; P<0.001). CPR by bystanders and defibrillation by the emergency medical technicians were more frequent than in the death group. Also, the initial rhythm of the survivors was mainly VT or VF (48.0% vs. 14.9%; P<0.003).
Conclusion:
In the HEMS mission with OHCA arrest, the patients with a cardiac origin, witnessed arrest, those with a shockable rhythm and shorter CPR time had a trend towards better survival and neurological outcomes in this study.

Key words: Resuscitation; Air ambulances; Out-of-hospital cardiac arrests