Evaluation of Pre-hospital Care Provided by 119 Rescuers in Out-of-Hospital Cardiac Arrests Transported to Tertiary Emergency Department Covering a Rural Area

Jun,  Yong Kyu; Jo,  Si On; Jeong,  Tae Oh; Jin,  Young Ho; Lee,  Jae Baek; Yoon,  Jae Chol; Kim,  Jin Hoe; Lee,  Hyeon Gyeong

J Korean Soc Emerg Med > Volume 22(5); 2011 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2011;22(5): 391-399.

Evaluation of Pre-hospital Care Provided by 119 Rescuers in Out-of-Hospital Cardiac Arrests Transported to Tertiary Emergency Department Covering a Rural Area

Yong Kyu Jun, Si On Jo, Tae Oh Jeong, Young Ho Jin, Jae Baek Lee, Jae Chol Yoon, Jin Hoe Kim, Hyeon Gyeong Lee

¹Department of Emergency Medicine, Chonbuk National University Hospital, Jeonju, Korea. jcyoon75@jbnu.ac.kr
²Department of Emergency Medical Service, College of Visual Image and Health, Kongju National University, Kongju, Korea.
³Department of Emergency Medical Technology, Seonam University, Asan, Korea.

ABSTRACT

PURPOSE:
The large disparity in outcomes of out-of-hospital cardiac arrest (OHCA) between communities makes it important determine pre-hospital factors associated with outcome of OHCA. The study evaluated pre-hospital care performed by 119 rescuers in OHCA and investigated pre-hospital factors that influenced return of spontaneous circulation (ROSC) and automated external defibrillator (AED) use.
METHODS:
We retrospectively analyzed 119 OHCA patients with presumed cardiac origin admitted to our emergency department transported by 119 rescuers from May 2007 to April 2010. Patients were divided according to achievement of ROSC and AED use prior to comparative analysis.
RESULTS:
Twenty six patients (21.8%) experienced ROSC and only five patients (4.2%) survived to discharge. In the study area, scene-to-hospital arrival time was significantly shorter in the ROSC group (15.0+/-5.8 minutes) than the non-ROSC group (19.4+/-9.1 minutes) (p=0.02) and electrocardiography (ECG) application was associated with non-AED use.
CONCLUSION:
Cooperation of emergency medical services and hospitals in the community to reduce hospital arrival time is needed to improve ROSC in OHCA patients. AED use on scene prior to ECG application will be encouraged and higher level training and continuous education of 119 rescuers for AED use will be needed to enhance AED application.

Key words: Out-of-Hospital cardiac arrest, Emergency medical services, Automated external defibrillators