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Application of a Dual-Dispatch System for Out-of-Hospital Cardiac Arrest Patients: Will More Hands Save More Lives?

Journal of Korean Medical Science 2019년 34권 34호 p.141 ~ 141
김정호 ( Kim Jung-Ho ) - Yeungnam University College of Medicine Yeungnam University Hospital Department of Emergency Medicine

 ( Ryoo Hyun-Wook ) - Kyungpook National University School of Medicine Kyungpook National University Hospital Department of Emergency Medicine
 ( Kim Jong-Yeon ) - Catholic University of Daegu School of Medicine Department of Preventive Medicine
안재윤 ( Ahn Jae-Yun ) - Kyungpook National University School of Medicine Kyungpook National University Hospital Department of Emergency Medicine
 ( Moon Sung-Bae ) - Kyungpook National University School of Medicine Kyungpook National University Hospital Department of Emergency Medicine
 ( Lee Dong-Eun ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Emergency Medicine
 ( Mun You-Ho ) - Yeungnam University College of Medicine Yeungnam University Hospital Department of Emergency Medicine

Abstract


Background: Recovery after out-of-hospital cardiac arrest (OHCA) is difficult, and emergency medical services (EMS) systems apply various strategies to improve outcomes. Multi-dispatch is one means of providing high-quality cardiopulmonary resuscitation (CPR), but no definitive best-operation guidelines are available. We assessed the effects of a basic life support (BLS)-based dual-dispatch system for OHCA.

Methods: This prospective observational study of 898 enrolled OHCA patients, conducted in Daegu, Korea from March 1, 2015 to June 30, 2016, involved patients > 18 years old with suspected cardiac etiology OHCA. In Daegu, EMS started a BLS-based dual-dispatch system in March 2015, for cases of cardiac arrest recognition by a dispatch center. We assessed the association between dual-dispatch and OHCA outcomes using multivariate logistic regressions. We also analyzed the effect of dual-dispatch according to the stratified on-scene time.

Results: Of 898 OHCA patients (median, 69.0 years; 65.5% men), dual-dispatch was applied in 480 (53.5%) patients. There was no difference between the single-dispatch group (SDG) and the dual-dispatch group (DDG) in survival at discharge and neurological outcomes (survival discharge, P = 0.176; neurological outcomes, P = 0.345). In the case of less than 10 minutes of on-scene time, the adjusted odds ratio was 1.749 (95% confidence interval [CI], 0.490?6.246) for survival discharge and 6.058 (95% CI, 1.346?27.277) for favorable neurological outcomes in the DDG compared with the SDG.

Conclusion: Dual-dispatch was not associated with better OHCA outcomes for the entire study population, but showed favorable neurological outcomes when the on-scene time was less than 10 minutes.

키워드

Basic Life Support; Cardiac Arrest; Emergency Medical Services
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