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Evaluation of outcomes for cardiac arrest patients treated by Provincial Ambulance Service personnel in the Lower Mainland of British Columbia Wilson, Lynn E.


Information was collected in an eight and a half month prospective study about 358 recent cardiac disease-related cardiac arrest cases which were attended by personnel from the Provincial Ambulance Service in the Lower Mainland of British Columbia. When possible, advanced life support personnel (EMA Ills), regular ambulance attendants (EMA Ms) and Fire Department staff are dispatched to cardiac arrest calls. At the time of this study some areas in the region did not have advanced life support coverage, and some cardiac arrest calls occurred while the EMA Ills were already engaged with another case. Such calls, attended by EMA lis, but not by EMA Ills, served as the comparison group for paramedic performance in this study. Patient outcomes were compared at admission to hospital and at discharge from hospital for the group of patients treated by EMA Ms and the group of patients treated by EMA Ills, or by a combination of EMA Ills and EMA Ms. Strongly significant differences in initial outcome (hospital admission) were found between the two patient groups, with EMA IM patients faring better (p.=0.002). Marginally significant differences in final outcome (discharge alive) between the two patient groups were found, with the EMA III group again doing better (p.=0.10). Whether or not the receiving hospital had a coronary care unit was not associated with a difference in initial (p.=0.45) or final outcome (p.=1.0) for the entire group of patients in the study. Short time in arrest without CPR was associated with better initial outcome (p.=0.00), and with better final outcome (p.=0.01) for all patients. in the study, as was short time to definitive care (initial outcome p.=0.001; final outcome p.=0.03). EMA II patients had a better chance of survival when they arrested during attendance by EMA lis than they did when they were found in arrest. This study suggests that significantly more cardiac arrest victims reach hospital alive, and more survive to be discharged alive from hospital, when their prehospital treatment is provided by advanced life support personnel than when it is provided by regular ambulance personnel.

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