J Korean Med Sci.  2019 Sep;34(34):e141. 10.3346/jkms.2019.34.e141.

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

Affiliations
  • 1Department of Emergency Medicine, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.
  • 2Department of Emergency Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea. ryoo@knu.ac.kr
  • 3Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
  • 4Department of Emergency Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

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.

Keyword

Basic Life Support; Cardiac Arrest; Emergency Medical Services

MeSH Terms

Cardiopulmonary Resuscitation
Daegu
Emergency Medical Services
Hand*
Heart Arrest
Humans
Korea
Logistic Models
Observational Study
Odds Ratio
Out-of-Hospital Cardiac Arrest*
Prospective Studies
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