J Korean Soc Emerg Med.  2023 Oct;34(5):394-402.

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

• Shin HM
• Lee Y
• Jung WJ
• Cha YS
• Cha KC
• Kim H
• Lee KH
• Hwang SO
• Kim OH

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.
Methods
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.

Keyword

Resuscitation; Air ambulances; Out-of-hospital cardiac arrests