Details

Autor(en) / Beteiligte

• DeRuyter, Nicolaas P
• Husain, Sofia
• Yin, Lihua
• Olsufka, Michele
• McCoy, Andrew M
• Maynard, Charles
• Cobb, Leonard A
• Rea, Thomas D
• Sayre, Michael R

Titel

The impact of first responder turnout and curb-to-care intervals on survival from out-of-hospital cardiac arrest

Ist Teil von

• Resuscitation, 2017-04, Vol.113, p.51-55

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2017

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Abstract Purpose Patients with out-of-hospital cardiac arrest (OHCA) are more likely to survive when emergency medical services (EMS) arrive quickly. The purpose of this study was to describe the time response in OHCA with special attention to EMS intervals before wheels roll (Turnout) and after wheels stop (Curb-to-Care) to understand how these intervals contribute to total time response and how they relate to clinical outcome. Methods We retrospectively evaluated responses to adult non-traumatic OHCA on EMS arrival from 2009 to 2014 in an urban, fire department based system. The overall call-to-care interval was comprised of four distinct time segments: (1) call received to EMS notification (Activation Interval), (2) EMS notification to vehicle wheels rolling (Turnout Interval), (3) EMS wheels rolling to address arrival interval (Travel Interval), and (4) arrival at scene address to hands-on EMS care (Curb-to-Care Interval). In addition, we created a new time interval (On-Feet Interval) comprised of the turnout and curb-to-care intervals. We used logistic regression to evaluate whether total EMS response interval and the discrete time intervals were related to survival to discharge. Results Of 1831 eligible cases, 1806 (98.6%) had complete time information. The mean call-to-care interval from 9-1-1 call receipt to first EMS chest compression was 7.2 ± 3.6 min. The mean call receipt to EMS activation interval was 58 ± 39 s, turnout interval was 63 ± 29 s, mean travel interval was 2.5 ± 1.3 min, and the mean curb-to-care interval was 2.4 ± 1.6 min. Collectively, the On Feet interval of turnout plus curb-to-care intervals accounted for about 50% of the total interval (3.5 ± 1.7 min). After adjustment for confounding variables, the “On Feet” interval was associated with OHCA survival (OR = 0.91 [95% CI = 0.83–1.00] for each additional minute). Conclusions Turnout and curb-to-care intervals collectively contributed to half of the total response interval in this urban EMS system. Thus measurement should incorporate turnout and curb-to-care intervals to accurately characterize the interval from call to care. These intervals provide distinct opportunities to reduce the professional response interval.