Survey of resuscitation practices at emergency medical service agencies in the U.S

• Type of Material: Article
• Authors: Paul S. Chan, Saint Luke's Mid America Heart Institute; Bryan McNally, Emory University; Rabab Al-Araji, Emory University; Kevin Kennedy, Saint Luke's Mid America Heart Institute; Marci Kennedy, Saint Luke's Mid America Heart Institute; Marina Del Rios, University of Iowa, Iowa City; Jessica Sperling, Duke University; Comilla Sasson, University of Colorado, Aurora; Khadijah Breathett, Indiana University; Kimberly C. Dukes, University of Iowa, Iowa City; Saket Girotra, University of Texas-Southwestern Medical Center
• Language: English
• Date: 2023-10-11
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): https://doi.org/10.1016/j.resplu.2023.100483
• Title of Journal or Parent Work: Resuscitation Plus
• Volume: 16
• Start Page: 100483
• Grant/Funding Information: Dr. Girotra is also supported by funding from the National Heart, Lung, and Blood Institute (R56HL158803).; Dr. Breathett has research funding from National Heart, Lung, and Blood Institute (K01HL142848, R01HL159216, R56HL159216, and L30HL148881).; Dr. Chan receives funding from the American Heart Association and the Missouri American College of Cardiology.; Dr. McNally is the Executive Director of CARES, which receives funding from the American Red Cross and American Heart Association.; Drs. Chan, Girotra, Breathett, Del Rios, Dukes, Sperling, and Sasson receive research funding from the National Heart, Lung, and Blood Institute (R01HL160734).
• Keywords: EMS; Outcomes; Survival; Cardiac arrest
• Research Categories: Health Sciences, Public Health; Health Sciences, Health Care Management

Abstract

Background Survival for out-of-hospital cardiac arrest (OHCA) varies across emergency medical service (EMS) agencies. Yet, little is known about resuscitation response and quality improvement activities at EMS agencies. We describe herein a novel survey to EMS agencies in a U.S. registry for OHCA. Methods Using data from the Cardiac Arrest Registry to Enhance Survival (CARES), we identified 577 EMS agencies with ≥10 OHCA cases annually between 2015 and 2019 that remained active in CARES. We administered a survey to EMS directors regarding agency characteristics, cardiac arrest response, relationships with first responders and dispatchers, quality improvement activities and perceived barriers in the community. Results Of eligible EMS agencies, 470 (81.5%) completed the survey. The high completion rate was likely due to frequent personalized emails and phone calls, liaising with CARES state coordinators to encourage survey response, and multiple periodic drawings of an automated external defibrillator during the survey period for participating EMS agencies. The survey examined rates of resuscitation training modalities; use of resuscitation equipment and devices in the field; frequency of simulation; non-EMS stakeholder response to OHCA (dispatchers, fire, police); quality improvement; and community factors affecting bystander response to OHCA. Conclusions In this study design paper on the RED-CASO survey, we provide summary data on EMS agency characteristics in the U.S. Upon linkage to CARES patient-level data, this survey will provide critical insights into ‘best practices’ at EMS agencies with the highest OHCA survival rates as well as provide insights into current disparities in outcomes.