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- Jonsson, M., et al.
(author)
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Survival after out-of-hospital cardiac arrest is associated with area-level socioeconomic status
- 2019
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In: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 105:8, s. 632-638
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Journal article (peer-reviewed)abstract
- Objective Out-of-hospital cardiac arrest (OHCA) is a major cause of death in the Western world. In this study we aimed to investigate the relationship between area-level socioeconomic status (SES) and 30-day survival after OHCA. We hypothesised that high SES at an area level is associated with an improved chance of 30-day survival. Methods Patients with OHCA in Stockholm County between 1 January 2006 and 31 December 2015 were analysed retrospectively. To quantify area-level SES, we linked the patient's home address to 250 x 250/1000 x 1000 meter grids with aggregated information about income and education. We constructed multivariable logistic regression models in which area-level SES measures were adjusted for age, sex, emergency medical services response time, witnessed status, initial rhythm, aetiology, location and year of cardiac arrest. Results We included 7431 OHCAs. There was significantly greater 30-day survival (p=0.003) in areas with a high proportion of university-educated people. No statistically significant association was seen between median disposable income and 30-day survival. The adjusted OR for 30-day survival among patients in the highest educational quintile was 1.70 (95% CI 1.15 to 2.51) compared with patients in the lowest educational quintile. We found no significant interaction for sex. Positive trend with increasing area-level education was seen in both men and women but the trend was only statistically significant among men (p=0.012) Conclusions Survival to 30 days after OHCA is positively associated with the average educational level of the residential area. Area-level income does not independently predict 30-day survival after OHCA.
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| 2. |
- Kristiansson, M., et al.
(author)
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Drones can be used to provide dispatch centres with on-site photos before arrival of EMS in time critical incidents
- 2024
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In: Resuscitation. - 0300-9572 .- 1873-1570. ; , s. 110312-110312
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Journal article (peer-reviewed)abstract
- BackgroundDrones are able to deliver automated external defibrillators in cases of out-of-hospital cardiac arrest (OHCA) but can be deployed for other purposes. Our aim was to evaluate the feasibility of sending live photos to dispatch centres before arrival of other units during time-critical incidents.MethodsIn this retrospective observational study, the regional dispatch centre implemented a new service using five existing AED-drone systems covering an estimated 200 000 inhabitants in Sweden. Drones were deployed automatically over a 4-month study period (December 2022–April 2023) in emergency calls involving suspected OHCAs, traffic accidents and fires in buildings. Upon arrival at the scene, an overhead photo was taken and transmitted to the dispatch centre. Feasibility of providing photos in real time, and time delays intervals were examined.ResultsOverall, drones were deployed in 59/440 (13%) of all emergency calls: 26/59 (44%) of suspected OHCAs, 20/59 (34%) of traffic accidents, and 13/59 (22%) of fires in buildings.The main reasons for non-deployment were closed airspace and unfavourable weather conditions (68%). Drones arrived safely at the exact location in 58/59 cases (98%). Their overall median response time was 3:49 min, (IQR 3:18–4:26) vs. emergency medical services (EMS), 05:51 (IQR: 04:29–08:04) p-value for time difference between drone and EMS = 0,05. Drones arrived first on scene in 47/52 cases (90%) and the largest median time difference was found in suspected OHCAs 4:10 min, (IQR: 02:57–05:28). The time difference in the 5/52 (10%) cases when EMS arrived first the time difference was 5:18 min (IQR 2:19–7:38), p = NA. Photos were transmitted correctly in all 59 alerts. No adverse events occurred.ConclusionIn a newly implemented drone dispatch service, drones were dispatched to 13% of relevant EMS calls. When drones were dispatched, they arrived at scene earlier than EMS services in 90% of cases. Drones were able to relay photos to the dispatch centre in all cases.Although severely affected by closed airspace and weather conditions, this novel method may facilitate additional decision-making information during time-critical incidents.
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| 5. |
- Melby, V, et al.
(author)
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Patient comfort in pre-hospital emergency care : A challenge to clinicians.
- 2012
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In: Journal of Paramedic Practice. - : M A Healthcare Ltd.. - 1759-1376. ; 4:7, s. 389-399
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Journal article (peer-reviewed)abstract
- Aim: The aim of this paper is to report on a study that compared ambulance clinicians' views of two different types of patient coverings, focusing on core caring concepts such as comfort, dignity, and safety. Design: Ambulance clinicians' views were gathered in respect of two types of patient coverings, and 128 ambulance patients were randomly distributed into a control or experimental group receiving respectively either the traditional cotton blanket or a multi-layered TelesPro rescue covering. Views were gathered using a short questionnaire developed by the authors. Findings: Ambulance clinicians, in their own view, maintained the core caring concepts no matter which type of covering was used. Findings suggest strongly that the rescue covering provided for a superior patient experience in respect of all core concepts and one functional aspect. Conclusions: Ambulance clinicians undertake caring that encompasses the core caring concepts of comfort, safety, and dignity, while remaining vigilant to threats to these constituents of caring.
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| 7. |
- Nordberg, P, et al.
(author)
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The implementation of a dual dispatch system in out-of--hospital cardiac arrest is associated withimproved short and long term survival
- 2014
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In: European Heart Journal. - : SAGE Publications. - 2048-8726 .- 2048-8734. ; 3:4, s. 293-303
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Journal article (peer-reviewed)abstract
- AIMS: To determine the impact of a dual dispatch system, using fire fighters as first responders, in out-of-hospital cardiac arrest (OHCA) on short (30 days) and long term (three years) survival, and, to investigate the potential differences regarding in-hospital factors and interventions between the patient groups, such as the use of therapeutic hypothermia and cardiac catheterization. METHODS AND RESULTS: OHCAs from 2004 (historical controls) and 2006-2009 (intervention period) were included. During the intervention period, fire fighters equipped with automated external defibrillators (AEDs) were dispatched in suspected OHCA. Logistic regression analyses of outcome data included: the intervention with dual dispatch, sex, age, location, aetiology, witnessed status, bystander-cardiopulmonary resuscitation, first rhythm and therapeutic hypothermia. In total, 2581 OHCAs were included (historical controls n=620, intervention period n=1961). Fire fighters initiated cardiopulmonary resuscitation and connected an AED before emergency medical services' arrival in 41% of the cases. The median time from dispatch to arrival of first responder or emergency medical services shortened from 7.7 in the control period to 6.7 min in the intervention period (p<0.001). The 30-day survival improved from 3.9% to 7.6% (p=0.001), adjusted odds ratio 2.8 (confidence interval 1.6-4.9). Survival to three years increased from 2.4% to 6.5% (p<0.001), adjusted odds ratio 3.8 (confidence interval 1.9-7.6). In the logistic regression analysis including in-hospital factors we found no outcome benefit of therapeutic hypothermia. CONCLUSIONS: The implementation of a dual dispatch system using fire fighters in OHCA was associated with increased 30-day and three-year survival. No major differences in the in-hospital treatment were seen between the studied patient groups.
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