EBQ:Paramedic Trial: Difference between revisions
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91 ambulance stations (selected for being urban and semi-urban) from 4 UK National Health Service (NHS) Ambulance Services (West Midlands, North East England, Wales, South Central). | 91 ambulance stations (selected for being urban and semi-urban) from 4 UK National Health Service (NHS) Ambulance Services (West Midlands, North East England, Wales, South Central). | ||
===Patient Demographics=== | ===Patient Demographics=== | ||
*No major differences in baseline characteristics | |||
**Mean age ~71 years | |||
**63% male | |||
**~87% presumed cardiac etiology | |||
**~82% arrests occurred at home | |||
**~62% witnessed arrests | |||
**~44% bystander CPR performed before EMS arrival | |||
**~6.4 minute response time from call to EMS arrival | |||
**~82% given IV medications | |||
**~46% intubated | |||
**~67% transported to hospital | |||
===Inclusion Criteria=== | ===Inclusion Criteria=== | ||
*Vehicle included in trial is first on scene | |||
*Patient in cardiac arrest outside of a hospital | |||
*Resuscitation attempted | |||
*Known or believed to be ≥18 years of age | |||
===Exclusion Criteria=== | ===Exclusion Criteria=== | ||
Latest revision as of 22:53, 7 August 2015
Under Review Journal Club Article
Perkins GD. et al.. "Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial". Lancet. 2015. 385(9972):947-55.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
Does prehospital LUCAS-2 mechanical CPR improve survival from out-of-hospital cardiac arrest?
Conclusion
The use of LUCAS-2 in non-traumatic, out-of-hospital cardiac arrests did not show improvement over manual CPR in patient survival to 30 days.
Major Points
- Survival to 30 days had no difference with 6% (LUCAS-2) vs. 7% (control)
- No difference in ROSC, survival of event, survival to 3 months, or survival to 12 months
- Decreased favorable neurologic outcome (CPC 1 or 2) in LUCAS-2 group
Study Design
Pragmatic, cluster randomized, controlled trial
Population
91 ambulance stations (selected for being urban and semi-urban) from 4 UK National Health Service (NHS) Ambulance Services (West Midlands, North East England, Wales, South Central).
Patient Demographics
- No major differences in baseline characteristics
- Mean age ~71 years
- 63% male
- ~87% presumed cardiac etiology
- ~82% arrests occurred at home
- ~62% witnessed arrests
- ~44% bystander CPR performed before EMS arrival
- ~6.4 minute response time from call to EMS arrival
- ~82% given IV medications
- ~46% intubated
- ~67% transported to hospital
Inclusion Criteria
- Vehicle included in trial is first on scene
- Patient in cardiac arrest outside of a hospital
- Resuscitation attempted
- Known or believed to be ≥18 years of age
Exclusion Criteria
- Cardiac arrest caused by trauma
- Known or apparent pregnancy