Positive Association Between Ambulance Double-Crewing and OHCA Outcomes: A New Zealand Observational Study

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aut.relation.articlenumber100187en_NZ
aut.relation.endpage100187
aut.relation.journalResuscitation Plusen_NZ
aut.relation.startpage100187
aut.relation.volume8en_NZ
dark.contributor.authorDicker, Ben_NZ
dark.contributor.authorGovender, Ken_NZ
dark.contributor.authorHowie, Gen_NZ
dark.contributor.authorSwain, Aen_NZ
dark.contributor.authorTodd, VFen_NZ
dc.date.accessioned2021-12-09T02:44:55Z
dc.date.available2021-12-09T02:44:55Z
dc.date.copyright2021-12en_NZ
dc.date.issued2021-12en_NZ
dc.description.abstractBackground and objectives New Zealand emergency medical service (EMS) crewing configurations generally place one (single) or two (double) crew on each responding ambulance unit. Recent studies demonstrated that double-crewing was associated with improved survival from out-of-hospital cardiac arrest (OHCA), therefore single-crewed ambulances have been phased out. We aimed to determine the association between this crewing policy change and OHCA outcomes in New Zealand. Methods This is a retrospective observational study using data from the St John OHCA Registry on patients treated during two different time periods: the Pre-Period (1 October 2013–30 June 2015), when single-crewed ambulances were in use by EMS, and the Post-Period (1 July 2016–30 June 2018) when single-crewed ambulances were being phased out. Geographic areas identified as having low levels of double crewing during the Pre-Period were selected for investigation. The outcome of survival to thirty-days post-OHCA was investigated using logistic regression analysis. Results The proportion of double-crewed ambulances arriving at OHCA events increased in the Post-Period (81.8%) compared to the Pre-Period (67.5%) (p ≤ 0.001). Response times decreased by two minutes (Pre-Period: median 8 min, IQR [6–11], Post-Period: median 6 min, IQR [4–9]; p ≤ 0.001). Thirty-day survival was significantly improved in the Post-Period (OR 1.63, 95%CI (1.04–2.55), p = 0.03). Conclusions An association between improved OHCA survival following increased responses by double-crewed ambulances was demonstrated. This study suggests that improvements in resourcing are associated with improved OHCA outcomes.
dc.identifier.citationResuscitation Plus, Volume 8, December 2021, 100187.
dc.identifier.doi10.1016/j.resplu.2021.100187en_NZ
dc.identifier.issn2666-5204en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/14796
dc.languageenen_NZ
dc.publisherElsevier BVen_NZ
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S2666520421001120
dc.rights(C) 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/)
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectResuscitation; Crew configuration; Double crewing; Survival; ROSC; EMS; New Zealand; OHCA; Cardiac Arrest; Out-of Hospital; Pre-Hospital; Paramedic; Ambulance
dc.titlePositive Association Between Ambulance Double-Crewing and OHCA Outcomes: A New Zealand Observational Studyen_NZ
dc.typeJournal Article
pubs.elements-id445641
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Faculty of Health & Environmental Science
pubs.organisational-data/AUT/Faculty of Health & Environmental Science/School of Clinical Sciences
pubs.organisational-data/AUT/Faculty of Health & Environmental Science/School of Clinical Sciences/Paramedicine Department
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HH Clinical Sciences 2018 PBRF
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