Application of a Dual-Dispatch System for Out-of-Hospital Cardiac Arrest Patients: Will More Hands Save More Lives?

• Published in: Journal of Korean medical science Vol. 34; no. 34; pp. e141 - 10
• Main Authors: Kim, Jung Ho, Ryoo, Hyun Wook, Kim, Jong-yeon, Ahn, Jae Yun, Moon, Sungbae, Lee, Dong Eun, Mun, You Ho
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 02.09.2019; 대한의학회
• Subjects: Aged; Cardiopulmonary Resuscitation; Emergency Medical Dispatch - methods; Emergency Medical Services; Female; Humans; Logistic Models; Male; Middle Aged; Odds Ratio; Original; Out-of-Hospital Cardiac Arrest - mortality; Out-of-Hospital Cardiac Arrest - pathology; Prospective Studies; Republic of Korea; Survival Rate; 의학일반; Republic of Korea; Cardiac Arrest; Emergency Medical Services; Basic Life Support
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2019.34.e141

Recovery after out-of-hospital cardiac arrest (OHCA) is difficult, and emergency medical services (EMS) systems apply various strategies to improve outcomes. Multi-dispatch is one means of providing high-quality cardiopulmonary resuscitation (CPR), but no definitive best-operation guidelines are available. We assessed the effects of a basic life support (BLS)-based dual-dispatch system for OHCA. This prospective observational study of 898 enrolled OHCA patients, conducted in Daegu, Korea from March 1, 2015 to June 30, 2016, involved patients > 18 years old with suspected cardiac etiology OHCA. In Daegu, EMS started a BLS-based dual-dispatch system in March 2015, for cases of cardiac arrest recognition by a dispatch center. We assessed the association between dual-dispatch and OHCA outcomes using multivariate logistic regressions. We also analyzed the effect of dual-dispatch according to the stratified on-scene time. Of 898 OHCA patients (median, 69.0 years; 65.5% men), dual-dispatch was applied in 480 (53.5%) patients. There was no difference between the single-dispatch group (SDG) and the dual-dispatch group (DDG) in survival at discharge and neurological outcomes (survival discharge, = 0.176; neurological outcomes, = 0.345). In the case of less than 10 minutes of on-scene time, the adjusted odds ratio was 1.749 (95% confidence interval [CI], 0.490-6.246) for survival discharge and 6.058 (95% CI, 1.346-27.277) for favorable neurological outcomes in the DDG compared with the SDG. Dual-dispatch was not associated with better OHCA outcomes for the entire study population, but showed favorable neurological outcomes when the on-scene time was less than 10 minutes.