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The Effect of Ambulance Response Time on Survival Following Out-of-Hospital Cardiac Arrest
This research study will help the (Insert Hospital Name) to improve on ambulance response rate on “Out of hospital cardiac arrest.”
The Research Summary
“Out of hospital cardiac arrest” or the OHCA is a common cause of death in various countries. One significant parameter in responding to OHCA is the Ambulance response time. Almost 50 percent of patients die from uneventful cardiac arrest without any resuscitation attempt. Death occurs due to bystanders failing to observe these events or the emergency medical team fails to reach the scene at an appropriate time (Hansen et al. 303-305; Schewe, et al. 232-234). Medical stakeholders should engage in a fully-fledged process of survival, including bystander resuscitations, arrival of medical resuscitation team and providing intensive care unit services. This research aims to assess the impact of ambulance response time on the survival following OHCA. The research will conduct a literature search on the medical reports from secondary hospitals. The research expects that rapid ambulance response significantly leads to higher survival rates from “Out of hospital cardiac arrest”. This research study will provide more information to the existing literature about safety practices to reduce OHCA fatalities.
The Literature Review
Cardiac arrests taking place outside medical facilities is a major health concern. This medical condition is a primary cause of uneventful deaths especially in developed nations. According to Graesner, Jan-Thorsten, et al. (188), the reported cases of OHCA annually in the United States and Europe have been about 420,000 and 275,000. The survival rates of cardiac arrests are a major medical issue. Researchers have dwelt on understanding the medical requirements and strategies of improving the survival rates through clinical practices. Medical stakeholders have challenges of comprehending the epidemiological characteristics of cardiac arrest in different regions. Despite being a leading mortality cause, the world lacks adequate surveillance standards of monitoring cardiac arrest incidences and outcomes (Perkins et al. 1286-1290). Besides, anoxic neurologic injury is a significant concern in mortality and morbidity for patients that have undergone initial resuscitation. The current treatment of patients after resuscitation from cardiac arrest is supportive. However, resuscitation process has failed in some instances due to inappropriate emergency medical practices (Graesner, Jan-Thorsten, et al. 188-189). Medical practitioners have failed to follow the necessary guidelines that would improve performance in emergency situations.
In improving the treatment process for patients that suffer cardiac arrests out of hospital, medical practitioners have regulatory guidelines on CPR (Greif, Robert, et al. 289-291). However, the implementation of these requirements and integration of necessary resources, the failure of resuscitation process is prevalent for cardiac arrests occurring out of medical facilities (Wu et al. 136-140). Various studies found that the period before the cardiopulmonary resuscitation has an impact on the resuscitation outcomes (Hasselqvist-Ax, Riva, Herlitz, et al 2307-2309; Rajan, Shahzleen, et al. 2095-2096). Studies reveal that the rate of ambulance response impacts on the cardiopulmonary resuscitation and the survival rate (Rajan, Shahzleen, et al. 2095-2096). However, the research studies have not engaged in practical assessments of how ambulance response rate affects the success of resuscitation and thus survival rates.
Objectives
The main objectives of the study include:
- To find out the number of deaths due to OHCA in relations to ambulance response time. The researcher will get this information from the secondary hospital for 2018-2019 period,
- To find the number of patient discharge versus the number of deaths due to OHCA,
- To assess the number of patients in return of spontaneous circulation and admission, and
- To assess the return of spontaneous circulation of patients undergoing OHCA
Expected Results
The general result expectation is that ambulance response time has significant impact to high survival rates for patients with “Out of hospital cardiac arrest”. However, the researcher expects the number of deaths due to OHCA to be higher when the ambulance response is slow. Other factors that may affect the survival chances includes age, gender, past medical history, initial heart rhythm, and site where the patient collapsed.
Research Implications to Medical Practice
The research study is relevant for improving medical practitioner’s skill-set. The physician handles emergency medical services both in the intensive care unit and outpatient area (Truhlar, Deakin, and Soar 148-152). This research will help in understanding the relationship between faster ambulance response rate and the survival chances for patients that have cardiac arrest out of hospital. The information from the study will help in building systems that would enhance high response rate towards emergency calls on cardiac arrest (Truhlar, Deakin, and Soar 148-152). Besides, the researcher expects to assess the importance of return of spontaneous circulation in achieving resuscitation (Kupari, Skrifvars, and Kuisma 34). The emergency medical response team will also coordinate on specific aspects such as management of resuscitation process at the site of collapse, movement of the patient to the hospital and other emergency processes within the hospital.
Work Cited
Graesner, Jan-Thorsten, et al. “EuReCa ONE-27 Nations, ONE Europe, ONE Registry: a prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe.” Resuscitation.-Limerick, 1972, currens105 (2016): 188-195.
Greif, Robert, et al. “European resuscitation council guidelines for resuscitation 2015: section 10. Education and implementation of resuscitation.” Resuscitation 95 (2015): 288-301.
Hansen, Carolina Malta, et al. “The role of bystanders, first responders, and emergency medical service providers in timely defibrillation and related outcomes after out-of-hospital cardiac arrest: results from a statewide registry.” Resuscitation96 (2015): 303-309.
Hasselqvist-Ax I, Riva G, Herlitz J, et al. Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest. N Engl J Med. 2015; 372: 2307–2315.
Kupari, Petteri, Markus Skrifvars, and Markku Kuisma. “External validation of the ROSC after cardiac arrest (RACA) score in a physician staffed emergency medical service system.” Scandinavian journal of trauma, resuscitation and emergency medicine 25.1 (2017): 34.
Perkins, Gavin D., et al. “Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the utstein resuscitation registry templates for out-of-Hospital cardiac arrest: a statement for healthcare professionals from a task force of the international liaison committee on resuscitation (American heart association, European resuscitation council, Australian and New Zealand council on resuscitation, heart and stroke foundation of Canada, Inter-American heart foundation, resuscitation council of southern Africa ….” Circulation 132.13 (2015): 1286-1300.
Rajan, Shahzleen, et al. “Association of bystander cardiopulmonary resuscitation and survival according to ambulance response times after out-of-hospital cardiac arrest.” Circulation 134.25 (2016): 2095-2104.
Schewe, Jens-Christian, et al. “Outcome of out-of-hospital cardiac arrest over a period of 15 years in comparison to the RACA score in a physician staffed urban emergency medical service in Germany.” Resuscitation 96 (2015): 232-238.
Truhlar, A., C. D. Deakin, and J. Soar. “European Resuscitation Council Guidelines for Resuscitation 2015: section 4. Cardiac arrest in special circumstances. Resuscitation 2015; 95: 148–201. e8 Letter to the Editor.” Emerg Med J: first published as 10 (2017).
Wu, Zhixin, et al. “Telephone cardiopulmonary resuscitation is independently associated with improved survival and improved functional outcome after out-of-hospital cardiac arrest.” Resuscitation 122 (2018): 135-140.
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