Prehospital advanced cardiac life support with a smartphone-based direct medical oversight in a metropolitan city: a before-after population-based study
- Jae Jin Hong Seong Jung Kim Yongjin Park
- Issued Date
- Out-of-hospital cardiac arrest Smartphone Advanced cardiac life support Emergency medical system
- Purpose: This study aimed to determine whether advanced life support (ALS) under emergency physician's direct medical oversight through video call on smartphones was associated with improved out-of-hospital cardiac arrest (OHCA) outcomes on "Smart Advanced Life Support (SALS)" pilot project. Methods: This study was conducted with a "before-after" controlled trial. We divided the OHCA patients in a metropolitan city with a population of 1.5 million into two periods. The 'Before' phase was performed the basic life support (BLS group) in 2014, and the 'after' phase was performed the ALS using video calls on smartphones (SALS group) in 2015. The primary and secondary outcomes were survival to discharge and a good neurological outcome, respectively. We conducted propensity score matching to equalize potential prognostic factors in both groups. Results: 235 OHCA patients were enrolled in the BLS group, 198 patients in the SALS group. The outcomes were better in the SALS group than in the BLS group for survival to discharge and good neurological outcome, respectively. The adjusted ORs of SALS group compared to those BLS group 1.33 (95% CI 1.00-1.77) for survival to discharge and 1.73 (95% CI 1.19-2.53) for good neurologic outcome. Conclusion: An emergency medical system intervention using the SALS protocol was associated with a significant increase in prehospital ROSC and an improved survival and neurologic outcome after OHCA.
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