Out-of-hospital Cardiac Arrest Survival Rates in an EMS System Utilizing the System Status Management Dispatch Model

• Published in: Academic emergency medicine 2003-05, Vol.10 (5), p.444-445
• Main Author: Fairbanks, R. J
• Format: Article
• Language: English
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1197/aemj.10.5.444-b

INTRODUCTION: There are no large cardiac arrest studies in the EMS literature that utilize the system status management (SSM) dispatch model. This dispatch model theoretically results in consistently short call-response intervals, which should improve out-of-hospital cardiac arrest (OHCA) survival rates. OBJECTIVE: To calculate call-response intervals and OHCA survival rates in a northeastern city where the SSM dispatch model was utilized. METHODS: EMS medical records were reviewed for all OHCA patients with a resuscitation attempt that occurred within the city limits (pop. 220,000) during a four year study period (1998-2001). Utstein criteria were used as a guide in data collection and reporting. Adult OHCA of cardiac etiology with complete survival data were included. The outcome measures were return of spontaneous circulation (ROSC), 30 day and one year survival. Survival was determined using hospital medical records, medical examiner data, and the Social Security Death Index. RESULTS: 1213 consecutive OHCA were identified. 546 met inclusion criteria, of which 456 (84%) had complete survival data. The median call-response interval was 5 minutes (range 0-21), with 93% less than 9 minutes. The initial rhythm was shockable in 209 cases (46%), not shockable in 155 cases (34%) and in the remaining 92 cases the initial rhythm was unknown (20%). 180 OHCA (39%) were bystander witnessed and 64 (14%) received bystander CPR. Overall, 86 patients experienced ROSC (19%), 16 survived to 30 days (4%), and 8 to one year (2%). CONCLUSION: Utilizing SSM resulted in good OHCA response intervals. However, the survival rates appear to be similar to national averages.