The Ramsey Social Justice Foundation (RSJF) and the StarwestTech team are proud to have been a small part in collaboration and support of this meaningful effort to increase the save rate by dedicated EMS professionals worldwide. This has been a successful and productive commitment in both Asia and the US. In both areas,
emergency medical doctors, EMS, firefighters, public dispatch professionals and trainers have worked in either real time situations or retrospective analysis. Communication pathways were built and modified for monitoring and evaluation. Importantly, extensive stakeholder engagement and awareness raising was conducted to support the continuity of "buy-in".
The Pan Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network (CRN) has published its findings in the Journal Resuscitation; 96(2015). In Phase I, a total of 66,780 OHCA cases were submitted from the participating Asian countries. There were 403 cases in Vietnam, 288 cases in Pakistan, 187 cases in India, 571 cases in China, 713 cases in the Philippines, and 1,854 cases in Malaysia. The rates of bystander cardiopulmonary resuscitation (CPR) rates have improved to "Dispatcher-Assisted Cardio-Pulmonary Training." Utstein rates improved from little measurement to (CPR) rates varying 10.5% to 40.9%.
The RSJF has provided funding and support to PAROS for analysis of participating member countries in OHCA protocol telephone dispatch assisted training. RSJF will assist in Phase II starting in July 2016.
For the US-Arizona project commitment, which was published in JAMA May 2016, the objective was to deliver comprehensive EMS ePCR source for scientific analysis and to investigate the effect of a TCPR bundle of care on TCPR process measures and outcomes. This was a prospective, before-after, observational study of adult patients with out-of-hospital cardiac arrest not receiving bystander CPR in the 9-1-1 call between October 1, 2010, and September 30, 2013.
Interventions were a TCPR program, including guideline-based protocols, tele-communicator training, data collection, and feedback in two regional dispatch centers servicing metropolitan Phoenix, Arizona. Audio recordings of out-of-hospital cardiac arrest calls were audited and linked with emergency medical services and hospital outcome data. Main outcomes and measures were survival and hospital discharge and functional outcome at hospital discharge. There were 2,334 out-of-hospital cardiac arrests (798 phase 1 [P1] and 1536 phase 2 [P2]).
The implementation of a guideline-based TCPR bundle of care was independently associated with significant improvements in a logistic regression model and an adjusted difference in survival rates to 95% P2. In the provision and timeliness of TCPR, EMS survival to hospital discharge, and survival with significantly favorable functional outcome for patients with a shockable initial rhythm.