Abstract
Aim
To conduct a systematic review to evaluate the impact of emergency medical service
(EMS) practitioner’s years of career experience and exposure to out-of-hospital cardiac
arrest (OHCA) on patient outcomes.
Methods
We searched electronic databases (Ovid MEDLINE, EMBASE, CINAHL, Cochrane Central Register
of Controlled Trials, Web of Science Core Collection) from inception until 10 April
2020. Studies were included that examined the exposures of interest on OHCA patient
outcomes: good neurological outcome at discharge/30 days, survival to hospital discharge/30
days, survival to hospital and return of spontaneous circulation (ROSC). Prospero
Registration: CRD42019153599.
Results
We included 7 of 22 observational studies shortlisted. Four of these studies examined
the years of career experience of EMS practitioners, and four studies examined their
exposure to attempted resuscitation. The evidence for both exposures of interest was
assessed as very-low certainty. Overall, we found no association between patient outcomes
and years of career experience. However, the best evidence found, from two large studies,
suggests greater recent exposure to cases of attempted resuscitation is associated
with better outcomes (ROSC/survival to hospital discharge). One of these studies also
reports lower survival to hospital discharge when the team attempting resuscitation
had no exposure in the previous six-months.
Conclusion
Very low certainty evidence suggests higher exposure to attempted resuscitation cases,
but not years of clinical EMS experience, is associated with improved OHCA patient
outcomes. This review highlights the need for EMS to monitor OHCA exposure, and the
need for further research exploring the relationship between EMS exposure and patient
outcomes.
Keywords
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Article info
Publication history
Published online: August 04, 2020
Accepted:
July 22,
2020
Received in revised form:
June 27,
2020
Received:
May 10,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
