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dc.contributor.authorBjornsson, Hjalti Mar
dc.contributor.authorBjornsdottir, Gudrun G
dc.contributor.authorOlafsdottir, Hronn
dc.contributor.authorMogensen, Brynjolfur Arni
dc.contributor.authorMogensen, Brynjolfur
dc.contributor.authorThorgeirsson, Gestur
dc.date.accessioned2021-08-31T10:59:50Z
dc.date.available2021-08-31T10:59:50Z
dc.date.issued2021-06
dc.date.submitted2021-08
dc.identifier.citationBjornsson HM, Bjornsdottir GG, Olafsdottir H, Mogensen BA, Mogensen B, Thorgeirsson G. Effect of replacing ambulance physicians with paramedics on outcome of resuscitation for prehospital cardiac arrest. Eur J Emerg Med. 2021 Jun 1;28(3):227-232. doi: 10.1097/MEJ.0000000000000786.en_US
dc.identifier.pmid33709992
dc.identifier.doi10.1097/MEJ.0000000000000786
dc.identifier.urihttp://hdl.handle.net/2336/621860
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen_US
dc.description.abstractIntroduction: Limited evidence suggests that the presence of a prehospital physician improves survival from cardiac arrest. A retrospective study is undertaken to examine this question. In Reykjavik, Iceland, prehospital physicians on ambulances were replaced by emergency medical technicians (EMTs) in 2007. The aim of this study is to compare the outcome of prehospital resuscitation from cardiac arrest during periods of time with and without prehospital physician involvement. Methods: All cardiac arrests that underwent prehospital resuscitation by emergency medical systems between 2004 and 2014 were included. The primary outcome was survival to hospital discharge, and the secondary outcome was return of spontaneous circulation (ROSC). Subgroup analyses were performed according to the type of cardiac arrest. Results: A total of 471 cardiac arrests were included for analysis, 200 treated by prehospital physicians from 2004 to 2007 and 271 treated by EMTs from 2008 to 2014. The overall rate of survival to hospital discharge and ROSC was 23 and 50% during the study period. No significant difference was observed in the rate of survival to hospital discharge [25 vs 22%, difference 3% (95% confidence interval (CI): 11-5%)] or ROSC [53 vs 47%, difference -6% (95% CI: 15-3%)] between these two time periods. In the subgroup of patients with pulseless electrical activity, survival to hospital discharge did not differ between the two periods, but the rate of ROSC was higher in the 'physician period' [50 vs 30%, difference -20% (95% CI: -40 to -1%)]. Conclusions: The presence of a prehospital physician on the ambulance was not found to result in a significant improvement in survival or ROSC after cardiac arrest compared to care by EMTs. Patients with pulseless electrical activity experienced an increase in ROSC when a physician was present but without improvement in survival to hospital discharge.en_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.urlhttps://journals.lww.com/euro-emergencymed/Fulltext/2021/06000/Effect_of_replacing_ambulance_physicians_with.14.aspxen_US
dc.rightsCopyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
dc.subjectBráðalækningaren_US
dc.subjectEndurlífgunen_US
dc.subject.meshCardiopulmonary Resuscitationen_US
dc.subject.meshEmergency Medicineen_US
dc.titleEffect of replacing ambulance physicians with paramedics on outcome of resuscitation for prehospital cardiac arrest.en_US
dc.typeArticleen_US
dc.identifier.eissn1473-5695
dc.contributor.department1Department of Emergency Medicine, Faculty of Medicine, University of Iceland, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 2Department of Aneaesthesia, Glasgow Royal Infirmary, Scotland, UK. 3Department of Orthopedic Surgery, Drammen Hospital, Norway. 4Department of Cardiology. 5Faculty of Medicine, University of Iceland, Research Institute in Emergency Medicine. 6Department of Cardiology, Landspitali-The National University Hospital of Iceland. Reykjavik, Iceland.en_US
dc.identifier.journalEuropean journal of emergency medicine : official journal of the European Society for Emergency Medicineen_US
dc.rights.accessLandspitali Access - LSH-aðganguren_US
dc.departmentcodeCAR12
dc.departmentcodeEAM12
dc.source.journaltitleEuropean journal of emergency medicine : official journal of the European Society for Emergency Medicine
dc.source.volume28
dc.source.issue3
dc.source.beginpage227
dc.source.endpage232
dc.source.countryEngland


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