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A multidisciplinary approach for improving the outcome of out-of-hospital cardiac arrest in South Korea

Kim, Gi Woona; Lee, Dong Keonb; Kang, Bo Rab; Jeong, Won Jungc; Lee, Choung Ahd; Oh, Young Taecke; Kim, Yu Jinb,,*; Park, Seung Minb,,*

European Journal of Emergency Medicine: June 3, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MEJ.0000000000000612
Original article: PDF Only
Open
PAP

Aim: Direct medical control using video conferencing capabilities of smartphones has never been conducted in out-of-hospital cardiac arrest patients. This study was conducted to investigate the feasibility and treatment effectiveness of real-time smartphone video conferencing calls for the management of out-of-hospital cardiac arrest.

Methods: This study was a pre–post-intervention prospective cohort study conducted from January 2013 to July 2015. The intervention was pre-hospital advanced life support under a physician’s direction using a smartphone video call.

Results: In total, 942 cardiac arrests occurred over the 2-year period; 308 patients were excluded, and 314 (49.5%) and 320 (50.5%) cardiac arrest patients were enrolled during the pre- and post-intervention study periods, respectively. There were 248/320 (77.5%) cases of smartphone video-assisted advanced life support during the post-intervention period. For patients in the pre- and post-intervention groups, the pre-hospital return of spontaneous circulation was 6.7 and 20%, respectively (adjusted odds ratio 3.3, 95% confidence interval 1.6–6.8, P < 0.01), and favourable neurological outcomes were ascertained in 1.9 and 6.9%, respectively (adjusted odds ratio 23.6, 95% confidence interval 3.4–164.0, P < 0.01). The smartphone voice and video quality were rated 8.5 and 8.2 out of 10, respectively, in physician evaluation, while the overall utility was rated 9.1.

Conclusion: We concluded that a multidisciplinary approach including the re-education of basic life support, simulation training for advanced life support, real-time medical direction via video call, and dispatching two teams rather than one team improved the outcome of out-of-hospital cardiac arrest.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

aDepartment of Emergency Medicine, Soonchunhyang University Bucheon Hospital

bDepartment of Emergency Medicine, Seoul National University Bundang Hospital

cDepartment of Emergency Medicine, St. Vincent’s Hospital, The Catholic University of Korea, Suwon

dDepartment of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital

eDepartment of Emergency Medicine, Armed Forces Daejeon Hospital, Republic of Korea

* Dr. Seung Min Park and Dr. Yu Jin Kim contributed equally to this article.

Received 1 April 2018 Accepted 8 May 2019

Correspondence to Seung Min Park, Department of Emergency Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Republic of Korea, Tel: +82 01 8908 2014; fax: +0504 428 0908; e-mail: aukawa1227@gmail.com

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