Department of Emergency Medicine, University of California San Francisco, 505 Parnassus Avenue, L 126, Mail Code 0208, San Francisco, CA 94143-0208, USA.
Resuscitation. 2012 Jan;83(1):76-80. doi: 10.1016/j.resuscitation.2011.06.026. Epub 2011 Jun 30.
To describe the demographic, organizational and provider characteristics of the Emergency Medical Services (EMS) agencies participating in the Cardiac Arrest Registry to Enhance Survival (CARES).
A web based survey instrument was developed by the CARES investigators and distributed to the EMS agencies participating in CARES in 2008. Survey questions addressed three domains related to prehospital care: (1) descriptors of the participating EMS agencies, (2) methods of clinical care and clinical protocols used by EMS agencies to deliver out-of-hospital cardiac arrest care and (3) use of resuscitation techniques by EMS agencies. Survey responses were collated and analyzed using descriptive statistics.
Surveys were received from 21/25 (84%) sites. The EMS agency characteristics including the response areas served by the agencies, organizational structure, medical direction status and deployment status are described. All respondents were non-volunteer agencies with a large number of them being fire-based (43%). Significant variability among the communities was observed with respect to their medical direction status and deployment status. We also observed differences in the management of OHCA among the participating agencies which included implementation of ACLS guideline updates, presence of termination of resuscitation protocol and destination policies for OHCA subjects. Similar variations between agencies were also observed in the use of resuscitation techniques.
Differences were observed between the EMS agencies participating in CARES. The clinical impact of these observed differences in agency and provider characteristics on OHCA outcomes deserves study.
描述参与心脏骤停注册以提高存活率（CARES）的紧急医疗服务（EMS）机构的人口统计学、组织和提供者特征。
CARES 调查员开发了一个基于网络的调查工具，并于 2008 年分发给参与 CARES 的 EMS 机构。调查问题涉及与院前护理相关的三个领域：（1）参与 EMS 机构的描述符，（2）EMS 机构用于提供院外心脏骤停护理的临床护理方法和临床协议，以及（3）EMS 机构使用的复苏技术。使用描述性统计对调查结果进行了整理和分析。
收到了来自 21/25（84%）个站点的调查。描述了 EMS 机构的特征，包括机构服务的响应区域、组织结构、医疗指导状况和部署状况。所有受访者均为非志愿机构，其中很大一部分是基于消防的（43%）。在医疗指导状况和部署状况方面，观察到各社区之间存在显著差异。我们还观察到参与机构之间 OHCA 管理的差异，包括实施 ACLS 指南更新、存在终止复苏协议和 OHCA 患者的目的地政策。在复苏技术的使用方面，机构之间也观察到类似的差异。
参与 CARES 的 EMS 机构之间存在差异。这些机构和提供者特征的差异对 OHCA 结果的临床影响值得研究。
