Beck Ben, Bray Janet E, Smith Karen, Walker Tony, Grantham Hugh, Hein Cindy, Thorrowgood Melanie, Smith Anthony, Inoue Madoka, Smith Tony, Dicker Bridget, Swain Andy, Bosley Emma, Pemberton Katherine, McKay Michael, Johnston-Leek Malcolm, Cameron Peter, Perkins Gavin D, Finn Judith
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Perth, Western Australia, Australia.
Emerg Med Australas. 2016 Dec;28(6):673-683. doi: 10.1111/1742-6723.12690. Epub 2016 Oct 11.
The present study aimed to describe and examine similarities and differences in the current service provision and resuscitation protocols of the ambulance services participating in the Aus-ROC Australian and New Zealand out-of-hospital cardiac arrest (OHCA) Epistry. Understanding these similarities and differences is important in identifying ambulance service factors that might explain regional variation in survival of OHCA in the Aus-ROC Epistry.
A structured questionnaire was completed by each of the ambulance services participating in the Aus-ROC Epistry. These ambulance services were SA Ambulance Service, Ambulance Victoria, St John Ambulance Western Australia, Queensland Ambulance Service, St John Ambulance NT, St John New Zealand and Wellington Free Ambulance. The survey aimed to describe ambulance service and dispatch characteristics, resuscitation protocols and details of cardiac arrest registries.
We observed similarities between services with respect to the treatment of OHCA and dispatch systems. Differences between services were observed in the serviced population; the proportion of paramedics with basic life support, advanced life support or intensive care training skills; the number of OHCA cases attended; guidelines related to withholding or terminating resuscitation attempts; and the variables that might be used to define 'attempted resuscitation'. All seven participating ambulance services were noted to have existing OHCA registries.
There is marked variation between ambulance services currently participating in the Aus-ROC Australian and New Zealand OHCA Epistry with respect to workforce characteristics and key variable definitions. This variation between ambulance services might account for a proportion of the regional variation in survival of OHCA.
本研究旨在描述和检验参与澳大利亚和新西兰院外心脏骤停（OHCA）病例登记研究（Aus-ROC）的救护车服务机构在当前服务提供和复苏方案方面的异同。了解这些异同对于确定可能解释Aus-ROC病例登记研究中OHCA存活率存在地区差异的救护车服务因素至关重要。
参与Aus-ROC病例登记研究的各救护车服务机构均完成了一份结构化问卷。这些救护车服务机构包括南澳大利亚州救护车服务机构、维多利亚州救护车服务机构、西澳大利亚州圣约翰救护车服务机构、昆士兰州救护车服务机构、北领地圣约翰救护车服务机构、新西兰圣约翰救护车服务机构以及惠灵顿免费救护车服务机构。该调查旨在描述救护车服务及调度特征、复苏方案以及心脏骤停登记的详细信息。
我们观察到各服务机构在OHCA治疗和调度系统方面存在相似之处。各服务机构在服务人群、具备基础生命支持、高级生命支持或重症监护培训技能的护理人员比例、处理的OHCA病例数量、与停止或终止复苏尝试相关的指南以及可能用于定义“尝试复苏”的变量等方面存在差异。注意到所有七个参与的救护车服务机构均有现有的OHCA登记。
目前参与澳大利亚和新西兰OHCA病例登记研究（Aus-ROC）的救护车服务机构在劳动力特征和关键变量定义方面存在显著差异。救护车服务机构之间的这种差异可能在一定程度上解释了OHCA存活率的地区差异。
