IMPROVED OUTCOME FOR PATIENTS WITH A CARDIAC-ARREST BY SUPERVISION OFTHE EMERGENCY MEDICAL-SERVICES SYSTEM

Background: The outcome for patients with an out-of-hospital cardiac a rrest can only be improved through optimal pre-hospital therapy by the emergency medical services (EMS) system. So far it is not clear if ph ysician supervision of the EMS system is necessary for an optimal resu lt. Methods: In a retrospective and prospective case series we describ e the changes in outcome for patients with an out-of-hospital cardiac arrest after the implementation of limited physician supervision of th e EMS system. We also analysed the factors that were responsible for t hese changes. Results: We studied 479 consecutive patients with an out -of-hospital cardiac arrest. In the pre-intervention period, the survi val rate for patients with an out-of-hospital cardiac arrest was 13%. This increased to 21.6% when physician supervision was implemented (p = 0.013). This increase in survival coincided with an improvement in p re-hospital advanced cardiac life support with an increase in the numb er of patients who arrived with a stable cardiac rhythm in the emergen cy department (p < 0.001). Conclusions: Limited physician supervision of an EMS system in a non-metropolitan area may improve the outcome fo r patients with an out-of-hospital cardiac arrest.