title: Influence of EMS-physician presence on survival after out-of-hospital cardiopulmonary resuscitation: systematic review and meta-analysis
creator: Böttiger, Bernd W.
creator: Bernhard, Michael
creator: Knapp, Jürgen
creator: Nagele, Peter
subject: ddc-610
subject: 610 Medical sciences Medicine
description: Background: Evidence suggests that EMS-physician-guided cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OOHCA) may be associated with improved outcomes, yet randomized controlled trials are not available. The goal of this meta-analysis was to determine the association between EMS-physician- versus paramedic-guided CPR and survival after OOHCA.   Methods and Results: Studies that compared EMS-physician- versus paramedic-guided CPR in OOHCA published until June 2014 were systematically searched in MEDLINE, EMBASE and Cochrane databases. All studies were required to contain survival data. Data on study characteristics, methods, and as well as survival outcomes were extracted. A random-effects model was used for the meta-analysis due to a high degree of heterogeneity among the studies (I  2 = 44 %). Return of spontaneous circulation [ROSC], survival to hospital admission, and survival to hospital discharge were the outcome measures. Out of 3,385 potentially eligible studies, 14 met the inclusion criteria. In the pooled analysis (n = 126,829), EMS-physician-guided CPR was associated with significantly improved outcomes compared to paramedic-guided CPR: ROSC 36.2% (95% confidence interval [CI] 31.0 – 41.7%) vs. 23.4% (95% CI 18.5 – 29.2%) (pooled odds ratio [OR] 1.89, 95% CI 1.36 – 2.63, p < 0.001); survival to hospital admission 30.1% (95% CI 24.2 – 36.7%) vs. 19.2% (95% CI 12.7 – 28.1%) (pooled OR 1.78, 95% CI 0.97 – 3.28, p = 0.06); and survival to discharge 15.1% (95% CI 14.6 – 15.7%) vs. 8.4% (95% CI 8.2 – 8.5%) (pooled OR 2.03, 95% CI 1.48 – 2.79, p < 0.001).   Conclusions: This systematic review suggests that EMS-physician-guided CPR in out-of-hospital cardiac arrest is associated with improved survival outcomes.
publisher: BioMed Central
date: 2016
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/20108/1/13054_2015_Article_1156.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-201081
identifier:   Böttiger, Bernd W. ; Bernhard, Michael ; Knapp, Jürgen ; Nagele, Peter  (2016) Influence of EMS-physician presence on survival after out-of-hospital cardiopulmonary resuscitation: systematic review and meta-analysis.  Critical care, 20 (4).  pp. 1-8.  ISSN 1466-609X     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/20108/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng