The Evaluation of Online Medical Consultation Use in Pediatric Out-of-Hospital Cardiac Arrest.

IF 2.1 3区 医学 Q2 EMERGENCY MEDICINE Prehospital Emergency Care Pub Date : 2024-11-04 DOI:10.1080/10903127.2024.2406029
SunHee Chung, Asia Wooten, Matthew Hansen, Matthew Neth, Joshua Lupton
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Abstract

Objectives: Our study details Online medical consultation (OLMC) usage for Pediatric out-of-hospital cardiac arrest (P-OHCA), including proportion of P-OHCA utilizing OLMC, the characteristics of cases using OLMC, the types of information exchanged during OLMC calls, and the outcomes in patients where Emergency Medical Services (EMS) contacted OLMC.

Methods: The study included P-OHCA patients treated by EMS agencies participating in the regional cardiac registry with total catchment population of approximately 1.5 million residents. We reviewed linked calls and EMS charts for P-OHCA cases treated from January 1st, 2018 through December 31st, 2022.

Results: In total, 112 cases from January 2018 to December 2022 were included in the final analysis. Twenty-two out of 112 utilized OLMC with a mean time from 9-1-1 call to OLMC of 28.8 min. The no OLMC group had a significantly higher transport rate than OLMC group as well as higher percentages of ROSC at any time and ROSC upon arrival at the ED. Both survival to admission and survival to discharge were more prevalent in the no OLMC group, while there were no instances of survival to discharge in the OLMC group. During the calls, the discussion of crucial prognostic factors, including witness status, initial rhythm, ETCO2, and arrest duration, appears inconsistent.

Conclusions: Pediatric-OHCA cases with OLMC tend to contact OLMC late in the resuscitation, have poor prognostic factors, and have poor survival outcomes. The information exchanged during OLMC calls was highly variable, representing a clear opportunity for improvement. Future studies should explore the potential effect of early OLMC contact on patient outcomes and if a standardized template for OLMC data exchange improves consistency in recommendations for P-OHCA.

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评估在线医疗咨询在小儿院外心脏骤停中的应用。
研究目的我们的研究详细介绍了小儿院外心脏骤停(P-OHCA)在线医疗咨询(OLMC)的使用情况,包括使用 OLMC 的小儿院外心脏骤停比例、使用 OLMC 的病例特征、OLMC 呼叫中交换的信息类型以及急诊医疗服务(EMS)联系 OLMC 的患者的治疗结果:研究对象包括参与地区心脏登记的急救医疗机构所治疗的 P-OHCA 患者,这些机构的总覆盖人口约为 150 万居民。我们审查了从 2018 年 1 月 1 日到 2022 年 12 月 31 日接受治疗的 P-OHCA 病例的链接呼叫和 EMS 病历:最终分析共纳入了 2018 年 1 月至 2022 年 12 月期间的 112 个病例。112 例中有 22 例使用了 OLMC,从 9-1-1 呼叫到 OLMC 的平均时间为 28.8 分钟。无 OLMC 组的转运率明显高于 OLMC 组,任何时间的 ROSC 百分比和到达急诊室时的 ROSC 百分比也更高。无 OLMC 组的入院存活率和出院存活率都更高,而 OLMC 组则没有出院存活率。在通话过程中,对关键预后因素(包括目击者状态、初始心律、ETCO2和心跳骤停持续时间)的讨论似乎并不一致:结论:使用 OLMC 的小儿 OHCA 病例往往在复苏后期才与 OLMC 联系,预后因素差,存活率低。在 OLMC 通话中交换的信息差异很大,这显然是一个改进的机会。未来的研究应探讨早期联系 OLMC 对患者预后的潜在影响,以及 OLMC 数据交换的标准化模板是否能提高 P-OHCA 建议的一致性。
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来源期刊
Prehospital Emergency Care
Prehospital Emergency Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.30
自引率
12.50%
发文量
137
审稿时长
1 months
期刊介绍: Prehospital Emergency Care publishes peer-reviewed information relevant to the practice, educational advancement, and investigation of prehospital emergency care, including the following types of articles: Special Contributions - Original Articles - Education and Practice - Preliminary Reports - Case Conferences - Position Papers - Collective Reviews - Editorials - Letters to the Editor - Media Reviews.
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