Influence of the Type of Physician on Survival from Emergency-Medical-Service-Witnessed Cardiac Arrest: An Observational Study.

Out-of-hospital cardiac arrest resuscitation by non-emergency dedicated physicians may not be positively associated with survival, as these physicians have less experience and exposure than specialised dedicated personnel. The aim of this study was to compare the survival results of the teams led by emergency dedicated physicians (EDPhy) with those of the teams led by non-emergency dedicated physicians (N-EDPhy) and with a team of basic life support (BLS) emergency technicians (EMTs) used as the control group. A retrospective, multicentre study of emergency-medical-service-witnessed cardiac arrest from medical causes in adults was performed. The records from 2006 to 2016 in a database of a regional emergency system were analysed and updated up to 31 December 2021. Two groups were studied: initial shockable and non-shockable rhythms. In total, 1359 resuscitation attempts were analysed, 281 of which belonged to the shockable group, and 1077 belonged to the non-shockable rhythm group. Any onsite return of spontaneous circulation, patients admitted to the hospital alive, global survival, and survival with a cerebral performance category (CPC) of 1-2 (good and moderate cerebral performance) were studied, with both of the latter categories considered at 30 days, 1 year (primary outcome), and 5 years. The shockable and non-shockable rhythm group (and CPC 1-2) survivals at 1 year were, respectively, as follows: EDPhy, 66.7 % (63.4%) and 14.0% (12.3%); N-EDPhy, 16.0% (16.0%) and 1.96 % (1.47%); and EMTs 32.0% (29.7%) and 1.3% (0.84%). The crude ORs were EDPhy vs. N-EDPhy, 10.50 (5.67) and 8.16 (4.63) (all p < 0.05); EDPhy vs. EMTs, 4.25 (2.65) and 12.86 (7.80) (p < 0.05); and N-EDPhy vs. EMTs, 0.50 (0.76) (p < 0.05) and 1.56 (1.32) (p > 0.05). The presence of an EDPhy was positively related to all the survival and CPC rates.

Efectividad de la consulta de enfermería en una central de coordinación de urgencias sanitarias / Efficacy of nurse consultants in a health emergency coordination center

Objetivo: Describir la actividad del enfermero de consulta (EC) en la Central de Coordinación de Urgencias Sanitarias de Galicia-061 (CCUSG-061), en términos de capacidad de resolución de problemas y adecuación de decisiones. Método: Estudio retrospectivo, observacional y descriptivo que incluyó todas las llamadas telefónicas atendidas por los EC entre julio de 2013 y 2014. Se consideró como resolución efectiva cualquier demanda que tras ser resuelta sin movilizar recursos no originase una nueva llamada telefónica, ingreso hospitalario o fallecimiento del paciente en las 24 horas siguientes. Resultados: Los EC atendieron 37.553 llamadas, 92% resueltas sin necesidad de movilizar recursos o pacientes. De ellas, el 97% no fue objeto de rellamada, ni de complicaciones en las 24 horas siguientes. Conclusiones: Los EC resuelven de forma segura la mayoría de las necesidades asistenciales de los pacientes, sin movilizar pacientes o recursos sanitarios (AU)

Objective: To describe nurse consultants’ work at the Health Emergency Coordination Center of Galicia (CCUSG-061) in terms of their ability to resolve problems and the appropriateness of their decisions. Methods: Retrospective, observational, descriptive study that included all telephone calls attended by nurses between July 2013 and 2014. The results of a consultation were considered successful if a request for help was resolved without mobilization of resources and did not lead to a new call to the emergency service, a hospital admission, or a death in the next 24 hours. Results: The nurses attended 37 553 calls, resolving 92% without mobilizing resources or patients. Ninety-seven percent of the calls resolved did not generate new calls or complications in the next 24 hours. Conclusions: Nurses resolve most patients’ emergency care requirements safely without moving patients or mobilizing health resources (AU)

[Efficacy of nurse consultants in a health emergency coordination center]. / Efectividad de la consulta de enfermería en una central de coordinación de urgencias sanitarias.

OBJECTIVES: To describe nurse consultants' work at the Health Emergency Coordination Center of Galicia (CCUSG-061) in terms of their ability to resolve problems and the appropriateness of their decisions. MATERIAL AND METHODS: Retrospective, observational, descriptive study that included all telephone calls attended by nurses between July 2013 and 2014. The results of a consultation were considered successful if a request for help was resolved without mobilization of resources and did not lead to a new call to the emergency service, a hospital admission, or a death in the next 24 hours. RESULTS: The nurses attended 37 553 calls, resolving 92% without mobilizing resources or patients. Ninety-seven percent of the calls resolved did not generate new calls or complications in the next 24 hours. CONCLUSION: Nurses resolve most patients' emergency care requirements safely without moving patients or mobilizing health resources.

OBJETIVO: Describir la actividad del enfermero de consulta (EC) en la Central de Coordinación de Urgencias Sanitarias de Galicia-061 (CCUSG-061), en términos de capacidad de resolución de problemas y adecuación de decisiones. METODO: Estudio retrospectivo, observacional y descriptivo que incluyó todas las llamadas telefónicas atendidas por los EC entre julio de 2013 y 2014. Se consideró como resolución efectiva cualquier demanda que tras ser resuelta sin movilizar recursos no originase una nueva llamada telefónica, ingreso hospitalario o fallecimiento del paciente en las 24 horas siguientes. RESULTADOS: Los EC atendieron 37.553 llamadas, 92% resueltas sin necesidad de movilizar recursos o pacientes. De ellas, el 97% no fue objeto de rellamada, ni de complicaciones en las 24 horas siguientes. CONCLUSIONES: Los EC resuelven de forma segura la mayoría de las necesidades asistenciales de los pacientes, sin movilizar pacientes o recursos sanitarios.