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Charles

Eur Heart J. 1999 Apr;20(7):535-40.     

Influence of ambulance crew's length of experience on the outcome of
out-of-hospital cardiac arrest.

Soo LH, Gray D, Young T, Skene A, Hampton JR.

Department of Cardiovascular Medicine, University Hospital, Queens
Medical Centre, Nottingham, U.K.

AIMS: To investigate whether an ambulance crew's length of experience
affected the outcome of out-of-hospital cardiac arrest. 

METHODS AND RESULTS: This was a population-based, retrospective
observational study of attempted resuscitations in 1547 consecutive
arrests of cardiac aetiology by Nottinghamshire Emergency Ambulance
Service crew. 
One thousand and seventy-one patients were managed by either a
paramedic or a technician crew without assistance from other trained
individuals at the scene of arrest. Overall, the chances of a patient
surviving to be discharged from hospital alive did not appear to be
affected by the paramedic's length of experience 

(among survivors, 18 months experience vs non-survivors 16 months
experience, P = 0.347) but there appears to be a trend in the effect
of a technician's length of experience on survival (among survivors,
60 months experience vs non-survivors 28 months experience, P =
0.075). However, when a technician had 4 years of experience or more
and a paramedic 1 year's experience, survival rates did improve.
Logistic regression analysis, adjusted for factors known to influence
outcome, revealed that chances of survival increased once technicians
had over 4 years of experience after qualification (odds ratio 2.71,
95% CI 1.17 to 6.32, P = 0.02) and paramedics after just 1 year of
experience (odds ratio 2.68, 95% CI 1.05 to 6.82, P = 0.04). 

CONCLUSIONS: Survival from out-of-hospital cardiac arrest varies with
the type of ambulance crew and length of experience after
qualification. Experience in the field seems important as paramedics
achieve better survival rates after just 1 year's experience, while
technicians need to have more than 4 years' experience to improve
survival.

--- URG-L
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