Impact of Emergency Responder Level of Certification on Successful Cardiac Arrest Resuscitation in a Pre-hospital Setting

Sudden cardiac arrest (SCA) is a leading cause of death in the US. Each year, approximately 250,000-450,000 Americans will experience SCA and approximately 95% will die within minutes. The standard care for victims in need of resuscitation consists of early access, CPR, defibrillation, and advanced cardiovascular life support (ACLS). There are four EMS certification levels with each level receiving additional training; however, only paramedics can provide ACLS. There is a need to determine if a more highly trained emergency responder (paramedic) provides greater outcomes (restored pulse) to SCA patients than a non-paramedic.

In this cross-sectional study, the researchers examined electronic patient care reports from five EMS providers that described care given by EMS responders to SCA patients between January 1, 2001 and December 31, 2007 in west Alabama. Controlling for SCA victims who could not be resuscitated (e.g. reports of DOA or rigor mortis) yielded a sample of 162. Pearson chi-square was conducted to determine if there was a difference between paramedics and non-paramedics in the success of resuscitation.

Chi-square analysis indicated a significant difference in survivability of patients receiving care from a paramedic (÷2=4.7,df=1,p=.03). Paramedics had higher success rates (20%) at resuscitation compared to non-paramedics (8%).

ACLS is often the difference between life and death for SCA victims; therefore, EMS providers should consider employing more paramedics in attempts to increase the care given to individuals experiencing SCA. Future studies should include a more extensive range of variables including other injuries/illnesses to determine if paramedic status influences outcomes.