The effect of paramedic experience on survival from cardiac arrest.
OBJECTIVE
We hypothesized that paramedics with more experience would be more successful at treating patients in ventricular fibrillation (VF) cardiac arrest than those with less experience. We conducted a study examining the relationship between the years of experience of paramedics and survival from out-of-hospital cardiac arrest.


METHODS
This retrospective cohort study examined all witnessed, out-of-hospital VF cardiac arrests (n = 699) that occurred between January 1, 2002, and December 31, 2006. Logistic regression was used to determine the odds of survival and the 95% confidence intervals (95% CIs) relating to the number of years of experience that each of the treating paramedics had.


RESULTS
We found that every additional year of experience of the medic in charge of implementing procedures such as intravenous line insertions, intubations, and provision of medications was associated with a 2% increase in the likelihood of survival of the patient (95% CI: 1.00-1.04). The number of years of experience of the paramedic who did not perform procedures but instead was in charge of treatment decisions was not significantly associated with survival (odds ratio [OR] 1.01, 95% CI: 0.99-1.03). When we combined both paramedics' years of experience, we saw a 1% increase in the odds of survival for every additional year of experience (95% CI: 1.00-1.03).


CONCLUSIONS
This study suggests that the amount of experience of the paramedic who performed procedures on cardiac arrest patients was associated with increased rates of survival. However, we did not find an association between survival from VF and the number of years of experience of the paramedic who made treatment decisions.
Gold
Laura S
LS
Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, USA. goldl@u.washington.edu
Eisenberg
Mickey S
MS
D000328:Adult; D000368:Aged; D002983:Clinical Competence; D015331:Cohort Studies; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000592:standards*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis