title: Physician experience in addition to ACLS training does not significantly affect the outcome of prehospital cardiac arrest.
abstract: BACKGROUND
  Little data exists on whether the physicians' skills in responding to cardiac arrest are fully developed after the advanced cardiac life support (ACLS) course, or if there is a significant improvement in their performance after an initial learning curve.
  
  
  OBJECTIVE
  To estimate the effect of physician experience on the results of prehospital cardiac arrests.
  
  
  METHODS
  Prospective data were collected on all prehospital resuscitative attempts in the area by ACLS-trained ambulance physicians.
  
  
  RESULTS
  Of 232 attempted cardiac resuscitations, 96 (41%) patients survived to hospital admission and 44 (19%) were discharged alive. A group of 39 physicians responded to from one up to 29 cases with a mean of four cases. Physicians responding to five or fewer cases had a trend to fewer patients surviving to admission compared with those responding to six or more (36 vs. 45%, P=0.31) but no difference was found on survival to discharge (19 vs. 20%, P=0.87).
  
  
  CONCLUSIONS
  In this study, resuscitative experience of the physician did not have a significant effect on survival suggesting that experience does not significantly add to the current ACLS training in responding to ventricular fibrillation/ventricular tachycardia. More studies are needed.
authors.affiliation: Department of Accident and Emergency Medicine, Landspitali University Hospital, Reykjavík, Iceland. hjaltimb@gmail.com
authors.forename: Hjalti Mar
authors.initials: HM
authors.lastname: Bjornsson
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Marelsson
authors.forename: Vidar
authors.initials: V
authors.lastname: Magnusson
authors.forename: Gardar
authors.initials: G
authors.lastname: Sigurdsson
authors.forename: Gestur
authors.initials: G
authors.lastname: Thorgeirsson
mesh_terms: D000328:Adult; D022561:Advanced Cardiac Life Support / Q000193:education* / Q000401:mortality*; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000401:mortality; D002423:Cause of Death; D016009:Chi-Square Distribution; D002983:Clinical Competence; D016208:Databases, Factual; D004632:Emergency Medical Services / Q000592:standards / Q000639:trends; D004635:Emergency Medicine / Q000193:education / Q000639:trends; D005260:Female; D006801:Humans; D007055:Iceland; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D011787:Quality of Health Care; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome