title: Does the number of emergency medical technicians affect the neurological outcome of patients with out-of-hospital cardiac arrest?
abstract: BACKGROUND
  It is unclear whether the number of paramedics in an ambulance improves the outcome of patients with out-of-hospital cardiac arrest (OHCA) or not.
  
  
  RESULTS
  This study was a prospective, observational study conducted on patients with OHCA. Patients were divided into the One-paramedic group (Group O) and the Two-or-more-paramedic group (Group T) and we analyzed the differences. Patients who were treated with only basic life support during transportation, and whose cause of cardiac arrest were extrinsic cause such as trauma and poisoning were excluded. Good neurological outcome was defined as cerebral performance category (CPC) 1 or 2. In Group O, there were 1516 patients (male/female, 922/594). In Group T, there were 2932 patients (male/female, 1798/1134). Return of spontaneous circulation (ROSC) was obtained in 528 patients (34.8%) in Group O and 1058 patients (36.1%) in Group T (p=0.589). 320 patients (21.1%) in Group O and 656 patients (22.4%) in Group T were admitted to hospital after ROSC (p=0.461). At 90days, there were 57 survivors (3.8%) in Group O and 114 survivors (3.9%) in Group T (p=0.873). At 90days, 14 patients (0.9%) in Group T had a CPC of 1 or 2, while 30 patients (1.0%) in Group T did so (p=0.87). From the results of logistic regression analysis, age [odds ratio (OR): 0.983, 95% confidence interval (CI): 0.952-0.993], witnessed OHCA (OR: 4.583, 95% CI: 1.587-13.234), and shockable rhythm as first documented (OR: 19.67, 95% CI: 9.181-42.13) were associated with good outcome.
  
  
  CONCLUSIONS
  The number of paramedics in an ambulance did not affect the outcome in OHCA patients.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Oshima
authors.forename: Makoto
authors.initials: M
authors.lastname: Aoki
authors.forename: Dai
authors.initials: D
authors.lastname: Miyazaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sakurai
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tahara
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yonemoto
authors.forename: Arino
authors.initials: A
authors.lastname: Yaguchi
authors.forename: Naoto
authors.initials: N
authors.lastname: Morimura
mesh_terms: D000368:Aged; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007564:Japan; D008020:Life Support Care / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D015337:Multicenter Studies as Topic; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications* / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012044:Regression Analysis; D016019:Survival Analysis; D000078329:Workforce
keywords: Advanced life support; Emergency medical technician (paramedic); Out-of-hospital cardiac arrest; Prehospital