Abstract
For out-of-hospital cardiac arrest (OHCA) patients, every second is vital for their life. Shortening the prehospital time is a challenge to emergency medical service (EMS) experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs) participating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247 cases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O), critical (NT-C), and noncritical (NT-NC) cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (T-CS), fracture fixation (T-F), and general trauma (T-G) cases. The average on-scene time of RN-attended cases showed a decrease of 21.05% in NT-O, 3.28% in NT-C, 0% in NT-NC, 18.44% in T-CS, 13.56% in T-F, and 3.46% in T-G compared to non-RN-attended. In NT-O and T-CS cases, the RNs' attendance can notably save the on-scene time with a statistical significance (P = .016 and .017, resp.). Furthermore, the return of spontaneous circulation within two hours (ROSC2 h) rate in the NT-O cases was increased by 12.86%. Based on the findings, the role of RNs in the EMTs could save the golden time in the prehospital medical care in Taiwan.
Highlights
Emergency medical service (EMS) systems may differ depending on the strategies and the plans in the transportation model and the constitution of the EMS team in different countries [1, 2]
A total of 51 patients who live in residences with challenging accessibility are excluded from the 1375 EMS cases, because the onscene time will be overly extended with significant deviations among the cases
After the exclusion of the 128 cases, the remaining 1247 EMS cases receive randomly first aid from 2T or 2T1N teams; 551 cases were involved in the 2T teams, while 696 cases were involved in 2T1N teams
Summary
Emergency medical service (EMS) systems may differ depending on the strategies and the plans in the transportation model and the constitution of the EMS team in different countries [1, 2]. For the EMS transportation, the Anglo-American model is based on the “patient to doctor” plan, whereas the Franco-German model is based on the “doctor to patient” plan [3,4,5]. Different transportation models will create different EMS teams, which may consist of emergency medical technicians (EMTs), nurses, and doctors for the prehospital patient care. In Taiwan, the EMS system follows the Anglo-American model, in which patients are transported to hospitals commonly by two EMTs (referred as 2T) [6, 7]. Many researchers emphasize shortening the prehospital EMS time in order to save the golden hours for the patient survival [13,14,15,16,17,18,19,20]
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