Abstract
PurposeAustrian out-of-hospital emergency physicians (OOHEP) undergo mandatory biannual emergency physician refresher courses to maintain their licence. The purpose of this study was to compare different reported emergency skills and knowledge, recommended by the European Resuscitation Council (ERC) guidelines, between OOHEP who work regularly at an out-of-hospital emergency service and those who do not currently work as OOHEP but are licenced.MethodsWe obtained data from 854 participants from 19 refresher courses. Demographics, questions about their practice and multiple-choice questions about ALS-knowledge were answered and analysed. We particularly explored the application of therapeutic hypothermia, intraosseous access, pocket guide use and knowledge about the participants’ defibrillator in use. A multivariate logistic regression analysed differences between both groups of OOHEP. Age, gender, years of clinical experience, ERC-ALS provider course attendance and the self-reported number of resuscitations were control variables.ResultsLicenced OOHEP who are currently employed in emergency service are significantly more likely to initiate intraosseous access (OR = 4.013, p < 0.01), they initiate mild-therapeutic hypothermia after successful resuscitation (OR = 2.550, p < 0.01) more often, and knowledge about the used defibrillator was higher (OR = 2.292, p < 0.01). No difference was found for the use of pocket guides.OOHEP who have attended an ERC-ALS provider course since 2005 have initiated more mild therapeutic hypothermia after successful resuscitation (OR = 1.670, p <0.05) as well as participants who resuscitated within the last year (OR = 2.324, p < 0.01), while older OOHEP initiated mild therapeutic hypothermia less often, measured per year of age (OR = 0.913, p <0.01).ConclusionLicenced and employed OOHEP implement ERC guidelines better into clinical practice, but more training on life-saving rescue techniques needs to be done to improve knowledge and to raise these rates of application.
Highlights
Austrian out-of-hospital emergency physicians (OOHEP) undergo mandatory biannual emergency physician refresher courses in order to retain their license
Inactive OOHEP are less likely to know the kind of defibrillator in use (OR = 0.203, p < 0.01)
By analysing OOHEP’s different practice in the field and their implementation of the European Resuscitation Council (ERC) guidelines in an Austria-wide survey, this study revealed that working OOHEP are more likely to apply current resuscitation standards described in the ERC guidelines, overall application of the recommendations could be improved considerably
Summary
Austrian out-of-hospital emergency physicians (OOHEP) undergo mandatory biannual emergency physician refresher courses in order to retain their license. The refresher courses are organized by different institutions with the aim to provide education and training in resuscitation and other emergency skills. Advanced Life Support (ALS) provider courses and valid recertification refresher courses are offered for emergency physicians with the aim to educate on resuscitation theory, practical skills and attitudes necessary to act safely and efficiently in cardiac arrest situations [1]. Mild therapeutic hypothermia after cardiac arrest is well known to be associated with favourable outcome and is considered standard treatment [2,3,4]. Defibrillation is the standard treatment for shockable rhythms in patients in cardiac arrest. There is no firm evidence that supports the use of pocket guides in resuscitation, some providers encourage using them [10]
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