Lives can be saved by reducing ambulance response time

Self-report. Cardiac arrest ambulance response time has doubled in the past 30 years. At the same time, the survival chances for those with cardiac arrest outside hospitals doubled. A correct understanding of how ambulance response time affects the chances of surviving a cardiac arrest is of great importance for future efforts in the “life-saving chain” to occur where they have the greatest benefit to the patient.

studies [1] It is based on data from 20,420 patients who suffered cardiac arrest during the years 2008-2017 and the Swedish Heart and Lung Lungs Registry was reported. It found that the 30-day survival was 9.4 percent if the ambulance response time was 10-15 minutes. At response times of 0-6 min, survival was instead 19.5 percent (Fig.1). The chance of survival increased when the ambulance response time decreased. This association was seen regardless of the initial cardiac rhythm, but also regardless of whether or not CPR was performed before the ambulance arrived (Fig.1).

It was also investigated how so-called life-saving interventions (cardiopulmonary resuscitation performed before the ambulance arrived) were related to the chance of survival during different ambulance response times.

The effect of life-saving interventions in cardiac arrest has been well documented since then [2], But the ambulance response times of 6-8 minutes. However, the importance of life-saving interventions is affected by increasingly longer ambulance response time. The study examines the relationship between ambulance response time and survival. Patients who received CPR before the ambulance arrived are compared to cases where no life-saving interventions were made.

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In patients judged to have a cardiac cause of cardiac arrest, it was not possible to observe that CPR before the ambulance arrived had any effect on the chance of survival if the ambulance response time exceeded 15 minutes.

Thus, there is much to suggest that the continuous increase in ambulance response time may jeopardize the improvements in cardiac arrest care that have been achieved thus far through more and more life-saving interventions.

Based on the results of the study, the chance of survival was also predicted for different ambulance response times. The model was applied to 6,135 patients who had suffered cardiac arrest outside of hospitals in 2018 and the Swedish cardiopulmonary rescue record was reported. The ambulance response time of 10 to 15 minutes was expected to result in 577. When the ambulance response time was reduced to 7-9 minutes, the model expected the 846 survivors instead. When the model’s ambulance response time was reduced to 0-6 minutes, 1194 survivors were expected. The 2019 annual cardiopulmonary resuscitation registry report states that 609 people actually survived for 30 days after cardiac arrest, and the average response time in Sweden was 11 minutes in 2018.

It is not clear why the ambulance response time increased. The increasing proportion of so-called high-priority prio 1 warnings, the increasingly frequent traffic situation and the increasing work tasks of ambulance crews are some of the possible explanations being discussed.

The study found that survival up to 30 days after cardiac arrest increased when the ambulance response time decreased. Efforts to reduce the ambulance response time from approximately 11 minutes are an important factor in saving more people for life after having a heart attack.

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La Cartdingen 7-7/2021

Lakartidningen.se

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