ACDC
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Neuro intact survival
|
Patient
|
|
Aufderheide TP., Frascone RJ., Wayne MA., Mahoney BD., Swor RA., Domeier RM., et al. Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: A randomised trial. Lancet 2011; 377(9762):301-11. Medline
|
|
I
|
Supportive (Green)
|
ETCO2 measurement of CPR efficacy
|
Process
|
PH-Paramedic
|
Orliaguet GA., Carli PA., Rozenberg A., Janniere D., Sauval P., Delpech P. End-tidal carbon dioxide during out-of-hospital cardiac arrest resuscitation: Comparison of active compression-decompression and standard CPR. Ann Emerg Med 1995; 25(1):48-51. Medline
|
|
I
|
Supportive (Green)
|
ROSC, 1 hour , 1 month, DC and DC neuro outcome
|
Patient
|
ED-MD
|
Plaisance P., Adnet F., Vicaut E., et al. Benefit of active compression-decompression cardiopulmonary resuscitation as a prehospital advanced cardiac life support. A randomized multicenter study. Circulation 1997; 95(4):955-61. Medline
|
|
I
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Paramedic
|
Skogvoll E., Wik L. Active compression-decompression cardiopulmonary resuscitation: A population-based, prospective randomised clinical trial in out-of-hospital cardiac arrest. Resuscitation 1999; 42(3):163-172. Medline
|
|
I
|
Supportive (Green)
|
Survival for one hour and to discharge
|
Patient
|
ED-MD
|
Stiell IG., Hebert PC., Wells GA., et al. The ontario trial of active compression-decompression cardiopulmonary resuscitation for in-hospital and prehospital cardiac arrest. JAMA 1996; 275(18):1417-1423. Medline
|
|
I
|
Neutral (Yellow)
|
In-hospital mortality
|
Patient
|
ED-MD
|
Frascone RJ., Wayne MA., Swor RA., et al. Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device. Resuscitation 2013; 84(9):1214-22. Medline
|
|
I
|
Neutral (Yellow)
|
Mortality
|
Patient
|
PH-Paramedic
|
Lafuente-Lafuente C., Melero-Bascones M. Active chest compression-decompression for cardiopulmonary resuscitation (Cochrane Review). In: The Cochrane Library, Issue 1, 2003. Oxford: Update Software Medline
|
|
I
|
Neutral (Yellow)
|
Supportive (Green)
|
Patient
|
ED-MD
|
Plaisance P., et al. A comparison of standard CPR and ACDC for OOHCA. NEJM 1999; 341:569-75. Medline
|
|
I
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Schwab TM., Callaham ML., Madsen CD., Utecht TA. A randomized clinical trial of active compression-decompression CPR vs standard CPR in out-of-hospital cardiac arrest in two cities. JAMA 1995; 273(16):1261-1268. Medline
|
|
I
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Wang CH., Tsai MS., Chang WT., et al. Active compression-decompression resuscitation and impedance threshold device for out-of-hospital cardiac arrest: A systematic review and metaanalysis of randomized controlled trials. Crit Care Med 2015; 43(4):889-896. Medline
|
|
II
|
Supportive (Green)
|
survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Ong ME., et al. Use of an automated, load-distributing band chest compression device for out-of-hospital cardiac arrest resuscitation. JAMA 2006; 295(22):2629-37. Medline
|
|
II
|
Supportive (Green)
|
Survival (alive upon ED admission)
|
Patient
|
PH-Paramedic
|
Thayne RC., Thomas DC., Neville JD., Van Dellen A. Use of an impedance threshold device improves short-term outcomes following out-of-hospital cardiac arrest. Resuscitation 2005; 67(1):103-8. Medline
|
|
II
|
Neutral (Yellow)
|
ROSC
|
Patient
|
|
Gunyadin YK., Cekmen B., Alkilli NB., Koylu R., Sert ET., Cander B. Comparative effectiveness of standard CPR vs active compression-decompression CPR with CardioPump for treatment of cardiac arrest. Am J Emerg Med 2016; 34(3):542-7. Medline
|
|
III
|
Supportive (Green)
|
PETCO2 levels
|
Patient
|
PH-Paramedic
|
Axelsson C., Karlsson T., Axelsson AB., Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) versus manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation 2009; 80(10):1099-103. Medline
|
|
III
|
Supportive (Green)
|
Neurologic Recovery
|
Patient
|
PH-Paramedic
|
Holmstrom P., Boyd J., Sorsa M., Kuisma M. A case of hypothermic cardiac arrest treated with an external chest compression device (LUCAS) during transport to re-warming. Resuscitation 2005; 67(1):139-41. Medline
|
|
III
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic
|
Lurie KG., Shultz JJ., Callaham ML., et al. Evaluation of active compression-decompression CPR in victims of out-of-hospital cardiac arrest. JAMA 1994; 271(18):1405-11. Medline
|
ACLS
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Survival at hospital discharge
|
Patient
|
PH-Paramedic
|
Bakalos G. Advanced Life Support versus Basic Life Support in the Pre-Hospital Setting: A Meta-Analysis. Resuscitation 2011; 82:1130-7. Medline
|
|
I
|
Supportive (Green)
|
Survival to discharge
|
Process
|
ED-MD
|
Yannopoulos D, Bartos J, Raveendran G, Walser E, Connett J, Murray TA, et al. Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): A phase 2, single centre, open-label, randomised controlled trial. Lancet 2020; 396(10265):1807-16. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
|
Evans CC., Petersen A., Meier EN., Buick JE., Schreiber M., Kannas D, et al. Prehospital traumatic cardiac arrest: Management and outcomes from the resuscitation outcomes consortium epistry-trauma and PROPHET registries. The journal of trauma and acute care surgery 2016; 81(2):285-93. Medline
|
|
II
|
Supportive (Green)
|
1-month survival
|
Patient
|
PH-Paramedic
|
Hagihara A, Onozuka D, Nagata T, Hasegawa M. Effects of advanced life support on patients who suffered cardiac arrest outside of hospital and were defibrillated. Am J Emerg Med 2018; 36(1):73-8 Medline
|
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic
|
Ma M., et al. Outcomes from OOHCA in Metro Taipan: does and ALS service make a difference? Resuscitation 2007; 74:461-9. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Markel DT., Gold LS., Fahrenbruch CE., Eisenberg MS. Prompt ALS Improves Survival VF. Prehospital Emerg Care 2009; 13(3):329-34. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
|
Morgenstern J., Heitz C., Milne WK. Hot Off the Press: Prehospital Advanced Cardiac Life Support for Out-of-hospital Cardiac Arrest. Academic Emergency Medicine 2018; 25(4):453-455. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Nichol G., Detsky AS., Stiell IG., O'Rourke K., Wells G., Laupacis A. Effectiveness of emergency medical services for victims of out-of-hospital cardiac arrest: A metaanalysis. Ann Emerg Med 1996; 27(6):700-10. Medline
|
|
II
|
Supportive (Green)
|
Quality of life
|
Patient
|
PH-Paramedic
|
van Alem AP., Waalewijn RA., Koster RW., de Vos R. Assessment of quality of life and cognitive function after out-of-hospital cardiac arrest with successful resuscitation. Am J Cardiol 2004; 93(2):131-135. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Woodall J., McCarthy M., Johnston T., Tippett V., Bonham R. Impact of advanced cardiac life support-skilled paramedics on survival from out-of-hospital cardiac arrest in a statewide emergency medical service. EMJ 2007; 24:134-8. Medline
|
|
II
|
Neutral (Yellow)
|
Resuscitation rates and 1-month survival rates
|
Patient
|
PH-Paramedic
|
Ohshige K., et al. Evaluation of OOHCA resuscitation with resuscitative drugs: a prospective comparative study in Japan. Resus 2005; 66:53-61. Medline
|
|
II
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Ryynanen OP., Iirola T., Reitala J., Palve H., Malmivaara A. Is advanced life support better than basic life support in prehospital care? A systematic review. Scand J Trauma Resusc Emerg Med 2010; 18:62-7241-18-62. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Sanghavi P., Jena AB., Newhouse JP., Zaslavsky AM. Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support. JAMA Intern Med 2015; 175(2):196-204. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Sanghavi P., Jena AB., Newhouse JP., Zaslavsky AM. Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support. JAMA Intern Med 2015; 175(2):196-204. Medline
|
|
II
|
Neutral (Yellow)
|
Peak expiratory flow rate
|
Patient
|
PH-Paramedic
|
Stiell IG., et al. Advanced Cardiac Life Support in Out-of-Hospital Cardiac Arrest. NEJM 2004; 351:647-56. Medline
|
|
II
|
Opposes (Red)
|
Survival and Neurological Recovery at 1 month
|
Patient
|
|
Hagihara A., Onozuka D., Nagata T., Hasegawa M. Effects of advanced life support on patients who suffered cardiac arrest outside of hospital and were defibrillated. Am J Emerg Med 2018; 36(1):73-8. Medline
|
|
II
|
Opposes (Red)
|
Survival and Neurological Recovery at 1 month
|
Patient
|
|
Hagihara A., Onozuka D., Nagata T., Hasegawa M. Effects of advanced life support on patients who suffered cardiac arrest outside of hospital and were defibrillated. Am J Emerg Med 2018; 36(1):73-8. Medline
|
|
II
|
Opposes (Red)
|
Sustained ROSC >20 min
|
Patient
|
PH-Paramedic
|
Stupca K, Scaturo N, Shomo E, King T, Frank M. Esmolol, vector change, and dose-capped epinephrine for prehospital ventricular fibrillation or pulseless ventricular tachycardia. Am J Emerg Med 2023; 64:46-50. Medline
|
|
III
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Rittenberger JC., et al. Predictors of ROSC in witnessed aeromedical cardiac arrests. Resuscitation 2008; 76:43-6. Medline
|
Bystander CCC
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Bystander
|
Bielski K, Smereka J, Chmielewski J, Pruc M, Chirico F, Gasecka A, et al. Meta-analysis of chest compression-only versus conventional cardiopulmonary resuscitation by bystanders for adult with out-of-hospital cardiac arrest. Cardiol J 2021. Medline
|
|
I
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
|
Zhan L., Yang LJ., Huang Y., He Q., Liu GJ. Continuous chest compression versus interrupted chest compression for cardiopulmonary resuscitation of non-asphyxial out-of-hospital cardiac arrest. The Cochrane database of systematic reviews 2017; 3:CD010134. Medline
|
|
II
|
Supportive (Green)
|
Neurologically favorable survival
|
Patient
|
|
Fukuda T., Ohashi-Fukuda N., Kondo Y., Sera T., Yahagi N. Effect of rescue breathing by lay rescuers for out-of-hospital cardiac arrest caused by respiratory disease: a nationwide, population-based, propensity score-matched study. Internal and emergency medicine 2017; 12(4):493-501. Medline
|
|
II
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Bystander
|
Ivan I, Budiman F, Ruby R, Wendi IP, Ridjab DA. Current evidence of survival benefit between chest-compression only versus standard cardiopulmonary resuscitation in out-of-hospital cardiac arrest : Updated systematic review and meta-analysis of randomized controlled trials with trial sequential analysi. Herz 2021; 46(S2):198–208. Medline
|
|
II
|
Supportive (Green)
|
1-month survival with favourable neurological outcome
|
Patient
|
PH-Bystander
|
Iwami T., Kitamura T., Kiyohara K., Kawamura T. Dissemination of chest compression-only cardiopulmonary resuscitation and survival after out-of-hospital cardiac arrest. Circulation 2015; 132(5):415-22. Medline
|
|
II
|
Supportive (Green)
|
All-causes survival at 30 days
|
Patient
|
PH-Paramedic & MD
|
Javaudin F, Raiffort J, Desce N, Baert V, Hubert H, Montassier E, et al. Neurological Outcome of Chest Compression-Only Bystander CPR in Asphyxial and Non-Asphyxial Out-Of-Hospital Cardiac Arrest: An Observational Study. Prehosp Emerg Care 2020:1-25. Medline
|
|
II
|
Supportive (Green)
|
Neurological function at 1 month
|
Patient
|
PH-Paramedic
|
Kitamura T., Iwami T., Kawamura T., et al. Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: A prospective, nationwide, population-based cohort study. Lancet 2010; 375(9723):1347-54. Medline
|
|
II
|
Supportive (Green)
|
1-month neurologically favourable survival
|
Patient
|
PH-Paramedic
|
Maeda T., Kamikura T., Tanaka Y., et al. Impact of bystander-performed ventilation on functional outcomes after cardiac arrest and factors associated with ventilation-only cardiopulmonary resuscitation: A large observational study. Resuscitation 2015; 91:122-30. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Ong ME., Ng FS., Anushia P., et al. Comparison of chest compression only and standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest in singapore. Resuscitation 2008; 78(2):119-26. Medline
|
|
II
|
Supportive (Green)
|
Favourable neurological outcome
|
Patient
|
PH-Paramedic
|
SOS-KANTO study group. Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): An observational study. Lancet 2007; 369(9565):920-926. Medline
|
|
II
|
Neutral (Yellow)
|
Neurological function at 1 month
|
Patient
|
PH-Paramedic
|
Kitamura T., Iwami T., Kawamura T., et al. Time-dependent effectiveness of chest compression-only and conventional cardiopulmonary resuscitation for out-of-hospital cardiac arrest of cardiac origin. Resuscitation 2011; 82(1):3-9. Medline
|
|
III
|
Neutral (Yellow)
|
CPR quality
|
Patient
|
SIM
|
Hong DY., Park SO., Lee KR., Baek KJ., Shin DH. A different rescuer changing strategy between 30:2 cardiopulmonary resuscitation and hands-only cardiopulmonary resuscitation that considers rescuer factors: A randomised cross-over simulation study with a time-dependent analysis. Resuscitation 2012; 83(3):353-9. Medline
|
Bystander CPR
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Rate of bystander-initiated CPR
|
Process
|
PH-Paramedic
|
Ringh M., Rosenqvist M., Hollenberg J., et al. Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest. N Engl J Med 2015; 372(24):2316-25. Medline
|
|
II
|
Supportive (Green)
|
In-hospital or 30 day mortality
|
Patient
|
PH-Bystander
|
Bielski K, Smereka J, Chmielewski J, Pruc M, Chirico F, Gasecka A, et al. Meta-analysis of chest compression-only versus conventional cardiopulmonary resuscitation by bystanders for adult with out-of-hospital cardiac arrest. Cardiol J 2021. Medline
|
|
II
|
Supportive (Green)
|
Bystander interventions; incidence and outcome of OHCA; 30-day survival.
|
Process
|
Other
|
Gantzel Nielsen C, Andelius LC, Hansen CM, Blomberg SNF, Christensen HC, Kjølbye JS, et al. Bystander interventions and survival following out-of-hospital cardiac arrest at Copenhagen International Airport. Resuscitation 2021. Medline
|
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Bystander
|
Grubic N, Hill B, Phelan D, Baggish A, Dorian P, Johri AM. Bystander interventions and survival after exercise-related sudden cardiac arrest: a systematic review. Br J Sport Med 2022; 56(7):410–6. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge with good neurological outcome
|
Patient
|
PH-Bystander
|
Grubic N, Peng YP, Walker M, Brooks SC; CARES Surveillance Group. Bystander-initiated cardiopulmonary resuscitation and automated external defibrillator use after out-of-hospital cardiac arrest: Uncovering disparities in care and survival across the urban-rural spectrum. Resuscitation 2022; 175:150–8. Medline
|
|
II
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Bystander
|
Ivan I, Budiman F, Ruby R, Wendi IP, Ridjab DA. Current evidence of survival benefit between chest-compression only versus standard cardiopulmonary resuscitation in out-of-hospital cardiac arrest : Updated systematic review and meta-analysis of randomized controlled trials with trial sequential analysi. Herz 2021; 46(S2):198–208. Medline
|
|
II
|
Supportive (Green)
|
Neurologic recovery at the discharge
|
Patient
|
PH-Bystander
|
Kim MW, Kim TH, Song KJ, Shin SD, Kim CH, Lee EJ, et al. Comparison between dispatcher-assisted bystander CPR and self-led bystander CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation 2021; 158:64-70. Medline
|
|
II
|
Supportive (Green)
|
Good neurological recovery at discharge
|
Patient
|
PH-Bystander
|
Kim SH, Park JH, Jeong J, Ro YS, Hong KJ, Song KJ, Do Shin S. Bystander cardiopulmonary resuscitation, automated external defibrillator use, and survival after out-of-hospital cardiac arrest. Am J Emerg Med April 2023; 66:85-90. Medline
|
|
II
|
Supportive (Green)
|
Neurological function at 1 month
|
Patient
|
PH-Paramedic
|
Kitamura T., Iwami T., Kawamura T., et al. Time-dependent effectiveness of chest compression-only and conventional cardiopulmonary resuscitation for out-of-hospital cardiac arrest of cardiac origin. Resuscitation 2011; 82(1):3-9. Medline
|
|
II
|
Supportive (Green)
|
1-year risks of anoxic brain damage
|
Patient
|
|
Kragholm K., Wissenberg M., Mortensen RN., Hansen SM., Malta HC., Thorsteinsson K., et al. Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest. N Engl J Med 2017; 376(18):1737-47. Medline
|
|
II
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Bystander
|
Lee J, Lee W, Lee YJ, Sim H, Lee WK. Effectiveness of bystander cardiopulmonary resuscitation in improving the survival and neurological recovery of patients with out-of-hospital cardiac arrest: A nationwide patient cohort study. PLoS One 2020; 15(12):e0243757. Medline
|
|
II
|
Supportive (Green)
|
Survival
|
Patient
|
|
Lee M., Demirtas D., Buick JE., Feldman MJ., Cheskes S., Morrison LJ., et al. Increased cardiac arrest survival and bystander intervention in enclosed pedestrian walkway systems. Resuscitation 2017; 118:1-7. Medline
|
|
II
|
Supportive (Green)
|
1-month neurologically favourable survival
|
Patient
|
PH-Paramedic
|
Maeda T., Kamikura T., Tanaka Y., et al. Impact of bystander-performed ventilation on functional outcomes after cardiac arrest and factors associated with ventilation-only cardiopulmonary resuscitation: A large observational study. Resuscitation 2015; 91:122-30. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Nichol G., Detsky AS., Stiell IG., O'Rourke K., Wells G., Laupacis A. Effectiveness of emergency medical services for victims of out-of-hospital cardiac arrest: A metaanalysis. Ann Emerg Med 1996; 27(6):700-10. Medline
|
|
II
|
Supportive (Green)
|
30-day survival
|
Patient
|
|
Nord A., Svensson L., Karlsson T., Claesson A., Herlitz J., Nilsson L. Increased survival from out-of-hospital cardiac arrest when off duty medically educated personnel perform CPR compared with laymen. Resuscitation 2017; 120:88-94. Medline
|
|
II
|
Supportive (Green)
|
Discharge from hospital with favourable neuro
|
Patient
|
PH-Paramedic
|
Olasveengen TM., Wik L., Steen PA. Standard basic life support vs. continuous chest compressions only in out-of-hospital cardiac arrest. Acta Anaesthesiol Scand 2008; 52(7):914-9. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Ong ME., Ng FS., Anushia P., et al. Comparison of chest compression only and standard cardiopulmonary resuscitation for out-of-hospital cardiac arrest in singapore. Resuscitation 2008; 78(2):119-26. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
|
Park GJ., Song KJ., Shin SD., Lee KW., Ahn KO., Lee EJ., et al. Timely bystander CPR improves outcomes despite longer EMS times. Am J Emerg Med 2017; 35(8):1049-1055. Medline
|
|
II
|
Supportive (Green)
|
30-day survival
|
Patient
|
|
Rajan S., Wissenberg M., Folke F., Hansen SM., Gerds TA., Kragholm K., et al. Association of Bystander Cardiopulmonary Resuscitation and Survival According to Ambulance Response Times After Out-of-Hospital Cardiac Arrest. Circulation 2016; 134(25):2095-104. Medline
|
|
II
|
Supportive (Green)
|
Hospital length of stay and ICU admission.
|
Process
|
|
Riddersholm S., Kragholm K., Mortensen RN., Pape M., Hansen CM., Lippert FK., et al. Association of bystander interventions and hospital length of stay and admission to intensive care unit in out-of-hospital cardiac arrest survivors. Resuscitation 2017; 119:99-106. Medline
|
|
II
|
Supportive (Green)
|
Favourable neurological outcome
|
Patient
|
PH-Paramedic
|
SOS-KANTO study group. Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): An observational study. Lancet 2007; 369(9565):920-926. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge.
|
Patient
|
PH-Paramedic
|
Stiell IG., Wells GA., DeMaio VJ., et al. Modifiable factors associated with improved cardiac arrest survival in a multicenter basic life support/defibrillation system: OPALS study phase I results. Ontario prehospital advanced life support. Ann Emerg Med 1999; 33(1):44-50. Medline
|
|
II
|
Supportive (Green)
|
Shockable rhythm on first EKG
|
Process
|
|
Takahashi H., Sagisaka R., Natsume Y., Tanaka S., Takyu H., Tanaka H. Does dispatcher-assisted CPR generate the same outcomes as spontaneously delivered bystander CPR in Japan? Am J Emerg Med 2018; 36(3):384-91. Medline
|
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
|
Viereck S., Palsgaard Møller T., Kjær Ersbøll A., Folke F., Lippert F. Effect of bystander CPR initiation prior to the emergency call on ROSC and 30day survival-An evaluation of 548 emergency calls. Resuscitation 2017; 111:55-61. Medline
|
|
II
|
Neutral (Yellow)
|
Prolonged Shockable Rhythm time with bystander CPR
|
Patient
|
PH-Bystander
|
Cournoyer A, Chauny JM, Paquet J, Potter B, Lamarche Y, de Montigny L, et al. Electrical rhythm degeneration in adults with out-of-hospital cardiac arrest according to the no-flow and bystander low-flow time. Resuscitation 2021. Medline
|
|
III
|
Supportive (Green)
|
CPR measures
|
Process
|
|
Gyllenborg T., Granfeldt A., Lippert F., Riddervold IS., Folke F. Quality of bystander cardiopulmonary resuscitation during real-life out-of-hospital cardiac arrest. Resuscitation 2017; 120:63-70. Medline
|
|
III
|
Supportive (Green)
|
CPR quality
|
Patient
|
SIM
|
Hong DY., Park SO., Lee KR., Baek KJ., Shin DH. A different rescuer changing strategy between 30:2 cardiopulmonary resuscitation and hands-only cardiopulmonary resuscitation that considers rescuer factors: A randomised cross-over simulation study with a time-dependent analysis. Resuscitation 2012; 83(3):353-9. Medline
|
|
III
|
Supportive (Green)
|
Survival time
|
Patient
|
PH-Paramedic
|
Wang HE., Min A., Hostler D., Chang CC., Callaway CW. Differential effects of out-of-hospital interventions on short- and long-term survival after cardiopulmonary arrest. Resuscitation 2005; 67(1):69-74. Medline
|
Chest Compression devices
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
ROSC
|
Patient
|
|
Anantharaman V, Ng BL, Ang SH, Lee CY, Leong SH, Ong ME, et al. Prompt use of mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest: The MECCA study report. Singapore Med J; 58(7):424-31. Medline
|
|
I
|
Supportive (Green)
|
Survival to admission
|
Patient
|
|
Bonnes JL., Brouwer MA., Navarese EP., Verhaert DV., Verheugt FW., Smeets JL., et al. Manual Cardiopulmonary Resuscitation Versus CPR Including a Mechanical Chest Compression Device in Out-of-Hospital Cardiac Arrest: A Comprehensive Meta-analysis From Randomized and Observational Studies. Ann Emerg Med 2016; 67(3):349-60.e3. Medline
|
|
I
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic
|
Chiang CY, Lim KC, Lai PC, Tsai TY, Huang YT, Tsai MJ. Comparison between Prehospital Mechanical Cardiopulmonary Resuscitation (CPR) Devices and Manual CPR for Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis. J Clin Med 2022; 11(5). Medline
|
|
I
|
Supportive (Green)
|
30 day mortality
|
Patient
|
PH-Paramedic
|
Perkins GD., Lall R., Quinn T., et al. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): A pragmatic, cluster randomised controlled trial. Lancet 2015; 385(9972):947-55. Medline
|
|
I
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Paramedic
|
Wang PL., Brooks SC. Mechanical versus manual chest compressions for cardiac arrest. The Cochrane database of systematic reviews 2018; 8 CD007260. Medline
|
|
I
|
Neutral (Yellow)
|
Long term outcomes (QoL)
|
Patient
|
|
Ji C., Lall R., Quinn T., Kaye C., Haywood K., Horton J., et al. Post-admission outcomes of participants in the PARAMEDIC trial: A cluster randomised trial of mechanical or manual chest compressions. Resuscitation 2017; 118:82-8. Medline
|
|
I
|
Neutral (Yellow)
|
Survival at 30 days
|
Patient
|
|
Khana S., Lonea A., Talluria S., et al. Efficacy and safety of mechanical versus manual compression in cardiac arrest – A Bayesian network meta-analysis. Resuscitation 2018; 130 182–188 Medline
|
|
I
|
Neutral (Yellow)
|
Serious or life-threatening visceral resuscitation-related damage
|
Patient
|
|
Koster RW., Beenen LF., van der BE., Spijkerboer AM., Tepaske R., van der WA., et al. Safety of mechanical chest compression devices AutoPulse and LUCAS in cardiac arrest: a randomized clinical trial for non-inferiority. Eur Heart J 2017; 38(40):3006-13. Medline
|
|
I
|
Neutral (Yellow)
|
In-hospital mortality
|
Patient
|
ED-MD
|
Ong ME., Mackey KE., Zhang ZC., et al. Mechanical CPR devices compared to manual CPR during out-of-hospital cardiac arrest and ambulance transport: A systematic review. Scand J Trauma Resusc Emerg Med 2012; 20:39-7241-20-39. Medline
|
|
I
|
Neutral (Yellow)
|
Injuries
|
Process
|
PH-Paramedic
|
Petrovich P, Berve PO, Barth-Heyerdahl Roald B, Wahl Kongsgård Hl. Injuries associated with mechanical chest compressions and active decompressions after out-of-hospital cardiac arrest: A subgroup analysis of non-survivors from a randomized study. Resusc Plus March 2023; 13:100362. Medline
|
|
I
|
Neutral (Yellow)
|
4-hour survival
|
Patient
|
PH-Paramedic
|
Rubertsson S., Lindgren E., Smekal D., et al. Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: The LINC randomized trial. JAMA 2014; 311(1):53-61. Medline
|
|
I
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Westfall M., Krantz S., Mullin C., Kaufman C., Mechanical Versus Manual Chest Compressions in Out-of-Hospital Cardiac Arrest: A Meta-Analysis. Crit Care 2013; 41: 7. Medline
|
|
I
|
Opposes (Red)
|
Survival to 4 hours after the 911 call
|
Patient
|
PH-Paramedic
|
Hallstrom A., et al. Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial.
JAMA 2006; 295(22):2620-8. Medline
|
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic
|
Chen YR, Liao CJ, Huang HC, Tsai CH, Su YS, Liu CH, et al. The Effect of Implementing Mechanical Cardiopulmonary Resuscitation Devices on Out-of-Hospital Cardiac Arrest Patients in an Urban City of Taiwan. Int J Environ Res Public Health 2021; 18(7). Medline
|
|
II
|
Supportive (Green)
|
Chest compression fraction
|
Process
|
PH-Paramedic
|
Esibov A., Banville I., Chapman FW., Boomars R., Box M., Rubertsson S. Mechanical chest compressions improved aspects of CPR in the LINC trial. Resuscitation 2015; 91:116-21. Medline
|
|
II
|
Supportive (Green)
|
Efficacy of mechanical CPR
|
Process
|
PH-Paramedic
|
Manoukian MAC, Tancredi DJ, Linvill MT, Wynia EH, Beaver B, Rose JS, Mumma BE. Manual versus Mechanical Delivery of High-Quality Cardiopulmonary Resuscitation on a River-Based Fire Rescue Boat. Prehosp Disaster Med 2022; 37(5):630–7. Medline
|
|
II
|
Supportive (Green)
|
CPC <2 at Discharge
|
Patient
|
ED-Paramedic & MD
|
Mistraletti G, Lancioni A, Bassi G, et al. Mechanical chest compression and extracorporeal life support for out-of-hospital cardiac arrest. A 30-month observational study in the metropolitan area of Milan, Italy. Resuscitation Dec 2022; 182:109659. Medline
|
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic
|
Omori K., Sato S., Sumi Y., et al. The analysis of efficacy for AutoPulse system in flying helicopter. Resuscitation 2013; 84(8):1045-50. Medline
|
|
II
|
Supportive (Green)
|
Feasibility
|
Process
|
|
Schmidbauer S., Herlitz J., Karlsson T., Axelsson C., Friberg H. Use of automated chest compression devices after out-of-hospital cardiac arrest in Sweden. Resuscitation 2017; 120:95-102. Medline
|
|
II
|
Neutral (Yellow)
|
ROSC on ED arrival
|
Process
|
PH-Paramedic
|
Casner M., Anderson D., Isaacs M. The impact of a new CPR assist device on rate of return of spontaneous circulation in out-of-hospital cardiac arrest. Prehosp Emer Care 2005; 9(1):61-7. Medline
|
|
II
|
Neutral (Yellow)
|
ROSC
|
Patient
|
Other
|
Frascone R, Pasquarella J, Hartigan M, Pasquarella C, Rupp P, Wewerka S. Automated Versus Manual Cardiopulmonary Resuscitation in Flight: Are We Being Safe? Air Med J 2022; 41(3):303–7. Medline
|
|
II
|
Neutral (Yellow)
|
ROSC
|
Patient
|
|
Hardig BM., Lindgren E., Östlund O., Herlitz J., Karlsten R., Rubertsson S. Outcome among VF/VT patients in the LINC (LUCAS IN cardiac arrest) trial-A randomised, controlled trial. Resuscitation 2017; 115:155-62. Medline
|
|
II
|
Neutral (Yellow)
|
Incidence and description of injury from mechanical CPR
|
Patient
|
PH-Paramedic
|
Hayashi M, Tanizaki S, Nishida N, et al. Compression-associated injuries using CLOVER3000 device in non-survivor patients of OHCA: A retrospective cohort study. Am J Emerg Med March 2023; 68:127-31. Medline
|
|
II
|
Neutral (Yellow)
|
Units transfused
|
Patient
|
PH-Paramedic & MD
|
Jennings PA., Harriss L., Bernard S., et al. An automated CPR device compared with standard chest compressions for out-of-hospital resuscitation. BMC Emerg Med 2012; 12:8-227X-12-8. Medline
|
|
II
|
Neutral (Yellow)
|
Hands off time.
|
Process
|
|
Maurin O., Frattini B., Jost D., Galinou N., Alhanati L., Dang MP., et al. Hands-off Time during Automated Chest Compression Device Application in Out-of-Hospital Cardiac Arrest: A Case Series Report. PEC 2016; 20(5):637-42. Medline
|
|
II
|
Neutral (Yellow)
|
Chest-compression associated injuries
|
Patient
|
ED-Paramedic & MD
|
Ondruschka B., Baier C., Bayer R., Hammer N., DreBler J., Bernhard M. Chest compression-associated injuries in cardiac arrest patients treated with manual chest compressions versus automated chest compression devices (LUCAS II) - a forensic autopsy-based comparison. Forensic science, medicine, and pathology 2018; 14(4) 515-25. Medline
|
|
II
|
Opposes (Red)
|
Survival to hospital discharge
|
Patient
|
|
Hayashida K., Tagami T., Fukuda T., Suzuki M., Yonemoto N., Kondo Y., et al. Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out-of-Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS-KANTO Survey of Survivo. Journal of the American Heart Association 2017; 6(11). Medline
|
|
II
|
Opposes (Red)
|
Good neurological outcome at discharge (CPC 1 or 2)
|
Patient
|
PH-Paramedic
|
Jung E, Hong KJ, Shin SD, Ro YS, Ryu HH, Song KJ, et al. Interaction Effect Between Prehospital Mechanical Chest Compression Device Use and Post-Cardiac Arrest Care on Clinical Outcomes After Out-Of-Hospital Cardiac Arrest. J Emerg Med 2021. Medline
|
|
II
|
Opposes (Red)
|
Neurologic outcomes and survival to discharge
|
Patient
|
PH-Paramedic
|
Min C, Lee DE, Ryoo HW, Jung H, Cho JW, et al. Neurologic outcomes of prehospital mechanical chest compression device use during transportation of out-of-hospital cardiac arrest patients: a multicenter observational study. Clin Exp Emerg Med 2022. Medline
|
|
II
|
Opposes (Red)
|
Survival to hospital discharge with favorable neurologic outcomes
|
Patient
|
|
Youngquist ST., Ockerse P., Hartsell S., Stratford C., Taillac P. Mechanical chest compression devices are associated with poor neurological survival in a statewide registry: A propensity score analysis. Resuscitation 2016; 106:102-7. Medline
|
|
III
|
Supportive (Green)
|
Feasibility
|
Process
|
SIM
|
Alexander E, Katharina T, Verena F, Jürgen G, Maximilian N, Calvin K, et al. Comparison of different mechanical chest compression devices in the alpine rescue setting: a randomized triple crossover experiment. Scand J Trauma Resusc Emerg Med 2021; 29(1):84. Medline
|
|
III
|
Supportive (Green)
|
CPR quality
|
Process
|
SIM
|
Fox J., Fiechter R., Gerstl P., et al. Mechanical versus manual chest compression CPR under ground ambulance transport conditions. Acute Card Care 2013; 15(1):1-6. Medline
|
|
III
|
Supportive (Green)
|
ROSC
|
Patient
|
|
Gao C., Chen Y., Peng H., Chen Y., Zhuang Y., Zhou S. Clinical evaluation of the AutoPulse automated chest compression device for out-of-hospital cardiac arrest in the northern district of Shanghai, China. AMS 2016; 12(3):563-70. Medline
|
|
III
|
Supportive (Green)
|
Time to first defibrillation
|
Process
|
|
Gyory RA., Buchle S.E, Rodgers D., Lubin JS. The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study. The western journal of emergency medicine 2017; 18(3):437-45. Medline
|
|
III
|
Supportive (Green)
|
Performance
|
Process
|
PH-Paramedic & MD
|
Jörgens M, Königer J, Kanz KG, Birkholz T, Hübner H, Prückner S, et al. Testing mechanical chest compression devices of different design for their suitability for prehospital patient transport - a simulator-based study. BMC Emerg Med 2021; 21(1):18. Medline
|
|
III
|
Supportive (Green)
|
This observational manikin-based study aimed to evaluate the effect of the speed of ambulance on the quality of chest compression performed by the two different types of mechanical devices and manual chest compression.
|
Process
|
SIM
|
Kamauzaman THT, Ngu JTH, Arithra A, Noh AYM, Siti-Azrin AH, Nor J. Simulation study on quality of CPR between manual chest compression and mechanical chest compression devices performed in ambulance. Med J Malaysia 2021; 76(2):171-6. Medline
|
|
III
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Risom M., Jorgensen H., Rasmussen LS., Sorensen AM. Resuscitation, prolonged cardiac arrest, and an automated chest compression device. J Emerg Med 2010; 38(4):481-3. Medline
|
|
III
|
Supportive (Green)
|
Injury
|
Patient
|
ED-MD
|
Smekal D., Johansson J., Huzevka T., Rubertsson S. A pilot study of mechanical chest compressions with the LUCAS device in cardiopulmonary resuscitation. Resuscitation 2011; 82(6):702-706. Medline
|
|
III
|
Supportive (Green)
|
Effectiveness of chest compressions
|
Process
|
SIM
|
Szarpak L, Truszewski Z, Czyzewski L, Frass M, Robak O. CPR using the lifeline ARM mechanical chest compression device: a randomized, crossover, manikin trial. Am J Emerg Med 2017; 35(1):96-100. Medline
|
|
III
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Axelsson C., Nestin J., Svensson L., Axelsson AB., Herlitz J. Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of OOHCA - a pilot study. Resuscitation 2006; 71:47-55. Medline
|
|
III
|
Neutral (Yellow)
|
CPR quality
|
Process
|
SIM
|
Gassler H., Ventzke MM., Lampl L., Helm M. Transport with ongoing resuscitation: A comparison between manual and mechanical compression. Emerg Med J 2013; 30(7):589-92. Medline
|
|
III
|
Neutral (Yellow)
|
Quality of Chest Compressions
|
Process
|
SIM
|
Kovic I., Lulic D., Lulic I. CPR PRO(R) device reduces rescuer fatigue during continuous chest compression cardiopulmonary resuscitation: A randomized crossover trial using a manikin model. J Emerg Med 2013; 45(4):570-7. Medline
|
|
III
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Krep H., et al. OOHCA resuscitation with the autopulse system: a prospective observational study with a new load-distributing band chest compression device. Resus 2007; 73:86-95. Medline
|
|
III
|
Neutral (Yellow)
|
Correct compressions
|
Process
|
SIM
|
Putzer G., Braun P., Zimmermann A., et al. LUCAS compared to manual cardiopulmonary resuscitation is more effective during helicopter rescue-a prospective, randomized, cross-over manikin study. Am J Emerg Med 2013; 31(2):384-9. Medline
|
|
III
|
Neutral (Yellow)
|
Hands off fraction
|
Patient
|
SIM
|
Tomte O., Sunde K., Lorem T., et al. Advanced life support performance with manual and mechanical chest compressions in a randomized, multicentre manikin study. Resuscitation 2009; 80(10):1152-1157. Medline
|
|
III
|
Opposes (Red)
|
Time to Defibrillation and No Flow Time
|
Process
|
SIM
|
Blomberg H., Gedeborg R., Berglund L., Karlsten R., Johansson J. Poor chest compression quality with mechanical compressions in simulated cardiopulmonary resuscitation: A randomized, cross-over manikin study. Resuscitation 2011; 82(10):1332-7. Medline
|
|
III
|
Opposes (Red)
|
Survival to
hospital discharge with a favourable neurologic outcome
|
Patient
|
|
Newberry R., Redman T., Ross E., Ely R., Saidler C., Arana A., et al. No Benefit in Neurologic Outcomes of Survivors of Out-of-Hospital Cardiac Arrest with Mechanical Compression Device. Prehosp Emerg Care. 2018; 22(3):338-344. Medline
|
|
III
|
Opposes (Red)
|
Injury
|
Patient
|
PH-Paramedic
|
Wind J., Bekkers SC., van Hooren LJ., van Heurn LW. Extensive injury after use of a mechanical cardiopulmonary resuscitation device. Am J Emerg Med 2009; 27(8):1017.e1-1017.e2. Medline
|
CPR feedback device
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Neutral (Yellow)
|
Survival to admission
|
Patient
|
|
Beesems SG, Berdowski J, Hulleman M, Blom MT, Tijssen JG, Koster RW. Minimizing pre- and post-shock pauses during the use of an automatic external defibrillator by two different voice prompt protocols. A randomized controlled trial of a bundle of measures. Resuscitation 2016; 106:1-6. Medline
|
|
I
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Bohn A., Weber TP., Wecker S., Harding U., Osada N., Van Aken H., et al. The addition of voice prompts to audiovisual feedback and debriefing does not modify CPR quality or outcomes in out of hospital cardiac arrest--a prospective, randomized trial. Resuscitation 2011; 82(3):257-62. Medline
|
|
I
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Hostler D., Everson-Stewart S., Rea TD., Stiell IG., et al. Effect of real-time feedback during cardiopulmonary resuscitation outside hospital: prospective cluster-randomized trial. BMJ 20011; 342d512. Medline
|
|
II
|
Supportive (Green)
|
CPR quality
|
Process
|
|
Guenther SPW., Schirren M., Boulesteix AL., Busen H., Poettinger T., Pichlmaier AM., et al. Effects of the Cardio First AngelTM on chest compression performance. Technology and health care 2018; 26(1):69-80. Medline
|
|
II
|
Supportive (Green)
|
CPR quality - depth, etc.
|
Process
|
PH-Paramedic
|
Kramer-Johansen J., et al. Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study. Resuscitation 2006; 71(3):283-92. Medline
|
|
II
|
Supportive (Green)
|
CPR quality
|
Process
|
PH-Paramedic
|
Weston BW, Jasti J, Lerner EB, Szabo A, Aufderheide TP, Colella MR. Does an individualized feedback mechanism improve quality of out-of-hospital CPR? Resuscitation 2017; 113:96-100. Medline
|
|
II
|
Neutral (Yellow)
|
ROSC, 24 hour survival
|
Patient
|
|
Botelho RM, Campanharo CR, Lopes MC, Okuno MF, Gois AF, Batista RE. The use of a metronome during cardiopulmonary resuscitation in the emergency room of a university hospital. Rev Lat Am; 24:e2829. Medline
|
|
II
|
Neutral (Yellow)
|
accuracy of simulated CPR sessions
|
Process
|
SIM
|
Musiari M, Saporito A, Ceruti S, Biggiogero M, Iattoni M, Glotta A, et al. Can a Glove-Coach Technology Significantly Increase the Efficacy of Cardiopulmonary Resuscitation on Non-healthcare Professionals? A Controlled Trial. Front Cardiovasc Med 2021; 8:685988. Medline
|
|
III
|
Supportive (Green)
|
CPR quality
|
Process
|
PH-Paramedic
|
Fletcher D., et al. Basics in advanced life support: A role for download audit and metronomes. Resus 2008; 78:127-34. Medline
|
|
III
|
Supportive (Green)
|
CPR feedback device improves CPR
|
Process
|
Other
|
Jaskuła J, Stolarz-Skrzypek K, Jaros K, Wordliczek J, Cebula G, Kloch M. Improvement in paramedics chest compression quality with use of real-time feedback device: Randomized trial. Kardiol Pol 2023. Medline
|
|
III
|
Supportive (Green)
|
Quality of CPR rate and depth
|
Process
|
SIM
|
Skorning M., Beckers SK., Brokmann JC., et al. New visual feedback device improves performance of chest compressions by professionals in simulated cardiac arrest. Resuscitation 2010; 81(1):53-58. Medline
|
|
III
|
Supportive (Green)
|
Mean correct rate and depth of compressions
|
Process
|
SIM
|
Skorning M., Derwall M., Brokmann JC., et al. External chest compressions using a mechanical feedback device: Cross-over simulation study. Anaesthesist 2011; 60(8):717-722. Medline
|
|
III
|
Supportive (Green)
|
Percentage of chest compressions with both correct rate and correct depth
|
Process
|
|
Wutzler A., von Ulmenstein S., Bannehr M., Valk K., Farster J., Storm C., et al. Improvement of lay rescuer chest compressions with a novel audiovisual feedback device : A randomized trial. Med Klin Intensivmed Notfmed 2018; 113(2):124-130. Medline
|
|
III
|
Neutral (Yellow)
|
No flow ratio
|
Process
|
PH-Paramedic
|
Stecher FS., Olsen JA., Stickney RE., Wik L. Transthoracic impedance used to evaluate performance of CPR during OOHCA. Resus 2008; 79:432-7. Medline
|
Epinephrine
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
ROSC
|
Process
|
PH-Paramedic
|
Gueugniaud PY., Mols P., Goldstein P., et al. A comparison of repeated high doses and repeated standard doses of epinephrine for cardiac arrest outside the hospital. European epinephrine study group. N Engl J Med 1998; 339(22):1595-601. Medline
|
|
I
|
Supportive (Green)
|
Survival at 30 days
|
Patient
|
|
Perkins GD., Ji C., Deakin CD., Quinn T., et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med 2018; 379(8):711-721. Medline
|
|
I
|
Neutral (Yellow)
|
6 month survival
|
Patient
|
PH-Paramedic & MD
|
Haywood KL, Ji C, Quinn T, Nolan JP, Deakin CD, Scomparin C, et al. Long term outcomes of participants in the PARAMEDIC2 randomised trial of adrenaline in out-of-hospital cardiac arrest. Resuscitation 2021; 160:84-93. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to hospital d/c
|
Patient
|
PH-Paramedic
|
Jacobs IG., Finn JC., Jelinick GA., Oxer HF., Thompson PL. Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomized, double-blind, placebo-controlled trial. Resusc 2011; 82(9)1138-43. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Lin S., Callaway CW., Shah PS., et al. Adrenaline for out-of-hospital cardiac arrest resuscitation: A systematic review and meta-analysis of randomized controlled trials. Resuscitation 2014; 85(6):732-740. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
ED-MD
|
Ong ME., Tiah L., Leong BS., et al. A randomised, double-blind, multi-centre trial comparing vasopressin and adrenaline in patients with cardiac arrest presenting to or in the emergency department. Resuscitation 2012; 83(8):953-60. Medline
|
|
I
|
Neutral (Yellow)
|
ROSC
|
Patient
|
ED-MD
|
Sillberg VAH., Perry JJ., Stiell IG., Wells GA. Is the combination of vasopressin and epinephrine superior to repeated doses of epi alone in the treatment of cardiac arrest - a systematic review. Resus 2008; 79:380-6. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to hospital admission
|
Patient
|
PH-Paramedic
|
Wenzel V., Krismer AC., et al. A Comparison of Vasopressin and Epinephrine for Out-of-Hospital Cardiopulmonary Resuscitation. New Engl J Med 2003; 350(2):105-13. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to discharge, neurological function
|
Patient
|
PH-Paramedic
|
Wyer PC., et al. Vasopressin or Epinephrine for Out-of-Hospital Cardiac Arrest. Ann Emerg Med 2006; 48(1):86-97. Medline
|
|
I
|
Neutral (Yellow)
|
Efficacy (ROSC rate)
|
Patient
|
|
Zhang Q., Liu B., Zhao L., Qi Z., Shao H., An L., et al. Efficacy of vasopressin-epinephrine compared to epinephrine alone for out of hospital cardiac arrest patients: A systematic review and meta-analysis. Am J Emerg Med 2017; 35(10):1555-60. Medline
|
|
II
|
Supportive (Green)
|
1-month survival
|
Patient
|
PH-Paramedic
|
Matsuyama T, Komukai S, Izawa J, Gibo K, Okubo M, Kiyohara K, et al. Epinephrine administration for adult out-of-hospital cardiac arrest patients with refractory shockable rhythm: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry. Eur Heart J Cardiovasc Pharmacother 2021. Medline
|
|
II
|
Supportive (Green)
|
Neurologically intact survival.
|
Patient
|
|
Tomio J., Nakahara S., Takahashi H., Ichikawa M., Nishida M., Morimura N., et al. Effectiveness of Prehospital Epinephrine Administration in Improving Long-term Outcomes of Witnessed Out-of-hospital Cardiac Arrest Patients with Initial Non-shockable Rhythms. Prehosp Emerg Care 2017; 21(4):432-441. Medline
|
|
II
|
Neutral (Yellow)
|
ROSC on ED arrival
|
Process
|
PH-Paramedic
|
Carvolth RD., Hamilton AJ. Comparison of high-dose epinephrine versus standard-dose epinephrine in adult cardiac arrest in the prehospital setting. Prehosp Disaster Med 1996; 11(3):219-22. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
|
Fisk CA., Olsufka M., Yin L., McCoy AM., Latimer AJ, Maynard C, et al. Lower-dose epinephrine administration and out-of-hospital cardiac arrest outcomes. Resuscitation 2018; 124:43-8. Medline
|
|
II
|
Neutral (Yellow)
|
Favourable CPC scores post-OHCA survival at 30 days.
|
Patient
|
PH-Paramedic
|
Fukuda T, Kaneshima H, Matsudaira A, Chinen T, Sekiguchi H, Ohashi-Fukuda N, et al. Epinephrine dosing interval and neurological outcome in out-of-hospital cardiac arrest. Perfusion 2021; 2676591211025163. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Ong MEH., et al. Survival outcomes with the introduction of intravenous epinephrine in the management of out-of-hospital cardiac arrest. Ann Emerg Med 2007; 50:635-42. Medline
|
|
II
|
Opposes (Red)
|
Survival to discharge neurologically intact
|
Patient
|
PH-Paramedic
|
Dumas F., Bougouin W., Geri G., et al. Is epinephrine during cardiac arrest associated with worse outcomes in resuscitated patients? J Am Coll Cardiol 2014; 64(22):2360-7. Medline
|
|
II
|
Opposes (Red)
|
Favourable neurological outcome
|
Patient
|
PH-Paramedic
|
Fukuda T., Fukuda-Ohashi N., Doi K., Matsubara T., Yahagi N. Effective pre-hospital care for out-of-hospital cardiac arrest caused by respiratory disease. Heart Lung Circ 2015; 24(3):241-9. Medline
|
|
II
|
Opposes (Red)
|
Neurologically intact (CPC1-2) survival at 1-month
|
Patient
|
|
Fukuda T., Ohashi-Fukuda N., Matsubara T., Gunshin M., Kondo Y., Yahagi N. Effect of prehospital epinephrine on out-of-hospital cardiac arrest: a report from the national out-of-hospital cardiac arrest data registry in Japan, 2011-2012. Eur J Clin Pharmacol 2016; 72(10):1255-64. Medline
|
|
II
|
Opposes (Red)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic & CCT
|
Goto Y., Maeda T., Goto YN. Effects of prehospital epinephrine during out-of-hospital cardiac arrest with initial non-shockable rhythm: An observational cohort study. Crit Care 2013; 17(5):R188. Medline
|
|
II
|
Opposes (Red)
|
Survival
|
Patient
|
ED-MD
|
Hagihara A., Manabu H., Takeru A., Takashi N., Yoshifumi W., Shogo M. Prehospital Epinephrine Use and Survival Among Patients With Out-of-Hospital Cardiac Arrest. JAMA 2012; 307(11):1161-8. Medline
|
|
II
|
Opposes (Red)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Han E, Kong T, You JS, Park I, Park G, Lee S, Chung SP; Korean Cardiac Arrest Research Consortium (KoCARC) Investigators. Effect of Prehospital Epinephrine on Out-of-Hospital Cardiac Arrest Outcomes: A Propensity Score-Matched Analysis. Yonsei Med J 2022; 63(2):187–94. Medline
|
|
II
|
Opposes (Red)
|
Transitions from ROSC to VF/VT
|
Patient
|
PH-Paramedic
|
Neset A., Nordseth T., Kramer-Johansen J., Wik L., Olasveengen TM. Effects of adrenaline on rhythm transitions in out-of-hospital cardiac arrest. Acta Anaesthesiol Scand 2013; 57(10):1260-7. Medline
|
|
II
|
Opposes (Red)
|
ROSC
|
Patient
|
PH-Paramedic
|
Niemann J., Stratton S. Endotracheal versus intravenous epinephrine and atropine in out-of-hospital "primary" and post countershock asystole. Critical Care Medicine 2000; 26(6):1815-9. Medline
|
|
II
|
Opposes (Red)
|
Survival to DC
|
Patient
|
PH-Paramedic
|
Olasveengen TM., Wik L., Sunde K., Steen PA. Outcome when adrenaline (epinephrine) was actually given vs. not given - post hoc analysis of a randomized clinical trial. Resuscitation 2012; 83(3):327-32. Medline
|
|
III
|
Supportive (Green)
|
Survival
|
Patient
|
ED-MD
|
Larabee TM., Liu KY., Campbell JA., Little CM. Vasopressors in cardiac arrest: A systematic review. Resuscitation 2012; 83(8):932-9. Medline
|
|
III
|
Neutral (Yellow)
|
Sustained ROSC
|
Patient
|
|
Lindner KH., Ahnefeld FW., Grunert A. Epinephrine versus norepinephrine in prehospital ventricular fibrillation. Am J Cardiol 1991; 67(5):427-8. Medline
|
|
III
|
Neutral (Yellow)
|
Survival to DC
|
Patient
|
PH-Paramedic
|
Olasveengen TM., Sunde K., Brunborg C., Thowsen J., Steen PA., Wik L. Intravenous drug administration during out-of-hospital cardiac arrest: A randomized trial. JAMA 2009; 302(20):2222-9. Medline
|
|
III
|
Neutral (Yellow)
|
Survival
|
Patient
|
ED-MD
|
Stiell IG., Hebert PC., Wells GA., et al. Vasopressin versus epinephrine for in-hospital cardiac arrest: a randomised controlled trial. Lancet 2001; 358(9276):105-9. Medline
|
|
III
|
Neutral (Yellow)
|
Survival time
|
Patient
|
PH-Paramedic
|
Wang HE., Min A., Hostler D., Chang CC., Callaway CW. Differential effects of out-of-hospital interventions on short- and long-term survival after cardiopulmonary arrest. Resuscitation 2005; 67(1):69-74. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Zhong H, Yin Z, Kou B, et al. Therapeutic and adverse effects of adrenaline on patients who suffer out-of-hospital cardiac arrest: a systematic review and meta-analysis. Eur J Med Res 2023; 28(1):24. Medline
|
Mechanical Intraosseous Insertion
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
First-attempt success
|
Process
|
PH-Paramedic
|
Reades R., Studnek JR., Vandeventer S., Garrett J. Intraosseous versus intravenous vascular access during out-of-hospital cardiac arrest: A randomized controlled trial. Ann Emerg Med 2011; 58(6):509-16. Medline
|
|
I
|
Neutral (Yellow)
|
ROSC
|
Patient
|
PH-Paramedic
|
Tan BKK, Chin YX, Koh ZX, Md SN, Rahmat M, Fook-Chong S, et al. Clinical evaluation of intravenous alone versus intravenous or intraosseous access for treatment of out-of-hospital cardiac arrest. Resuscitation 2021; 159:129-36. Medline
|
|
II
|
Supportive (Green)
|
First pass success
|
Process
|
ED-MD
|
Drumheller BC, Edgar MD, Tape MK, Vongviphut D, Herres JP. Comparison of the NIO and EZIO for Resuscitative Vascular Access in the Emergency Department: A Quasi-Experimental, Before-and-After Study. Mil Med 2022. Medline
|
|
II
|
Supportive (Green)
|
First attempt success
|
Patient
|
|
Sunde G., Heradstveit B., Vikenes B., HeltneJ. Emergency intraosseous access in a helicopter
emergency medical service: a retrospective study. Scan J Trauma, Resus and Emerg Med 2010; 18:52. Medline
|
|
II
|
Supportive (Green)
|
Success rates of establishing the
access route
|
Process
|
PH-Paramedic
|
Yang SC, Hsu YH, Chang YH, Chien LT, Chen IC, Chiang WC. Epinephrine administration in adults with out-of-hospital cardiac arrest: A comparison between intraosseous and intravenous route. Am J Emerg Med 2023; 67:63-9. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
|
Feinstein BA., Stubbs BA., Rea T., Kudenchuk PJ. Intraosseous compared to intravenous drug resuscitation in out-of-hospital cardiac arrest. Resuscitation 2017; 117:91-6. Medline
|
|
II
|
Neutral (Yellow)
|
Insertion success rate
|
Process
|
PH-Paramedic
|
Frascone RJ., Jensen JP., Kaye K., Salzman JG. Consecutive field trials using two different IO devices. Prehosp Emer Care 2007; 11:164-71. Medline
|
|
II
|
Neutral (Yellow)
|
Neurological outcome
|
Patient
|
PH-Paramedic
|
Hsieh YL, Wu MC, Wolfshohl J, d'Etienne J, Huang CH, Lu TC, et al. Intraosseous versus intravenous vascular access during cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of observational studies. Scand J Trauma Resusc Emerg Med 2021; 29(1):44. Medline
|
|
II
|
Neutral (Yellow)
|
Neurologically favorable outcome at hospital discharge
|
Patient
|
|
Kawano T., Grunau B., Scheuermeyer FX., Gibo K., Fordyce CB., Lin S., et al. Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. Ann Emerg Med 2018; 71(5):588-596 Medline
|
|
II
|
Neutral (Yellow)
|
OHCA patients with IO in femur, humerus or tibia
|
Process
|
PH-Paramedic
|
Rayas EG, Winckler C, Bolleter S, Stringfellow M, Miramontes D, Shumaker J, et al. Distal femur versus humeral or tibial IO, access in adult out of hospital cardiac resuscitation. Resuscitation 2022; 170:11–6. Medline
|
|
II
|
Neutral (Yellow)
|
First attempt IO insertion success
|
Process
|
PH-Paramedic
|
Reades R., Studnek JR., Garrett JS., Vandeventer S., Blackwell T. Comparison of first-attempt success between tibial and humeral intraosseous insertions during out-of-hospital cardiac arrest. Prehosp Emerg Care 2011; 15(2):278-81. Medline
|
|
III
|
Supportive (Green)
|
Number of attempts required
|
Process
|
SIM
|
Brenner T., Bernhard M., Helm M., Doll S., Völkl A., Ganion N., Friedmann C., Sikinger M., Knapp J., Martin E., Gries A. Comparison of two intraosseous infusion systems for adult emergency medical use. Resuscitation 2008; 78:314-9. Medline
|
|
III
|
Supportive (Green)
|
Success
|
Process
|
|
Kurowski A., Timler D., Evrin T., Szarpak L. Comparison of 3 different intraosseous access devices for adult during resuscitation. Randomized crossover manikin study. Am J Emerg Med 2014; 32(12):1490-3. Medline
|
|
III
|
Supportive (Green)
|
First attempt success
|
Process
|
SIM
|
Ong ME., Ngo AS., Wijaya R. An observational, prospective study to determine the ease of vascular access in adults using a novel intraosseous access device. Ann Acad Med Singapore 2009; 38:121-4. Medline
|
|
III
|
Supportive (Green)
|
Time to AW insertion
|
Process
|
SIM
|
Reiter DA., Strother CG., Weingart SD. The quality of cardiopulmonary resuscitation using supraglottic airways and intraosseous devices: A simulation trial. Resuscitation 2013; 84(1):93-7. Medline
|
|
III
|
Supportive (Green)
|
Overall placement success
|
Process
|
PH-Paramedic
|
Schalk R., Schweigkofler U., Lotz G., Zacharowski K., Latasch L., Byhahn C. Efficacy of the EZ-IO needle driver for out-of-hospital intraosseous access--a preliminary, observational, multicenter study. Scand J Trauma Resusc Emerg Med 2011; 19:65-7241-19-65. Medline
|
|
III
|
Supportive (Green)
|
Time to insertion of IO
|
Process
|
|
Szarpak Å., Truszewski. Z, Smereka J. Which intravascular access method to choose during cardiopulmonary resuscitation? Am J Emerg Med 2016; 34(6):1160. Medline
|
|
X
|
Not Yet Graded (White)
|
-
|
|
|
Szarpak L, Truszewski Z, Smereka J, Krajewski P, Fudalej M, Adamczyk P, Czyzewski L. A Randomized Cadaver Study Comparing First-Attempt Success Between Tibial and Humeral Intraosseous Insertions Using NIO Device by Paramedics: A Preliminary Investigation. Medicine (Baltimore). 2016 May;95(20):e3724 Medline
|
PAI-CPR/Defib
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
CPR quality
|
Process
|
|
Lin YY., Chiang WC., Hsieh MJ., Sun JT., Chang YC., Ma MH. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation: A systematic review and meta-analysis. Resuscitation 2018; 123:77-85. Medline
|
|
I
|
Neutral (Yellow)
|
Survival to hospital
discharge
|
Patient
|
PH-Paramedic
|
Hallstrom AP. Dispatcher-assisted "phone" cardiopulmonary resuscitation by chest compression alone or with mouth-to-mouth ventilation. Crit Care Med 2000; 28(S11):N190-2. Medline
|
|
I
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Hupfl M., Selig HF., Nagele P. Chest-compression-only versus standard cardiopulmonary resuscitation: A meta-analysis. Lancet 2010; 376(9752):1552-7. Medline
|
|
I
|
Neutral (Yellow)
|
30 Day Survival
|
Patient
|
PH-Paramedic
|
Svensson L., et al. Compression-Only CPR or Standard CPR in Out-of-Hospital Cardiac Arrest. NEJM 2010; 363:434-442. Medline
|
|
II
|
Supportive (Green)
|
survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Chang I, Ro YS, Shin SD, Song KJ, Park JH, Kong SY. Association of dispatcher-assisted bystander cardiopulmonary resuscitation with survival outcomes after pediatric out-of-hospital cardiac arrest by community property value. Resuscitation 2018; 132:120-6. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge (neuro intact).
|
Patient
|
PH-Bystander
|
Eberhard KE, Linderoth G, Gregors MCT, Lippert F, Folke F. Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: a systematic review. Scand J Trauma Resusc Emerg Med 2021; 29(1):70. Medline
|
|
II
|
Supportive (Green)
|
Survival from OHCA
|
Patient
|
PH-Bystander
|
Gantzel Nielsen C, Andelius LC, Hansen CM, Blomberg SNF, Christensen HC, Kjølbye JS, et al. Bystander interventions and survival following out-of-hospital cardiac arrest at Copenhagen International Airport. Resuscitation 2021. Medline
|
|
II
|
Supportive (Green)
|
Initial shockable rhythm
|
Patient
|
PH-Bystander
|
Goto Y, Funada A, Maeda T. Association of dispatcher-assisted cardiopulmonary resuscitation with initial shockable rhythm and survival after out-of-hospital cardiac arrest. Eur J Emerg Med 2021. Medline
|
|
II
|
Supportive (Green)
|
1-month neurologically intact survival
|
Process
|
PH-Paramedic
|
Goto Y, Funada A, Maeda T. Dispatcher instructions for bystander cardiopulmonary resuscitation and neurologically intact survival after bystander-witnessed out-of-hospital cardiac arrests: a nationwide, population-based observational study. Crit Care 2021; 25(1):408. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge with good neurological outcome.
|
Patient
|
PH-Bystander
|
Grubic N, Peng YP, Walker M, Brooks SC; CARES Surveillance Group. Bystander-initiated cardiopulmonary resuscitation and automated external defibrillator use after out-of-hospital cardiac arrest: Uncovering disparities in care and survival across the urban-rural spectrum. Resuscitation 2022; 175:150–8. Medline
|
|
II
|
Supportive (Green)
|
Likelihood of survival
|
Process
|
PH-Bystander
|
Guerrero A, Blewer AL, Joiner AP, Leong BSH, Shahidah N, Pek PP, et al. Evaluation of Telephone-Assisted Cardiopulmonary Resuscitation Recommendations for Out-Of-Hospital Cardiac Arrest. Resuscitation 2022. Medline
|
|
II
|
Supportive (Green)
|
Bystander defibrillation according to the location of the cardiac arrest
|
Process
|
|
Hansen SM., Hansen CM., Folke F., Rajan S., Kragholm K., Ejlskov L., et al. Bystander Defibrillation for Out-of-Hospital Cardiac Arrest in Public vs Residential Locations. JAMA cardiology 2017; 2(5):507-14. Medline
|
|
II
|
Supportive (Green)
|
Survival to admission
|
Patient
|
|
Harjanto S., Na MX., Hao Y., Ng YY., Doctor N., Goh ES., et al. A before-after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore. Resuscitation 2016; 102:85-93. Medline
|
|
II
|
Supportive (Green)
|
Neurologic outcome
|
Patient
|
PH-Bystander
|
HS L, You K, JP J, Kim C, Kim S. The effect of video-instructed versus audio-instructed dispatcher-assisted cardiopulmonary resuscitation on patient outcomes following out of hospital cardiac arrest in Seoul. Sci Rep 2021; 11(1):15555. Medline
|
|
II
|
Supportive (Green)
|
Neurologic recovery at hospital discharge
|
Patient
|
PH-Bystander
|
Kim MW, Kim TH, Song KJ, Shin SD, Kim CH, Lee EJ, et al. Comparison between dispatcher-assisted bystander CPR and self-led bystander CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation 2021; 158:64-70. Medline
|
|
II
|
Supportive (Green)
|
Survival at 1 month with a favorable neurologic outcome
|
Patient
|
|
Kitamura T., Kiyohara K., Sakai T., Matsuyama T., Hatakeyama T., Shimamoto T., et al. Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan. N Engl J Med 2016; 375(17):1649-59. Medline
|
|
II
|
Supportive (Green)
|
One-month survival with favorable neurological outcome
|
Patient
|
|
Kiyohara K., Kitamura T., Sakai T., Nishiyama C., Nishiuchi T., Hayashi Y., et al. Public-access AED pad application and outcomes for out-of-hospital cardiac arrests in Osaka, Japan. Resuscitation 2016; 106:70-5. Medline
|
|
II
|
Supportive (Green)
|
Accurate identification
|
Process
|
PH-Bystander
|
Ng JYX, Sim ZJ, Siddiqui FJ, Shahidah N, Leong BS, et al. Incidence, characteristics and complications of dispatcher-assisted cardiopulmonary resuscitation initiated in patients not in cardiac arrest. Resuscitation 2022; 170:266–73. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Process
|
PH-Bystander
|
Ong MEH, Shin SD, Ko PC, Lin X, Ma MH, Ryoo HW, Wong KD, et al. International multi-center real world implementation trial to increase out-of-hospital cardiac arrest survival with a dispatcher-assisted cardio-pulmonary resuscitation package (Pan-Asian resuscitation outcomes study phase 2). Resuscitation 2022; 171:80–9. Medline
|
|
II
|
Supportive (Green)
|
Good neurologic recovery at discharge.
|
Patient
|
|
Park JH., Ro YS., Shin SD., Song KJ., Hong KJ., Kong SY. Dispatcher-assisted bystander cardiopulmonary resuscitation in rural and urban areas and survival outcomes after out-of-hospital cardiac arrest. Resuscitation 2018; 125:1-7. Medline
|
|
II
|
Supportive (Green)
|
30-day survival
|
Process
|
Other
|
Riva G, Jonsson M, Ringh M, Claesson A, Djärv T, Forsberg S, et al. Survival after dispatcher-assisted cardiopulmonary resuscitation in out-of-hospital cardiac arrest. Resuscitation 2020; 157:195-201. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
|
Ro YS., Shin SD., Lee YJ., Lee SC., Song KJ., Ryoo HW., et al. Effect of Dispatcher-Assisted Cardiopulmonary Resuscitation Program and Location of Out-of-Hospital Cardiac Arrest on Survival and Neurologic Outcome. Ann Emerg Med 2017; 69(1):52-61.e1. Medline
|
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Bystander
|
Siman-Tov M, Strugo R, Podolsky T, Rosenblat I, Blushtein O. Impact of dispatcher assisted CPR on ROSC rates: A National Cohort Study. Am J Emerg Med 2021; 44:333–8. Medline
|
|
II
|
Supportive (Green)
|
Shockable rhythm on first EKG
|
Process
|
|
Takahashi H., Sagisaka R., Natsume Y., Tanaka S., Takyu H., Tanaka H. Does dispatcher-assisted CPR generate the same outcomes as spontaneously delivered bystander CPR in Japan? Am J Emerg Med 2018; 36(3):384-91. Medline
|
|
II
|
Supportive (Green)
|
Rate of Bystander CPR (B-CPR)
|
Process
|
PH-Bystander
|
Wong XY, Fan Q, Shahidah N, De Souza CR, Arulanandam S, Ng YY, et al. Impact of dispatcher-assisted cardiopulmonary resuscitation and myResponder mobile app on bystander resuscitation. Ann Acad Med Singap 2021; 50(3):212-21 Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
|
Wu Z., Panczyk M., Spaite DW., Hu C., Fukushima H., Langlais B., et al. Telephone cardiopulmonary resuscitation is independently associated with improved survival and improved functional outcome after out-of-hospital cardiac arrest. Resuscitation 2018; 122:135-40. Medline
|
|
II
|
Supportive (Green)
|
Neurologically favourable outcome 1 month after cardiac arrest
|
Patient
|
PH-Bystander
|
Yoshimoto H, Fukui K, Nishimoto Y, et al. Annual improvement trends in resuscitation outcome of patients defibrillated by laypersons after out-of-hospital cardiac arrests and compression-only resuscitation of laypersons. Resuscitation 2023; 183:109672. Medline
|
|
II
|
Neutral (Yellow)
|
Consistency
|
Process
|
SIM
|
Ballesteros-Peña S, Fernández-Aedo I, Vallejo-De la Hoz G, Etayo-Sancho A, Alonso-Pinillos A. Analysis of dispatcher-assisted cardiopulmonary resuscitation instructions to laypersons in an out-of-hospital cardiac arrest. Anales del Sistema Sanitario de Navarra 2020; 43(2):203-7. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to Discharge
|
Patient
|
PH-Paramedic
|
Bohm K., Vaillancourt C., Charette ML., Dunford J., Castren M. In patients with out-of-hospital cardiac arrest, does the provision of dispatch cardiopulmonary resuscitation instructions as opposed to no instructions improve outcome: A systematic review of the literature. Resuscitation 2011; 82(12):1490-5. Medline
|
|
II
|
Neutral (Yellow)
|
Frequency of bystander CPR
|
Process
|
PH-Paramedic
|
Fujie K., Nakata Y., Yasuda S., Mizutani T., Hashimoto K. Do dispatcher instructions facilitate bystander-initiated cardiopulmonary resuscitation and improve outcomes in patients with out-of-hospital cardiac arrest? A comparison of family and non-family bystanders. Resuscitation 2014; 85(3):315-9. Medline
|
|
II
|
Neutral (Yellow)
|
Bystander CPR performance/ quality
|
Process
|
|
Fukushima H., Kawai Y., Asai H., Seki T., Norimoto K., Urisono Y., et al. Performance review of regional emergency medical service pre-arrival cardiopulmonary resuscitation with or without dispatcher instruction: a population-based observational study. Acute medicine & surgery 2017; 4(3):293-9. Medline
|
|
II
|
Neutral (Yellow)
|
Initial shockable rhythm
|
Patient
|
PH-Paramedic
|
Goto Y, Funada A, Maeda T. Association of dispatcher-assisted cardiopulmonary resuscitation with initial shockable rhythm and survival after out-of-hospital cardiac arrest. Eur J Emerg Med 2022; 29(1):42–8. Medline
|
|
II
|
Neutral (Yellow)
|
Favourable neurological outcome
|
Patient
|
PH-Paramedic
|
Japanese Circulation Society Resuscitation Science Study Group. Chest-compression-only bystander cardiopulmonary resuscitation in the 30:2 compression-to-ventilation ratio era. nationwide observational study. Circ J 2013; 77(11):2742-50. Medline
|
|
II
|
Neutral (Yellow)
|
Favourable neurological outcome at 1 mo.
|
Patient
|
PH-Bystander
|
Komori A, Iriyama H, Abe T. Impact of defibrillation with automated external defibrillator by bystander before defibrillation by emergency medical system personnel on neurological outcome of out-of-hospital cardiac arrest with non-cardiac etiology. Resusc Plus 2023; 13:100363. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to ED
|
Patient
|
|
Lwanga A., Garcia-Sayan E., Lwanga S., Karreman E., Mohamed A. Automated External Defibrillators and Survival After Nonresidential Out of Hospital Cardiac Arrest in a Small North American City. Am J Cardiol 2017; 119(12):1979-82. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
|
Shah M., Bartram C., Irwin K., Vellano K., McNally B., Gallagher T., et al. Evaluating Dispatch-Assisted CPR Using the CARES Registry. Prehosp Emerg Care 2018; 22(2):222-228. Medline
|
|
II
|
Neutral (Yellow)
|
Recognition
|
Process
|
PH-Paramedic
|
Vaillancourt C., Verma A., Trickett J., et al. Evaluating the effectiveness of dispatch-assisted cardiopulmonary resuscitation instructions. Acad Emerg Med 2007; 14(10):877-883. Medline
|
|
III
|
Supportive (Green)
|
CPR Compression Rate and Depth
|
Process
|
SIM
|
Birkenes TS., Myklebust H., Neset A., Kramer-Johansen J. Quality of CPR performed by trained bystanders with optimized pre-arrival instructions. Resuscitation 2014; 85(1):124-30. Medline
|
|
III
|
Supportive (Green)
|
Chest compression rate and depth
|
Process
|
SIM
|
Dias JA., Brown TB., Saini D., et al. Simplified dispatch-assisted CPR instructions outperform standard protocol. Resuscitation 2007; 72(1):108-14. Medline
|
|
III
|
Supportive (Green)
|
Successful shock delivery
|
Process
|
SIM
|
Ecker R., Rea TD., Meischke H., Schaeffer SM., Kudenchuk P., Eisenberg MS. Dispatcher assistance and automated external defibrillator performance among elders. Acad Emerg Med 2001; 8(10):968-73. Medline
|
|
III
|
Supportive (Green)
|
Chest Compression Quality
|
Process
|
SIM
|
Lee SGW, Kim TH, Lee HS, Shin SD, Song KJ, Hong KJ, et al. Efficacy of a new dispatcher-assisted cardiopulmonary resuscitation protocol with audio call-to-video call transition. Am J Emerg Med 2021; 44:26-32. Medline
|
|
III
|
Supportive (Green)
|
Safety
|
Process
|
PH-Paramedic
|
Lerner EB., Sayre MR., Brice JH., et al. Cardiac arrest patients rarely receive chest compressions before ambulance arrival despite the availability of pre-arrival CPR instructions. Resuscitation 2008; 77(1):51-56. Medline
|
|
III
|
Supportive (Green)
|
Composite outcome score based on time to first compression, hand position, chest compression depth and rate and hands-off time
|
Patient
|
|
Rasmussen SE., Nebsbjerg MA., Krogh LQ., Bjørnshave K., Krogh K., Povlsen JA., et al. A novel protocol for dispatcher assisted CPR improves CPR quality and motivation among rescuers-A randomized controlled simulation study. Resuscitation 2017; 110:74-80. Medline
|
|
III
|
Supportive (Green)
|
CPR quality - no flow time
|
Process
|
|
Spelten O., Warnecke T., Wetsch WA., Schier R., Böttiger BW., Hinkelbein J. Dispatcher-assisted compression-only cardiopulmonary resuscitation provides best quality cardiopulmonary resuscitation by laypersons: A randomised controlled single-blinded manikin trial. Eur J Anaesthesiol 2016; 33(8):575-80. Medline
|
|
III
|
Supportive (Green)
|
Accuracy
|
Patient
|
PH-Paramedic
|
Vaillancourt C., Charette M., Kasaboski A., et al. Cardiac arrest diagnostic accuracy of 9-1-1 dispatchers: A prospective multi-center study. Resuscitation 2015; 90:116-120. Medline
|
|
III
|
Supportive (Green)
|
Time to First Compression
|
Process
|
PH-Paramedic
|
Van Vleet LM., Hubble MW. Time to first compression using medical priority dispatch system compression-first dispatcher-assisted cardiopulmonary resuscitation protocols. Prehosp Emerg Care 2012; 16(2):242-250. Medline
|
|
III
|
Supportive (Green)
|
Time to first compression
|
Process
|
SIM
|
Williams JG., Brice JH., De Maio VJ., Jalbuena T. A simulation trial of traditional dispatcher-assisted CPR versus compressions--only dispatcher-assisted CPR. Prehosp Emerg Care 2006; 10(2):247-253. Medline
|
|
III
|
Neutral (Yellow)
|
Rate of Administration of PAI-CPR
|
Process
|
PH-Paramedic
|
Bohm K. Dispatcher-assisted telephone guided CPR: An underused lifesaving system. Eur J Emerg Med 2007; 4:256-9. Medline
|
|
III
|
Neutral (Yellow)
|
Quality of CPR
|
Process
|
PH-Paramedic
|
Brown TB., Saini D., Pepper T., Mirza M., et al. Instructions to « put the phone down » do not improve the quality of bystander initiated, dispatcher-assisted cardiopulmonary resuscitation. Resusc 2008; 76(2)249-55. Medline
|
|
III
|
Neutral (Yellow)
|
Diagnostic accuracy of advanced medical priority dispatch system (AMPDS) software
|
Process
|
PH-Paramedic
|
Cairns KJ., Hamilton AJ., Marshall AH., Moore MJ., Adgey AA., Kee F. The obstacles to maximising the impact of public access defibrillation: An assessment of the dispatch mechanism for out-of-hospital cardiac arrest. Heart 2008; 94(3):349-53. Medline
|
|
III
|
Neutral (Yellow)
|
CPR quality
|
Process
|
SIM
|
Dorph E., Wik L., Steen PA. Dispatcher-assisted cardiopulmonary resuscitation. An evaluation of efficacy amongst elderly. Resuscitation 2003; 56(3):265-73. Medline
|
|
III
|
Neutral (Yellow)
|
Time to first compression
|
Patient
|
SIM
|
Harve H., Jokela J., Tissari A., et al. Can untrained laypersons use a defibrillator with dispatcher assistance? Acad Emerg Med 2007; 14(7):624-8. Medline
|
|
III
|
Neutral (Yellow)
|
Ventilation quality
|
Patient
|
SIM
|
Harve H., Jokela J., Tissari A., et al. Defibrillation and the quality of layperson cardiopulmonary resuscitation-dispatcher assistance or training? Resuscitation 2009; 80(2):275-7. Medline
|
|
III
|
Neutral (Yellow)
|
Efficacy
|
Process
|
SIM
|
Lee JS., Jeon WC., Ahn JH., Cho YJ., Jung YS., Kim GW. The effect of a cellular-phone video demonstration to improve the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation as compared with audio coaching. Resuscitation 2011; 82(1):64-8. Medline
|
|
III
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Rea TD., Fahrenbruch C., Culley L., Donohoe RT., Hambly C., Innes J., et al. CPR with chest compression alone or with rescue breathing. N Engl J Med 2010; 363(5):423-33. Medline
|
|
III
|
Neutral (Yellow)
|
Relative compression depth
|
Process
|
SIM
|
van Tulder R., Roth D., Krammel M., et al. Effects of repetitive or intensified instructions in telephone assisted, bystander cardiopulmonary resuscitation: An investigator-blinded, 4-armed, randomized, factorial simulation trial. Resuscitation 2014; 85(1):112-118. Medline
|
|
III
|
Neutral (Yellow)
|
CPR metrics
|
Process
|
SIM
|
Woollard M., Smith A., Whitfield R., et al. To blow or not to blow: A randomised controlled trial of compression-only and standard telephone CPR instructions in simulated cardiac arrest. Resuscitation 2003; 59(1):123-131. Medline
|
|
III
|
Opposes (Red)
|
Time to initiating CPR
|
Process
|
SIM
|
Angkoontassaneeyarat C, Yuksen C, Jenpanitpong C, Rukthai P, Seanpan M, Pongprajak D, et al. Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS). Prehosp Disaster Med 2021; 36(6):702–7. Medline
|
Standard CPR
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
ROSC
|
Patient
|
|
Anantharaman V, Ng BL, Ang SH, Lee CY, Leong SH, Ong ME, et al. Prompt use of mechanical cardiopulmonary resuscitation in out-of-hospital cardiac arrest: The MECCA study report. Singapore Med J; 58(7):424-31. Medline
|
|
I
|
Supportive (Green)
|
Neuro intact survival
|
Patient
|
PH-Paramedic
|
Aufderheide TP., Frascone RJ., Wayne MA., et al. Standard cardiopulmonary resuscitation versus active compression-decompression cardiopulmonary resuscitation with augmentation of negative intrathoracic pressure for out-of-hospital cardiac arrest: A randomised trial. Lancet 2011; 377(9762):301-11. Medline
|
|
I
|
Supportive (Green)
|
Survival to admission/ discharge
|
Patient
|
PH-Paramedic
|
Cummins RO., Eisenberg MS., Litwin PE., Graves JR., Hearne TR., Hallstrom AP. Automatic external defibrillators used by emergency medical technicians: A controlled clinical trial. JAMA 1987; 257:1606-10. Medline
|
|
I
|
Supportive (Green)
|
ROSC
|
Patient
|
|
Gunyadin YK., Cekmen B., Alkilli NB., Koylu R., Sert ET., Cander B. Comparative effectiveness of standard CPR vs active compression-decompression CPR with CardioPump for treatment of cardiac arrest. Am J Emerg Med 2016; 34(3):542-7. Medline
|
|
I
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
Nichol G., Leroux B., Wang H., et al. Trial of continuous or interrupted chest compressions during CPR. N Engl J Med 2015; 373(23):2203-14. Medline
|
|
I
|
Supportive (Green)
|
30 day mortality
|
Patient
|
PH-Paramedic
|
Perkins GD., Lall R., Quinn T., et al. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): A pragmatic, cluster randomised controlled trial. Lancet 2015; 385(9972):947-55. Medline
|
|
I
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Paramedic
|
Skogvoll E., Wik L. Active compression-decompression cardiopulmonary resuscitation: A population-based, prospective randomised clinical trial in out-of-hospital cardiac arrest. Resuscitation 1999; 42(3):163-172. Medline
|
|
I
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
PH-Paramedic
|
Wik L., Hansen T., Fylling F., Steen T., Vaagenes P., Auestad B., Steen P. Delaying Defibrillation to Give Basic Cardiopulmonary Resuscitation to Patients With Out-of-hospital Ventricular Fibrillation A Randomized Trail. JAMA 2003; 289(11):1389-1395. Medline
|
|
I
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Hupfl M., Selig HF., Nagele P. Chest-compression-only versus standard cardiopulmonary resuscitation: A meta-analysis. Lancet 2010; 376(9752):1552-7. Medline
|
|
II
|
Supportive (Green)
|
Survival and neurologic status at hospital discharge
|
Patient
|
PH-Paramedic
|
Cobb L., Fahrenbruch C., Walsh T., et al. Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA 1999; 281:1182-8. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
PH-Paramedic
|
De Maio VJ., Stiell IG., Spaite DW., et al. CPR-only survivors of out-of-hospital cardiac arrest: Implications for out-of-hospital care and cardiac arrest research methodology. Ann Emerg Med 2001; 37(6):602-8. Medline
|
|
II
|
Supportive (Green)
|
Degradation to asystole
|
Patient
|
PH-Paramedic
|
Hostler D., Rittenberger JC., Roth R., Callaway CW. Increased chest compression to ventilation ratio improves delivery of CPR. Resuscitation 2007; 74:446-52. Medline
|
|
II
|
Supportive (Green)
|
1-month survival with favourable neurological outcome
|
Patient
|
PH-Paramedic
|
Iwami T., et al. Continuous improvements in 'chain of survival' increased survival after OOHCA. Circulation 2009; 119:728-34. Medline
|
|
II
|
Supportive (Green)
|
Neurological function at 1 month
|
Patient
|
PH-Paramedic
|
Kitamura T., Iwami T., Kawamura T., et al. Time-dependent effectiveness of chest compression-only and conventional cardiopulmonary resuscitation for out-of-hospital cardiac arrest of cardiac origin. Resuscitation 2011; 82(1):3-9. Medline
|
|
II
|
Supportive (Green)
|
CPR quality - depth, etc.
|
Process
|
PH-Paramedic
|
Kramer-Johansen J., et al. Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study. Resuscitation 2006; 71(3):283-92. Medline
|
|
II
|
Supportive (Green)
|
1-month neurologically favourable survival
|
Patient
|
PH-Paramedic
|
Maeda T., Kamikura T., Tanaka Y., et al. Impact of bystander-performed ventilation on functional outcomes after cardiac arrest and factors associated with ventilation-only cardiopulmonary resuscitation: A large observational study. Resuscitation 2015; 91:122-30. Medline
|
|
II
|
Supportive (Green)
|
Discharge from hospital with favourable neuro
|
Patient
|
PH-Paramedic
|
Olasveengen TM., Wik L., Steen PA. Standard basic life support vs. continuous chest compressions only in out-of-hospital cardiac arrest. Acta Anaesthesiol Scand 2008; 52(7):914-9. Medline
|
|
II
|
Supportive (Green)
|
ROSC
|
Patient
|
PH-Paramedic
|
Omori K., Sato S., Sumi Y., et al. The analysis of efficacy for AutoPulse system in flying helicopter. Resuscitation 2013; 84(8):1045-50. Medline
|
|
II
|
Supportive (Green)
|
Survival with CPC 1-2
|
Patient
|
PH-Paramedic
|
Pearson DA., Darrell Nelson R., Monk L., Tyson C., Jollis JG., Granger CB., et al. Comparison of team-focused CPR vs standard CPR in resuscitation from out-of-hospital cardiac arrest: Results from a statewide quality improvement initiative. Resuscitation 2016; 105:165-72. Medline
|
|
II
|
Supportive (Green)
|
Health Utilities Index Mark III
|
Patient
|
PH-Paramedic
|
Stiell I., Nichol G., Wells G., DeMaio V., Nesbitt L., Blackburn J., Spaite D. Health-Related Quality of Life is Better for Cardiac Arrest Survivors Who Received Citizen Cardiopulmonary Resuscitation. Circulation 2003; 108(16):1939-1944. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge.
|
Patient
|
PH-Paramedic
|
Yao L., Wang P., Zhou L., et al. Compression-only cardiopulmonary resuscitation vs standard cardiopulmonary resuscitation: An updated meta-analysis of observational studies. Am J Emerg Med 2014; 32(6):517-523. Medline
|
|
II
|
Neutral (Yellow)
|
Survival to discharge
|
Process
|
PH-Paramedic
|
Chiang CY, Lim KC, Lai PC, Tsai TY, Huang YT, Tsai MJ. Comparison between Prehospital Mechanical Cardiopulmonary Resuscitation (CPR) Devices and Manual CPR for Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis. J Clin Med 2022; 11(5). Medline
|
|
II
|
Neutral (Yellow)
|
Prevalence of chest wall injuries secondary to OHCA with CPR
|
Patient
|
ICU
|
Prins JTH, Van Lieshout EMM, Van Wijck SFM, Scholte NTB, Den Uil CA, Vermeulen J, et al. Chest wall injuries due to cardiopulmonary resuscitation and the effect on in-hospital outcomes in survivors of out-of-hospital cardiac arrest. J Trauma Acute Care Surg 2021; 91(6):966–75. Medline
|
|
II
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Stiell IG., et al. Advanced Cardiac Life Support in Out-of-Hospital Cardiac Arrest. NEJM 2004; 351:647-56. Medline
|
|
II
|
Neutral (Yellow)
|
CPR metrics
|
Process
|
PH-Paramedic
|
Wik L., et al. Quality of Cardiopulmonary Resuscitation during Out-of-Hospital Cardiac Arrest. JAMA 2005; 293:299-304. Medline
|
|
III
|
Supportive (Green)
|
PETCO2 levels
|
Patient
|
PH-Paramedic
|
Axelsson C., Karlsson T., Axelsson AB., Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) versus manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation 2009; 80(10):1099-103. Medline
|
|
III
|
Supportive (Green)
|
Percent efficacy
|
Process
|
OR
|
Bardy GH., Gliner BE., Kudenchuk PJ., et al. Truncated biphasic pulses for transthoracic defibrillation. Circulation 1995; 91(6):1768-74. Medline
|
|
III
|
Supportive (Green)
|
Survival
|
Patient
|
In-Patient
|
Fletcher GF., Cantwell JD. Ventricular fibrillation in a medically supervised cardiac exercise program: clinical, angiographic, and surgical correlations. JAMA 1977; 238:2627-9. Medline
|
|
III
|
Supportive (Green)
|
1 month survival
|
Patient
|
PH-Paramedic
|
Holmberg M., Holmberg S., Herlitz J. Factors modifying the effect of bystander CPR on survival in out-of-hospital cardiac arrest patients in Sweden. Eur Heart J 2001; 22(6):511-9. Medline
|
|
III
|
Supportive (Green)
|
Major cardiovascular complications
|
Patient
|
In-Patient
|
Van Camp SP., Peterson RA. Cardiovascular complications of outpatient cardiac rehabilitation programs. JAMA 1986; 256:1160-1163. Medline
|
|
III
|
Supportive (Green)
|
Survival
|
Patient
|
PH-Paramedic
|
Weaver WD., Cobb LA., Fahrenbruch CE., et al. Use of the automatic external defibrillator in the management of out-of-hospital cardiac arrest. N Engl J Med 1988; 319:661-666. Medline
|
|
III
|
Neutral (Yellow)
|
CPR quality
|
Process
|
ED-MD
|
Abella BS., et al. Chest compression rates during cardiopulmonary resuscitation are suboptimal. Circulation 2005; 111:428-34. Medline
|
|
III
|
Neutral (Yellow)
|
CPR Compression Rate and Depth
|
Process
|
SIM
|
Birkenes TS., Myklebust H., Neset A., Kramer-Johansen J. Quality of CPR performed by trained bystanders with optimized pre-arrival instructions. Resuscitation 2014; 85(1):124-30. Medline
|
|
III
|
Neutral (Yellow)
|
Survival to hospital discharge
|
Patient
|
|
Cheskes S, Schmicker RH, Rea T, Morrison LJ, Grunau B, Drennan IR, et al. The association between AHA CPR quality guideline compliance and clinical outcomes from out-of-hospital cardiac arrest. Resuscitation 2017; 116:39-45. Medline
|
|
III
|
Neutral (Yellow)
|
Survival
|
Patient
|
PH-Paramedic
|
Eisenberg MS., Horwood BT., Cummins RO., et al. Cardiac arrest and resuscitation: a tale of 29 cities. Ann Emerg Med 1990; 19:179-86. Medline
|
|
III
|
Neutral (Yellow)
|
Survival to DC
|
Patient
|
PH-Paramedic
|
Roth R., Stewart RD., Rogers K., et al. Out of hospital cardiac arrest: factors associated with survival. Ann Emerg Med 1984; 13:237-43. Medline
|
Termination Resuscitation ALS
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
II
|
Supportive (Green)
|
Neurological outcome (CPC score)
|
Patient
|
|
Cheong RW., Li H., Doctor NE., Ng YY., Goh ES., Leong BS., et al. Termination of Resuscitation Rules to Predict Neurological Outcomes in Out-of-Hospital Cardiac Arrest for an Intermediate Life Support Prehospital System. Prehospital emergency care 2016; 20(5):623-9 Medline
|
|
II
|
Supportive (Green)
|
In-hospital death
|
Patient
|
|
Chiang WC, Huang YS, Hsu SH, Chang AM, Ko PC, Wang HC, et al. Performance of a simplified termination of resuscitation rule for adult traumatic cardiopulmonary arrest in the prehospital setting. EMJ 2017; 34(1):39-45. Medline
|
|
II
|
Supportive (Green)
|
Sensitivity and specificity
|
Process
|
PH-Paramedic
|
Cone DC., Bailey D., Spackman AB. The safety of field termination -of-resuscitation protocol. Prehosp Emer Care 2005; 9(3):276-81. Medline
|
|
II
|
Supportive (Green)
|
Positive predictive value
|
Patient
|
PH-Paramedic
|
Diskin FJ., Camp-Rogers T., Peberdy MA., Ornato JP., Kurz MC. External validation of termination of resuscitation guidelines in the setting of intra-arrest cold saline, mechanical CPR, and comprehensive post resuscitation care. Resuscitation 2014; 85(7):910-14. Medline
|
|
II
|
Supportive (Green)
|
Survival to hospital discharge
|
Patient
|
|
Drennan IR., Case E., Verbeek PR., Reynolds JC., Goldberger ZD., Jasti J., et al. A comparison of the universal TOR Guideline to the absence of prehospital ROSC and duration of resuscitation in predicting futility from out-of-hospital cardiac arrest. Resuscitation 2017; 111:96-102. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Process
|
PH-Paramedic
|
Glober NK, Lardaro T, Christopher S, Tainter CR, Weinstein E, Kim D. Validation of the NUE rule to predict futile resuscitation of out-of-hospital cardiac arrest. PEC 2020:1-8. Medline
|
|
II
|
Supportive (Green)
|
Specificity
|
Process
|
PH-Paramedic
|
Glober NK., Tainter CR., Abramson TM., Staats K., Gilbert G., Kim D. A simple decision rule predicts futile resuscitation of out-of-hospital cardiac arrest. Resuscitation 2019; 142:8-13. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Patient
|
|
Grunau B., Taylor J., Scheuermeyer FX., Stenstrom R., Dick W., Kawano T., et al. External Validation of the Universal Termination of Resuscitation Rule for Out-of-Hospital Cardiac Arrest in British Columbia. Ann Emerg Med 2017; 70(3):374-81.e1. Medline
|
|
II
|
Supportive (Green)
|
-
|
Process
|
|
Jabre P., Bougouin W., Dumas F., Carli P., Antoine C., Jacob L., et al. Early Identification of Patients With Out-of-Hospital Cardiac Arrest With No Chance of Survival and Consideration for Organ Donation. Ann Intern Med 2016; 165(11):770-8. Medline
|
|
II
|
Supportive (Green)
|
Futility
|
Patient
|
PH-Paramedic
|
Jouffroy R., Saade A., Alexandre P., Philippe P., Carli P., Vivien B. Epinephrine administration in non-shockable out-of-hospital cardiac arrest. Am J Emerg Med 2018. Medline
|
|
II
|
Supportive (Green)
|
Pronouncement rate
|
Patient
|
PH-Paramedic
|
Morrison LJ., et al. Derivation and evaluation of a termination of resuscitation clinical prediction rule for advanced life support providers. Resuscitation 2007; 74:266-75. Medline
|
|
II
|
Supportive (Green)
|
Survival to DC
|
Patient
|
PH-Paramedic
|
Schmidbauer S, Yates EJ, Andréll C, Bergström D, Olson H, Perkins GD, et al. Outcomes and interventions in patients transported to hospital with ongoing CPR after out-of-hospital cardiac arrest - An observational study. Resusc Plus 2021; 8:100170. Medline
|
|
II
|
Supportive (Green)
|
Survival with unfavorable neurologic outcome (CPC 3, 4, or 5) at one month
|
Patient
|
PH-Paramedic
|
Shibahashi K., Sugiyama K., Hamabe Y. A potential termination of resuscitation rule for EMS to implement in the field for out-of-hospital cardiac arrest: An observational cohort study. Resuscitation 2018; 130:28-32. Medline
|
|
II
|
Supportive (Green)
|
One month survival with favourable neurological outcome
|
Patient
|
PH-Paramedic
|
SOS–KANTO 2012 Study Group. A New Rule for Terminating Resuscitation of Out-of-Hospital Cardiac Arrest Patients in Japan: A Prospective Study. J Emerg Med 2017; 53(3):345-52. Medline
|
|
II
|
Supportive (Green)
|
Functional survival
|
Patient
|
PH-Paramedic
|
Stratton SJ., Brickett K., Crammer T. Prehospital pulseless, unconscious penetrating trauma victims: Field assessments associated with survival. J of Trauma, Injury, Infection and Critical Care 1998; 45:96-100. Medline
|
|
II
|
Supportive (Green)
|
Rate of transport to hospital with ongoing CPR
|
Patient
|
PH-Paramedic
|
Stub D., Nehme Z., Bernard S., Lijovic M., Kaye DM., Smith K. Exploring which patients without return of spontaneous circulation following ventricular fibrillation out-of-hospital cardiac arrest should be transported to hospital? Resuscitation 2014; 85(3):326-331. Medline
|
|
II
|
Supportive (Green)
|
Survival to discharge
|
Process
|
PH-Paramedic
|
Yates EJ., Schmidbauer S., Smyth AM., Ward M., Dorrian S., Siriwardena AN., et al. Out-of-hospital cardiac arrest termination of resuscitation with ongoing CPR: An observational study. Resuscitation 2018; 130:21-7. Medline
|
|
II
|
Neutral (Yellow)
|
Prediction of 30 day survival
|
Patient
|
PH-Paramedic & MD
|
Hsu SH, Sun JT, Huang EP, Nishiuchi T, Song KJ, et al. The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study. PLoS One 2022;17(8):e0270986. Medline
|
|
II
|
Neutral (Yellow)
|
Predictive value
|
Patient
|
PH-Paramedic
|
Lin YY, Lai YY, Chang HC, Lu CH, Chiu PW, Kuo YS, Huang SP, Chang YH, Lin CH. Predictive performances of ALS and BLS termination of resuscitation rules in out-of-hospital cardiac arrest for different resuscitation protocols. BMC Emerg Med 2022; 22(1):53. Medline
|
|
III
|
|