Background: Prehospital drug administration is crucial for improving resuscitation efforts in emergency departments (EDs) and enhancing survival rates for out-of-hospital cardiac arrest (OHCA) patients. While evidence supports the prehospital use of life-saving medications like epinephrine, the effects of prehospital vascular access routes remain under-researched. This study collects two years of data on adult patients with non-traumatic OHCA transported by Taoyuan Emergency Medical Services (EMS), aiming to evaluate how prehospital vascular access impacts resuscitation success and survival outcomes. Methods: This was a retrospective study conducted by the Taoyuan Fire Department and Taoyuan General Hospital. Data were collected from January 1, 2023 to September 30, 2024. The inclusion criteria consisted of adult patients experiencing non-traumatic OHCA who had established vascular access at the scene. Exclusion criteria were those with missing data and EMS-witnessed OHCA enroute. The outcome measurements aimed to assess whether establishing vascular access from prehospital improves the efficiency of epinephrine administration in the ED and enhances survival rates among OHCA patients. Data were collected using the Electronic Patient Care Report. Results: A total of 185 cases were included in the analysis, consisting of 97 males (52.4%) and 88 females (47.6%), with an average age of 71 years. When comparing the 95 cases with vascular access to the 90 cases without vascular access, the overall time from arrival in the emergency room to the administration of epinephrine was significantly shorter for those with vascular access, averaging 2 minutes compared to 4 minutes for those without (p < 0.001). Additionally, the cumulative time-event analysis using the Kaplan-Meier method showed a significant reduction in the time to epinephrine administration (p < 0.001). Conclusion: Establishing prehospital vascular access significantly enhances ED resuscitation efficiency in non-traumatic OHCA. These findings support integrating vascular access protocols into prehospital care practices to improve outcomes for cardiac arrest.
Yang et al. (Mon,) studied this question.