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Association Between Driving Distance From Nearest Fire Station and  Survival of Out-of-Hospital Cardiac Arrest.

Publication ,  Journal Article
Hansen, SM; Hansen, CM; Fordyce, CB; Dupre, ME; Monk, L; Tyson, C; Torp-Pedersen, C; McNally, B; Vellano, K; Jollis, J; Granger, CB ...
Published in: J Am Heart Assoc
November 6, 2018

Background Firefighter first responders dispatched in parallel with emergency medical services ( EMS ) personnel for out-of-hospital cardiac arrests ( OHCA ) can provide early defibrillation to improve survival. We examined whether survival following first responder defibrillation differed according to driving distance from nearest fire station to OHCA site. Methods and Results From the CARES (Cardiac Arrest Registry to Enhance Survival) registry, we identified non- EMS witnessed OHCA s of presumed cardiac cause from 2010 to 2014 in Durham, Mecklenburg, and Wake counties, North Carolina. We used logistic regression to estimate the association between calculated driving distances (≤1, 1-1.5, 1.5-2, and >2 miles) and survival to hospital discharge following first responder defibrillation compared with defibrillation by EMS personnel. In total, 5020 OHCA s were included in the study. First responders more often applied the first automated external defibrillators at the shortest distances (≤1 mile) versus longest distances (>2 miles) (53.4% versus 46.6%, respectively, P<0.001). When compared with EMS defibrillation, first responder defibrillation within 1 mile and 1 to 1.5 miles of the nearest fire station was associated with increased survival to hospital discharge (odds ratio 2.01 [95% confidence interval 1.46-2.78] and odds ratio 1.61 [95% confidence interval 1.10-2.35], respectively). However, at the longest distances (1.5-2.0 and >2.0 miles), survival following first responder defibrillation did not differ from EMS defibrillation (odds ratio 0.77 [95% confidence interval 0.48-1.21] and odds ratio 0.97 [95% confidence interval 0.67-1.41], respectively). Conclusions Shorter driving distance from nearest fire station to OHCA location was associated with improved survival following defibrillation by first responders. These results suggest that the location of first responder units should be considered when organizing prehospital systems of OHCA care.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 6, 2018

Volume

7

Issue

21

Start / End Page

e008771

Location

England

Related Subject Headings

  • Time-to-Treatment
  • Survival Rate
  • Out-of-Hospital Cardiac Arrest
  • Middle Aged
  • Male
  • Humans
  • Firefighters
  • Female
  • Emergency Medical Services
  • Automobile Driving
 

Citation

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Chicago
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Hansen, S. M., Hansen, C. M., Fordyce, C. B., Dupre, M. E., Monk, L., Tyson, C., … CARES Surveillance Group, . (2018). Association Between Driving Distance From Nearest Fire Station and  Survival of Out-of-Hospital Cardiac Arrest. J Am Heart Assoc, 7(21), e008771. https://doi.org/10.1161/JAHA.118.008771
Hansen, Steen M., Carolina Malta Hansen, Christopher B. Fordyce, Matthew E. Dupre, Lisa Monk, Clark Tyson, Christian Torp-Pedersen, et al. “Association Between Driving Distance From Nearest Fire Station and  Survival of Out-of-Hospital Cardiac Arrest.J Am Heart Assoc 7, no. 21 (November 6, 2018): e008771. https://doi.org/10.1161/JAHA.118.008771.
Hansen SM, Hansen CM, Fordyce CB, Dupre ME, Monk L, Tyson C, et al. Association Between Driving Distance From Nearest Fire Station and  Survival of Out-of-Hospital Cardiac Arrest. J Am Heart Assoc. 2018 Nov 6;7(21):e008771.
Hansen, Steen M., et al. “Association Between Driving Distance From Nearest Fire Station and  Survival of Out-of-Hospital Cardiac Arrest.J Am Heart Assoc, vol. 7, no. 21, Nov. 2018, p. e008771. Pubmed, doi:10.1161/JAHA.118.008771.
Hansen SM, Hansen CM, Fordyce CB, Dupre ME, Monk L, Tyson C, Torp-Pedersen C, McNally B, Vellano K, Jollis J, Granger CB, CARES Surveillance Group. Association Between Driving Distance From Nearest Fire Station and  Survival of Out-of-Hospital Cardiac Arrest. J Am Heart Assoc. 2018 Nov 6;7(21):e008771.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

November 6, 2018

Volume

7

Issue

21

Start / End Page

e008771

Location

England

Related Subject Headings

  • Time-to-Treatment
  • Survival Rate
  • Out-of-Hospital Cardiac Arrest
  • Middle Aged
  • Male
  • Humans
  • Firefighters
  • Female
  • Emergency Medical Services
  • Automobile Driving