Translation of ERC resuscitation guidelines into clinical practice by emergency physicians
Sammanfattning
PURPOSE:
Austrian out-of-hospital emergency physicians (OOHEP) undergo mandatory biannual emergency
physician refresher courses to maintain their licence. The purpose of this study was to compare
different reported emergency skills and knowledge, recommended by the European Resuscitation
Council (ERC) guidelines, between OOHEP who work regularly at an out-of-hospital emergency
service and those who do not currently work as OOHEP but are licenced.
METHODS:
We obtained data from 854 participants from 19 refresher courses. Demographics, questions about
their practice and multiple-choice questions about ALS-knowledge were answered and analysed. We
particularly explored the application of therapeutic hypothermia, intraosseous access, pocket guide
use and knowledge about the participants' defibrillator in use. A multivariate logistic regression
analysed differences between both groups of OOHEP. Age, gender, years of clinical experience,
ERC-ALS provider course attendance and the self-reported number of resuscitations were control
variables.
RESULTS:
Licenced OOHEP who are currently employed in emergency service are significantly more likely to
initiate intraosseous access (OR = 4.013, p < 0.01), they initiate mild-therapeutic hypothermia after
successful resuscitation (OR = 2.550, p < 0.01) more often, and knowledge about the used
defibrillator was higher (OR = 2.292, p < 0.01). No difference was found for the use of pocket
guides.OOHEP who have attended an ERC-ALS provider course since 2005 have initiated more mild
therapeutic hypothermia after successful resuscitation (OR = 1.670, p <0.05) as well as participants
who resuscitated within the last year (OR = 2.324, p < 0.01), while older OOHEP initiated mild
therapeutic hypothermia less often, measured per year of age (OR = 0.913, p <0.01).
CONCLUSION:
Licenced and employed OOHEP implement ERC guidelines better into clinical practice, but more
training on life-saving rescue techniques needs to be done to improve knowledge and to raise these
rates of application.