Outcomes of prehospital traumatic cardiac arrest managed by helicopter emergency medical service personnel in Japan: a registry data analysis
Dublin Core
Title
Outcomes of prehospital traumatic cardiac arrest managed by helicopter emergency medical service personnel in Japan: a registry data analysis
Subject
Helicopter emergency medical service, Mortality, Prehospital, Registry data, Traumatic cardiac arrest
Description
Background Traumatic cardiac arrest (TCA) is associated with poor outcomes. Helicopter emergency medical
services (HEMSs) are often used to transport critically ill patients to hospitals. However, the role of HEMS in the treat‐
ment of TCA remains unclear. Therefore, in this study, we aimed to determine the current status of patients with pre‐
hospital TCA managed by HEMS personnel in Japan and compare the outcomes of patients who experienced TCA
before and after the arrival of HEMS.
Methods The Japanese Society for Aeromedical Services registry data of patients managed by HEMS personnel
from April 2015 to March 2020 were analyzed in this retrospective cohort study. HEMS arrival and physicians’ interven‐
tions at the scene were the variables of interest. The survival rate and neurological outcomes at 28 days after injury
were analyzed.
Results Of the 55 299 registered patients, 722 who experienced prehospital TCA were included in the analysis. The
distribution of first-witnessed TCA was as follows: pre-emergency medical service (EMS) arrival (n=426/722, 60.3%),
after EMS arrival (n=113/722, 16.0%), and after HEMS arrival (n=168/722, 23.8%). The 28-day survival rate was 6.2%
(n=44/706), with a cerebral performance category of 1 or 2 in 18 patients. However, patients who experienced TCA
after receiving interventions provided by physicians before HEMS arrival had the worst outcomes, with only 0.6%
of them surviving with favorable neurological outcomes. Multivariable analysis revealed that securing the intravenous
route by the EMS team (adjusted odds ratio: 2.43, 95% confidence interval [CI]: 1.11–5.30) and tranexamic acid infu‐
sion by the HEMS team (adjusted odds ratio: 2.78, 95% CI: 1.16–6.64) may have increased the return of spontaneous
circulation (ROSC) rate.
Conclusions The results of our study were similar to those reported in previous studies with regards to the use
of HEMS in Japan for transporting patients with TCA. Our findings suggest that in patients with severe trauma, cardiac
arrest after initiation of HEMS, the highest level of prehospital medical intervention, may be associated with an inferior
prognosis. Tracheal intubation and administration of tranexamic acid by the EMS team may increase the rate of ROSC
in TCA.
services (HEMSs) are often used to transport critically ill patients to hospitals. However, the role of HEMS in the treat‐
ment of TCA remains unclear. Therefore, in this study, we aimed to determine the current status of patients with pre‐
hospital TCA managed by HEMS personnel in Japan and compare the outcomes of patients who experienced TCA
before and after the arrival of HEMS.
Methods The Japanese Society for Aeromedical Services registry data of patients managed by HEMS personnel
from April 2015 to March 2020 were analyzed in this retrospective cohort study. HEMS arrival and physicians’ interven‐
tions at the scene were the variables of interest. The survival rate and neurological outcomes at 28 days after injury
were analyzed.
Results Of the 55 299 registered patients, 722 who experienced prehospital TCA were included in the analysis. The
distribution of first-witnessed TCA was as follows: pre-emergency medical service (EMS) arrival (n=426/722, 60.3%),
after EMS arrival (n=113/722, 16.0%), and after HEMS arrival (n=168/722, 23.8%). The 28-day survival rate was 6.2%
(n=44/706), with a cerebral performance category of 1 or 2 in 18 patients. However, patients who experienced TCA
after receiving interventions provided by physicians before HEMS arrival had the worst outcomes, with only 0.6%
of them surviving with favorable neurological outcomes. Multivariable analysis revealed that securing the intravenous
route by the EMS team (adjusted odds ratio: 2.43, 95% confidence interval [CI]: 1.11–5.30) and tranexamic acid infu‐
sion by the HEMS team (adjusted odds ratio: 2.78, 95% CI: 1.16–6.64) may have increased the return of spontaneous
circulation (ROSC) rate.
Conclusions The results of our study were similar to those reported in previous studies with regards to the use
of HEMS in Japan for transporting patients with TCA. Our findings suggest that in patients with severe trauma, cardiac
arrest after initiation of HEMS, the highest level of prehospital medical intervention, may be associated with an inferior
prognosis. Tracheal intubation and administration of tranexamic acid by the EMS team may increase the rate of ROSC
in TCA.
Creator
Hiroki Nagasawa1*, Kazuhiko Omori1
, Ken‐ichi Muramatsu1
, Ikuto Takeuchi1
, Hiromichi Ohsaka1
,
Kouhei Ishikawa1 and Youichi Yanagawa1
, Ken‐ichi Muramatsu1
, Ikuto Takeuchi1
, Hiromichi Ohsaka1
,
Kouhei Ishikawa1 and Youichi Yanagawa1
Source
https://doi.org/10.1186/s12245-023-00550-9
Date
2023
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Hiroki Nagasawa1*, Kazuhiko Omori1
, Ken‐ichi Muramatsu1
, Ikuto Takeuchi1
, Hiromichi Ohsaka1
,
Kouhei Ishikawa1 and Youichi Yanagawa1, “Outcomes of prehospital traumatic cardiac arrest managed by helicopter emergency medical service personnel in Japan: a registry data analysis,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12214.