Did Advanced Prehospital Care by Emergency Lifesaving Technicians Improve the Prognosis of Patient with Out-of Hospital Cardiopulmonary Arrest in Japan? Appraisal of the Japanese Paramedical System

In order to provide an advanced prehospital care for patients suffering out-of-hospital cardiopulmonary arrest, Japanese paramedical system was developed in 1991. Since then, it was possible for emergency lifesaving technicians to perform airway management with device, semi-automatic defibrillation, and IV placement. However, several studies indicated that the outcome of out of hospital cardiopulmonary arrest had not improved. The possible reasons for the poor outcome may include: (1) the time required for emergency lifesaving technicians to treat patients is excessive, (2) emergency lifesaving technicians are not permitted to intubate or administer epinephrine, and (3) the number of individuals to perform bystander CPR remains very low. In addition, reported survival rates for out-of-hospital cardiopulmonary arrest varied widely, presumably due to some variations in definitions. Thus, it is recommended that survival data should be analyzed by using common templates such as Utstein style to compare each other