Impact of the COVID-19 Pandemic on Prehospital Intervention and Survival of Patients With Out-of-Hospital Cardiac Arrest in Osaka City, Japan.

Background: The coronavirus disease (COVID-19) pandemic may have influenced the prehospital emergency care and deaths of individuals experiencing an out-of-hospital cardiac arrest (OHCA).

Methods and results: We analyzed the registry data of 2,420 and 2,371 OHCA patients in Osaka City, Japan in 2019 and 2020, respectively, according to the 3 waves of the COVID-19 pandemic. Patient outcomes were compared using multivariable logistic regression analyses with the 2019 data as the reference.

A Mobile App for Self-Triage for Pediatric Emergency Patients in Japan: 4 Year Descriptive Epidemiological Study.

Background: When children suffer sudden illness or injury, many parents wonder whether they should go to the hospital immediately or call an ambulance. In 2015, we developed a mobile app that allows parents or guardians to determine the urgency of their child's condition or call an ambulance and that indicates available hospitals and clinics when their child is suddenly sick or injured by simple selection of the child's chief complaints and symptoms. However, the effectiveness of medical apps used by the general public has not been well evaluated.

Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO) by ambulance personnel during cardiopulmonary resuscitation: A prospective observational analysis of 87 cases in Osaka city, Japan.

Background: Regional cerebral oxygen saturation (rSO) is a non-invasive method of measuring cerebral perfusion; However, serial changes in cerebral rSO values among out-of-hospital cardiac arrest (OHCA) patients in pre-hospital settings have not been sufficiently investigated. We aimed to investigate the association between the serial change in rSO pattern and patient outcome.

Methods: We evaluated rSO in OHCA patients using portable monitoring by emergency life-saving technicians (ELTs) from June 2013 to December 2019 in Osaka City, Japan.

Influence of COVID-19 pandemic on bystander interventions, emergency medical service activities, and patient outcomes in out-of-hospital cardiac arrest in Osaka City, Japan.

Background: The coronavirus disease (COVID-19) pandemic may have negatively affected bystander interventions, emergency medical service (EMS) personnel activities, and patient outcomes after out-of-hospital cardiac arrest (OHCA). This study assessed bystander interventions, EMS activities, and patient outcomes during the COVID-19 pandemic era and compared them with those during the non-COVID-19 pandemic era in Osaka City, Japan, where public-access automated external defibrillators (AEDs) are well established.

Methods: We conducted this population-based cohort study that included all cases with non-traumatic OHCA treated by EMS personnel and excluded cases with no resuscitation attempt, traumatic cases, cases occurring in healthcare facilities, or cases witnessed by EMS personnel.

Influence of the COVID-19 pandemic on an emergency medical service system: a population-based, descriptive study in Osaka, Japan.

Aim: Novel coronavirus infection (COVID-19) was confirmed in Wuhan, China in December 2019, and the COVID-19 pandemic has spread around the world. However, no clinical studies on the impact of the COVID-19 pandemic on emergency medical service (EMS) systems have been carried out.

Methods: This was a retrospective study with a study period from 1 January 2020 to 14 April 2020.

Gender disparities in the application of public-access AED pads among OHCA patients in public locations.

Background: Female out-of-hospital cardiac arrest (OHCA) patients have been reported to be less likely to receive cardiopulmonary resuscitation by bystanders compared with male patients in prehospital settings. However, no clinical studies have investigated gender disparities in the application of public-access automated external defibrillator (AED) pads among OHCA patients in public locations.

Methods: OHCA data from 2011 to 2018 were obtained from the OHCA registry in Osaka City, Japan and OHCAs that occurred in public locations were included.

Effectiveness of dispatcher instructions-dependent or independent bystander cardiopulmonary resuscitation on neurological survival among patients with out-of-hospital cardiac arrest.

Background: We evaluated the association between survival and bystandercardiopulmonary resuscitation (CPR) with or without dispatcher instructions (DI) considering the time from emergency call receipt by the dispatch center to emergency medical services (EMS) personnel's contact with the patient (i.e. time to EMS arrival).

Public-access automated external defibrillator pad application and favorable neurological outcome after out-of-hospital cardiac arrest in public locations: A prospective population-based propensity score-matched study.

Background: Randomized controlled trials or observational studies showed that the use of public-access automated external defibrillator (AED) was effective for patients with out-of-hospital cardiac arrest (OHCA). However, it is unclear whether public-access AED use is effective for all patients with OHCA irrespective of first documented rhythm. We aimed to evaluate the effect of public-access AED use for OHCA patients considering first documented rhythm (shockable or non-shockable) in public locations.

Characteristics of Sports-Related Emergency Transport: A Population-Based Descriptive Study in Osaka City.

Background: Little is known about the characteristics of emergency patients transported to hospital while participating in sports activity. Hence, we identified characteristics of emergency patients transported to hospital by emergency medical service (EMS) while participating in sports activity in Osaka City.

Methods: Population-based ambulance records of Osaka Municipal Fire Department were reviewed.

Cardiopulmonary resuscitation performed by off-duty medical professionals versus laypersons and survival from out-of-hospital cardiac arrest among adult patients.

Background: Cardiopulmonary resuscitation (CPR) performed by bystanders is a key factor for out-of-hospital cardiac arrest (OHCA) survival. This study aimed to evaluate the relationship between CPR performed by off-duty medical professionals vs. laypersons and one-month survival with favorable neurological outcome after OHCA.

Characteristics and Outcomes of Out-of-Hospital Cardiac Arrest Occurring While in a Motor Vehicle.

This study aimed to investigate the incidence, patient characteristics, and outcomes of out-of-hospital cardiac arrest (OHCA) occurring while in a motor vehicle in Osaka City, Japan (with a population of 2.6 million), from 2009 to 2015. The OHCA data used in this study were obtained from the population-based Utstein-style registry in Osaka City.

Evaluation of factors associated with the difficulty in finding receiving hospitals for traffic accident patients at the scene treated by emergency medical services: a population-based study in Osaka City, Japan.

Aim: Although the prolongation of the time between injury and hospital arrival of traffic accident patients can influence their prognosis, factors associated with the difficulty in hospital acceptance of these patients have not been sufficiently evaluated in Japan.

Methods: We retrospectively analyzed the population-based ambulance records of all traffic accident patients for whom the Osaka Municipal Fire Department (Osaka City, Japan) dispatched an ambulance in 2013. We defined "cases with difficulty in hospital acceptance" as cases that required ≥4 calls by emergency medical service personnel at the scene before receiving hospital acceptance.

Improvements in Patient Acceptance by Hospitals Following the Introduction of a Smartphone App for the Emergency Medical Service System: A Population-Based Before-and-After Observational Study in Osaka City, Japan.

Background: Recently, the number of ambulance dispatches has been increasing in Japan, and it is therefore difficult for hospitals to accept emergency patients smoothly and appropriately because of the limited hospital capacity. To facilitate the process of requesting patient transport and hospital acceptance, an emergency information system using information technology (IT) has been built and introduced in various communities. However, its effectiveness has not been thoroughly revealed.

Factors associated with prehospital death among traffic accident patients in Osaka City, Japan: A population-based study.

Objective: Although it is important to assess the factors associated with traffic accident fatalities to decrease them as a matter of public health, such factors have not been fully identified.

Methods: Using a large-scale data set of ambulance records in Osaka City, Japan, we retrospectively analyzed all traffic accident patients transported to hospitals by emergency medical service personnel from 2013 to 2014. In this study, prehospital death was defined as that occurring at the scene or in the emergency department immediately after hospital arrival.

Factors associated with the difficulty in hospital acceptance among elderly emergency patients: A population-based study in Osaka City, Japan.

Aim: We aimed to investigate prehospital factors associated with difficulty in hospital acceptance among elderly emergency patients.

Methods: We reviewed ambulance records in Osaka City from January 2013 through December 2014, and enrolled all elderly emergency patients aged ≥65 years who were transported by on-scene emergency medical service personnel to a hospital that the personnel had selected. The definition of difficulty in hospital acceptance was to the requirement for ≥4 phone calls to hospitals by emergency medical service personnel before receiving a decision from the destination hospitals.

Out-of-hospital cardiac arrests during exercise among urban inhabitants in Japan: Insights from a population-based registry of Osaka City.

Background: The patient characteristics, pre-hospital interventions, and outcomes of out-of-hospital cardiac arrests (OHCA) occurring during exercise, have not been sufficiently investigated among the general population.

Methods: OHCA data from 2009 to 2015 were obtained from the population-based OHCA registry in Osaka City, Japan. Patients who suffered OHCA, which occurred during exercise before the arrival of emergency medical service personnel, were included.

Factors associated with the difficulty in hospital acceptance at the scene by emergency medical service personnel: a population-based study in Osaka City, Japan.

Objectives: To investigate the association between the difficulty in hospital acceptance at the scene by emergency medical service (EMS) personnel and prehospital demographic factors and reasons for EMS calls.

Design: A retrospective, observational study.

Setting: Osaka City, Japan.

High-rise buildings and neurologically favorable outcome after out-of-hospital cardiac arrest.

Background: The number of people living in high-rise buildings has recently been increasing in Japan, and delayed transport time by emergency-medical-service (EMS) personnel from higher floors could lead to lower survival after out-of-hospital cardiac arrest (OHCA). However, there are no clinical studies assessing the association between the floor where patients reside and neurologically favorable outcome after OHCA.

Methods: This was a prospective, population-based study conducted in Osaka City, Japan that enrolled adults aged >=18years suffering an OHCA of cardiac origin before EMS arrival between 2013 and 2014.

Pre-hospital portable monitoring of cerebral regional oxygen saturation (rSO2) in seven patients with out-of-hospital cardiac arrest.

Background: In recent years, measurement of cerebral regional oxygen saturation (rSO2) has attracted attention during resuscitation. However, serial changes of cerebral rSO2 in pre-hospital settings are unclear. The objective of this study was to clarify serial changes in cerebral rSO2 of patients with out-of-hospital cardiac arrest (OHCA) in the pre-hospital setting.

Incidence and outcomes of emergency self-harm among adolescents: a descriptive epidemiological study in Osaka City, Japan.

Objectives: To evaluate the incidence and outcomes of self-harm from ambulance records.

Design: A retrospective, observational study.

Setting: Osaka City, Japan.

Characteristics and Outcomes of Bath-Related Out-of-Hospital Cardiac Arrest in Japan.

Background: Characteristics and outcomes of emergency patients with bath-related sudden cardiac arrest in prehospital settings have not been sufficiently investigated.

Methods and results: From a prospective population-based registry, which covers all out-of-hospital cardiac arrests (OHCAs) in Osaka City, a total of 642 patients who had a bath-related OHCA from 2012 to 2014 were enrolled in the analyses. The characteristics and outcomes of OHCA were compared by three locations of arrest: home baths (n=512), public baths (n=102), and baths in other public institutions (n=28).

Characteristics and outcomes of emergency patients with self-inflicted injuries: a report from ambulance records in Osaka City, Japan.

Background: Few studies have evaluated the actual situations of emergency patients with self-inflicted injuries treated by emergency-medical-service (EMS) personnel.

Methods: This study retrospectively reviewed population-based ambulance records in Osaka City, Japan, between January 2010 and December 2012, and enrolled emergency patients who suffered from self-inflicted injuries such as poisoning by drugs or gas, cutting/piercing skin, jumping from heights, hanging, and drowning. The endpoint was the annual incidence per 100,000 populations in Osaka City of emergency patients who presented with self-inflicted injuries by age and sex.

Effectiveness of prehospital Magill forceps use for out-of-hospital cardiac arrest due to foreign body airway obstruction in Osaka City.

Background: Although foreign body airway obstruction (FBAO) accounts for many preventable unintentional accidents, little is known about the epidemiology of FBAO patients and the effect of forceps use on those patients. This study aimed to assess characteristics of FBAO patients transported to hospitals by emergency medical service (EMS) personnel, and to verify the relationship between prehospital Magill forceps use and outcomes among out-of-hospital cardiac arrests (OHCA) patients with FBAO.

Methods: We retrospectively reviewed ambulance records of all patients who suffered FBAO, and were treated by EMS in Osaka City from 2000 through 2007, and assessed the characteristics of those patients.

Ambulance calls and prehospital transportation time of emergency patients with cardiovascular events in Osaka City.

Aim: This study investigated the association between the number of phone calls made to hospitals from ambulances requesting if they can accept prehospital emergency patients with cardiovascular events, and the prehospital transportation time.

Methods: Using ambulance records, we retrospectively enrolled adult patients suffering acute myocardial infarction from 1998 to 2007, and out-of-hospital cardiac arrest of cardiac origin from 2000 to 2007, transported to medical institutions by the emergency medical service in Osaka City.

Results: During the study period, 8,596 patients with acute myocardial infarction without arrest and 9,283 out-of-hospital cardiac arrests of cardiac origin were registered.

An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings.

Background: Stroke is difficult to diagnose when consciousness is disturbed. However few reports have discussed the clinical predictors of stroke in out-of-hospital emergency settings. This study aims to evaluate the association between initial systolic blood pressure (SBP) value measured by emergency medical service (EMS) and diagnosis of stroke among impaired consciousness patients.