The Role of Paramedics in Prehospital Management of Cardiac Arrest: Innovations in Cardiopulmonary Resuscitation and Defibrillation Techniques

Abstract

Background: Out-of-hospital cardiac arrests (OHCAs) remain a critical challenge for emergency medical services (EMS), with global survival rates stagnating between 5% and 10%. Despite advancements in training and technology, these rates highlight the urgent need for improved prehospital interventions. This systematic review evaluates the impact of high-performance cardiopulmonary resuscitation (HP CPR) and multi-tiered response (MTR) strategies on OHCA outcomes.

Methods: A comprehensive literature search was conducted across multiple databases, yielding 208 relevant publications from 2000 to 2023. The analysis reveals that HP CPR, which emphasizes team dynamics and defined roles, correlates with improved return of spontaneous circulation (ROSC) and survival to discharge.

Results: Key findings indicate that early defibrillation significantly enhances outcomes, particularly when facilitated by MTR systems. Notably, the ratio of emergency medical technicians (EMTs) to paramedics plays a crucial role; higher paramedic involvement correlates with better survival rates. Conversely, reliance on mechanical CPR devices has shown limited benefits, suggesting a paradigm shift towards minimizing interruptions in manual chest compressions.

Conclusions: The findings underscore the necessity for tailored EMS protocols that prioritize team proficiency and resource allocation. This review highlights the potential of HP CPR and MTR strategies to enhance patient outcomes in OHCA cases, advocating for further research to standardize best practices in prehospital cardiac arrest management.