Variations in Cardiac Arrest Regionalization in California

Area of Science:

• Emergency Medicine
• Cardiovascular Care
• Public Health Systems

Background:

• Regionalization of care and dedicated cardiac arrest centers show promise for improving out-of-hospital cardiac arrest (OHCA) survival.
• Assessing current practices in OHCA treatment and routing is crucial for system development.

Purpose of the Study:

• To survey California's Local EMS Agencies (LEMSA) on their OHCA patient treatment and routing protocols.
• To evaluate the extent of regionalized OHCA care across California.

Main Methods:

• A survey was administered to all 33 LEMSA in California.
• The survey focused on adherence to current OHCA management recommendations for treatment and routing.

Main Results:

• Only two counties (29% of CA population) have formally regionalized cardiac arrest care.
• 20 LEMSA (36% of population) direct OHCA patients to percutaneous coronary intervention (PCI)-capable hospitals.
• Significant variation exists in influencing in-hospital care, with only 36% of agencies accessing outcome data.

Conclusions:

• Formal regionalization of OHCA care is present in only two of 33 California LEMSA.
• While many LEMSA direct patients to PCI-capable hospitals, regional coordination and quality improvement efforts are limited.
• Access to crucial patient outcome data is lacking for most LEMSA, hindering system-wide improvements.