The Cardiac Arrest Support Tier: a service evaluation

Area of Science:

• Emergency medicine
• Pre-hospital care
• Cardiac arrest management

Background:

• The pre-hospital Cardiac Arrest Support Tier (CAST) was implemented by a Hazardous Area Response Team (HART) to enhance out-of-hospital cardiac arrest (OHCA) response.
• A service evaluation was conducted to assess the clinical effectiveness, feasibility, and acceptability of the CAST during its initial pilot year.

Purpose of the Study:

• To evaluate the clinical effectiveness of the CAST in delivering post-Return of Spontaneous Circulation (ROSC) care.
• To determine the feasibility and logistical aspects of CAST implementation.
• To assess the acceptability of the CAST among frontline ambulance service staff.

Main Methods:

• Auditing chest compression feedback, ROSC care delivery, and CAST paramedic exposure to OHCA incidents.
• Assessing the number of incidents attended and staff commitment by CAST.
• Utilizing an online questionnaire to gauge staff acceptability of the CAST project.

Main Results:

• CAST attended 178 OHCAs, committing a median of three paramedics per incident.
• CAST demonstrated superior delivery of post-ROSC care compared to regional and national data (80% vs 68.5% vs 77.46%).
• Chest compression feedback was unavailable due to equipment issues; however, 64.6% of staff found CAST beneficial, and 63.1% desired its continuation.

Conclusions:

• The CAST is logistically feasible and acceptable to the majority of ambulance service staff.
• CAST successfully demonstrated the delivery of evidence-based practice in OHCA incidents.
• Despite challenges with feedback equipment, the CAST shows promise for improving pre-hospital cardiac arrest care.