Recommendations on ambulance cardiopulmonary resuscitation in basic life support systems

Marcus Eng Hock Ong, Sang Do Shin, Soon Swee Sung, Hideharu Tanaka, Matthew Huei-Ming, Kyoung Jun Song, Tatsuya Nishiuchi, Benjamin Sieu Hon Leong, Sarah Abdul Karim, Chih Hao Lin, Hyun Wook Ryoo, Hyun Ho Ryu, Taku Iwami, Kentaro Kajino, Patrick Chow In Ko, Kyung Won Lee, Nathida Sumetchotimaytha, Robert Swor, Brent Myers, Kevin MackeyBryan McNally

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


AbstractAim. Cardiopulmonary resuscitation (CPR) during ambulance transport can be a safety risk for providers and can affect CPR quality. In many Asian countries with basic life support (BLS) systems, patients experiencing out-of-hospital cardiac arrest (OHCA) are routinely transported in ambulances in which CPR is performed. This paper aims to make recommendations on best practices for CPR during ambulance transport in BLS systems. Methods. A panel consisting of 20 experts (including 4 North Americans) in emergency medical services (EMS) and resuscitation science was selected, and met over two days. We performed a literature review and selected 33 candidate issues in five core areas. Using Delphi methodology, the issues were classified into dichotomous (yes/no), multiple choice, and ranking questions. Primary consensus between experts was reached when there was more than 70% agreement. Questions with 60-69% agreement were made more specific and were submitted for a second round of voting. Results. The panel agreed upon 24 consensus statements with more than 70% agreement (2 rounds of voting). The recommendations cover the following: length of time on the scene; advanced airway at the scene; CPR prior to transport; rhythm analysis and defibrillation during transport; prehospital interventions; field termination of resuscitation (TOR); consent for TOR; destination hospital; transport protocol; number of staff members; restraint systems; mechanical CPR; turning off of the engine for rhythm analysis; alternative CPR; and feedback for CPR quality. Conclusion. Recommendations for CPR during ambulance transport were developed using the Delphi method. These recommendations should be validated in clinical settings.

Original languageEnglish
Pages (from-to)491-500
Number of pages10
JournalPrehospital Emergency Care
Issue number4
Publication statusPublished - 2013 Oct

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency

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