A Meta-Analysis and Consensus Conference on Updating a List of Medicines for Out-of-Hospital Cardiac Arrests in the Emergency Care System
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Abstract
Background and Rationale: Having a list of essential emergency medicines and management guidelines requires clear evidence approach. Based on the hospital’s potential, this study intended to update a list of essential medicines for managing out-of-hospital cardiac arrest (OHCA) patients for appropriate cadres of emergency responders in the emergency care system (ECS) Chiang Mai case study.
Methodology: The study was divided into two parts. The meta-analysis started from literature search then data extraction by two independent researchers. The PICO (patient, intervention, comparison, outcome) keyword search for full-text studies published in English between 1990 and 2021 in electronic databases such as PubMed, Medline, Embase, Cochrane, including references was undertaken. The search yielded 2,096 papers, 866 duplicate articles were eliminated, as well as 1,199 papers with unrelated titles and abstracts. Thirty-one papers were good for meta-analysis and reached recommendations on an essential emergency medicine list for OHCA patients. The second step was a consensus conclusion based on evidence gathered from in-depth interviews with 12 academic professionals and 12 emergency medical practitioners.
Results and Conclusion: The list of drugs for OHCA patients was developed through a thorough analysis and the inputs from experts. Dopamine, norepinephrine, and epinephrine injections are three items required at the advanced life support (ALS) level. OHCA patients who received epinephrine within ten minutes of calling the ECS had a high survival rate and clinical prognosis. The emergency and pharmacy departments should have the emergency medicine kits handy. After the ECS dispatch, pharmacists should monitor the use of and refill the emergency drugs ensuring preparedness of the kit for next emergency incident.
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