{"pk":10814,"title":"Variations in Cardiac Arrest Regionalization in California","subtitle":null,"abstract":"Introduction:\n The development of cardiac arrest centers and regionalization of systems of care may improve survival of patients with out-of-hospital cardiac arrest (OHCA). This survey of the local EMS agencies (LEMSA) in California was intended to determine current practices regarding the treatment and routing of OHCA patients and the extent to which EMS systems have regionalized OHCA care across California. \nMethods:\n We surveyed all of the 33 LEMSA in California regarding the treatment and routing of OHCA patients according to the current recommendations for OHCA management. \nResults:\n Two counties, representing 29% of the California population, have formally regionalized cardiac arrest care. Twenty of the remaining LEMSA have specific regionalization protocols to direct all OHCA patients with return of spontaneous circulation to designated percutaneous coronary intervention (PCI)-capable hospitals, representing another 36% of the population. There is large variation in LEMSA ability to influence inhospital care. Only 14 agencies (36%), representing 44% of the population, have access to hospital outcome data, including survival to hospital discharge and cerebral performance category scores. \nConclusion:\n Regionalized care of OHCA is established in two of 33 California LEMSA, providing access to approximately one-third of California residents. Many other LEMSA direct OHCA patients to PCI-capable hospitals for primary PCI and targeted temperature management, but there is limited regional coordination and system quality improvement. Only one-third of LEMSA have access to hospital data for patient outcomes.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"emergency medical services"},{"word":"Out-of-hospital Cardiac Arrest"},{"word":"Delivery of Healthcare"},{"word":"Hypothermia, Induced"},{"word":"Hospital Mortality"}],"section":"Emergency Medical Services","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6t0549pv","frozenauthors":[{"first_name":"Brian","middle_name":"L.","last_name":"Chang","name_suffix":"","institution":"University of California San Francisco School of Medicine, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Mary","middle_name":"P.","last_name":"Mercer","name_suffix":"","institution":"University of California San Francisco School of Medicine, Department of Emergency Medicine, San Francisco, California","department":"None"},{"first_name":"Nichole","middle_name":"","last_name":"Bosson","name_suffix":"","institution":"Los Angeles County Emergency Medical Service Agency, Los Angeles, California \nHarbor-UCLA Medical Center and the Los Angeles Biomedical Research Institute, Carson, California","department":"None"},{"first_name":"Karl","middle_name":"A.","last_name":"Sporer","name_suffix":"","institution":"University of California San Francisco School of Medicine, Department of Emergency \nAlameda County Emergency Medical Service Agency, Alameda, California","department":"None"}],"date_submitted":"2017-05-16T21:40:32Z","date_accepted":"2017-05-16T21:40:32Z","date_published":"2018-02-19T18:10:17Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/10814/galley/5886/download/"}]}