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oai:figshare.com:article/33995408 2026-09-25T13:27:25Z category_7 category_12 category_15 category_16 category_21 category_46 category_132 category_135 portal_87 item_type_3 month_year_09_2026

A Robust Educational Initiative for EMS Clinicians Focusing on Pit-Crew CPR Improves Neurologically Intact Survival David H. Yang (22661135) Yi-Hsuan Yen (25110335) Ross Logan (25110338) Joseph DeAngelis (25110341) Thomas Lardaro (20862592) Katherine Couturier (12867028) Daniel Joseph (10854201) Sarah Perman (3834781) Alexander R. Nelson (12867031) Medicine Cell Biology Neuroscience Physiology Biotechnology Immunology Infectious Diseases Computational Biology shockable initial rhythm good neurological function findings support structured comprising structured didactic 44 ), suggesting observational study using crew cardiopulmonary resuscitation cardiac arrest registry 01 – 1 significant immediate improvement robust educational initiative adjusted odds ratio 1917 adult non hospital cardiac arrest progression since intervention neurologically intact survival ems clinicians focusing hospital discharge prior 1 – 1 significant gradual increase ci ], 1 agency ems system traumatic ohca patients crew cpr intervention intervention .</ p gradual improvement significant increase ems clinicians hospital discharge witnessed arrest study period based resuscitation arrest location aor 1 sustained return spontaneous circulation september 28 primary outcome month interval evaluate whether effective strategy confidence interval cares ). based training august 2 922 pre <p>To evaluate whether the implementation of a region-wide pit-crew cardiopulmonary resuscitation (CPR) initiative was associated with improved survival to hospital discharge with good neurological function among adults with non-traumatic out-of-hospital cardiac arrest (OHCA) in a heterogenous, multi-agency emergency medical services (EMS) system in south-central Connecticut.</p> <p>We conducted a retrospective, before-and-after observational study using the Cardiac Arrest Registry to Enhance Survival (CARES). The pit-crew CPR intervention, comprising structured didactic and hands-on simulation-based training was delivered across 27 EMS agencies from September 28, 2021 through August 2, 2022. The primary outcome was survival to hospital discharge with good neurological function (Cerebral Performance Category 1–2). Secondary outcomes included survival to hospital discharge and sustained return of spontaneous circulation (ROSC). We performed an interrupted time series analysis using the beginning of our intervention (September 28, 2021) as the interruption to model. Multivariable logistic regression models were adjusted for age, sex, race, shockable initial rhythm, witnessed arrest, arrest location, and bystander CPR.</p> <p>A total of 1917 adult non-traumatic OHCA patients (922 pre-intervention; 995 post-intervention) were resuscitated by EMS clinicians in the study period. In progression since intervention, there was a significant increase in neurologically intact survival per 4-month interval (adjusted odds ratio [OR] 1.20; 95% confidence interval [CI], 1.01–1.44), suggesting a gradual improvement in outcomes over time after protocol implementation. At intervention start, there was a significant increase in ROSC (aOR 1.41; 95% CI, 1.1–1.81). There was no change in survival to hospital discharge prior to the intervention, at the time of the intervention, or following the intervention.</p> <p>Implementation of a pit-crew CPR model across a heterogenous, multi-agency EMS system was associated with a significant gradual increase in neurologically intact survival in the post-intervention period, as well as a significant immediate improvement in ROSC at the time of protocol implementation. These findings support structured, team-based resuscitation as a feasible and effective strategy to improve cardiac arrest outcomes within existing EMS systems.</p> 2026-09-25T13:27:25Z Dataset Dataset 10.6084/m9.figshare.33995408.v1 https://figshare.com/articles/dataset/A_Robust_Educational_Initiative_for_EMS_Clinicians_Focusing_on_Pit-Crew_CPR_Improves_Neurologically_Intact_Survival/33995408 CC BY 4.0