Objective To describe neurological outcomes after sudden cardiac arrests (SCAs) in road and long-distance races using a rapid mobile automated external defibrillator system (RMAEDS) intervention. Methods A total of 42 SCAs from 3 214 701 runners in 334 road and long-distance races from 1 February 2007 to 29 February 2020 were examined. Demographics, SCA interventions, EMS-related data and SCA-related outcomes were measured. Primary endpoints were favourable neurological outcomes (Cerebral Performance Categories 1–2) at 1-month and 1-year post-SCA. Secondary endpoints were factors related to the field return of spontaneous circulation (ROSC) and resuscitation characteristics, including the initial ECG waveform classification and resuscitation sequence times according to the initial ECG rhythm. Results The SCA incidence rate was 1.31 per 100 000 runners (age: median (IQR), 51 (36.5, 58.3) years). Field ROSC and full neurological recovery at 1-month post-SCA was achieved 90.4% and 92.9% of cases, respectively. In 22 cases in which bystander cardiopulmonary resuscitation was initiated within 1 min and defibrillation performed within 3 min, full neurological recovery was achieved at 1-month and 1-year post-SCA in 95.5.% and 95.5% of cases, respectively. Conclusions The RMAEDS successfully treated patients with SCA during road and long-distance races yielding a high survival rate and favourable neurological outcomes. These findings support rapid intervention and the proper placement of healthcare teams along the race course to initiate chest compressions within 1 min and perform defibrillation within 3 min.

Background/Objectives: Accurate telephone triage of emergency medical cases plays a crucial role in improving outcomes for critically ill patients. Effective triage enables emergency medical dispatchers to provide appropriate pre-arrival instructions and to deploy operational units according to the patient’s severity level. This study aimed to develop and assess the content validity of the Emergency Medical Triage Protocol and Criteria-Based Dispatch Code (EMTP-CBDC) for Thailand. The objective was to ensure the tool’s content accuracy and applicability in prioritizing emergency responses in line with medical urgency, considering global changes and universal standards. Methods: A cross-sectional descriptive study was conducted from 15–30 April 2024. The content validity of the newly developed EMTP-CBDC, comprising 30 symptom groups, was evaluated by five emergency physician experts with at least 1 year of experience in emergency medical oversight. The assessment focused on four aspects: relevance, clarity, simplicity, and ambiguity. The Content Validity Index (CVI) was calculated at both the item level (I-CVI) and the scale level using the average index (S-CVI/Ave). To adjust for chance agreement, the probability of chance agreement (Pc) and the modified kappa coefficient (k*) were calculated for each item. Results: The content validation revealed I-CVI values ranging from 0.80 to 1.00 across all items. The S-CVI/Ave scores were 0.97 for relevance, 0.93 for clarity, 0.98 for simplicity, and 0.94 for ambiguity. These values surpassed the accepted thresholds for content validity. Conclusions: The EMTP-CBDC developed for Thailand demonstrated good content validity across relevance, clarity, simplicity, and ambiguity. Further studies are needed to establish its reliability and field performance before routine implementation.

Objective: In recent years, the efficacy of tracheal intubation for out-of-hospital cardiac arrest (OHCA) performed by emergency medical technicians has been a subject of considerable debate. This study aimed to compare the success rate, complication rate, return of spontaneous circulation (ROSC), neurological prognosis (cerebral performance categories 1-2 [CPC1-2]), and regional differences between the use of video laryngoscopes (VLs) and Macintosh laryngoscopes (MLs) in OHCA patients. Methods: This retrospective cohort study utilized data from 10,067 OHCAs and emergency medical transports, extracted from national Utstein-style data and compared using propensity score matching. The primary endpoints were the success rate of tracheal intubation and the complication rate. Results: In this study, 885 intubated OHCA patients were enrolled, and 664 were analyzed after propensity score matching. The success rate was significantly higher in the VL group (94.0%; 312/332) than in the ML group (89.8%; 298/332) (relative risk, 1.05; 95% confidence interval, 1.00-1.10; P=0.040). Esophageal intubation occurred in 0% (0/332) of the VL group and in 5.7% (19/332) of the ML group, reflecting a statistically significant difference (relative risk, 1.06; 95% confidence interval, 1.03-1.09; P<0.001). The ROSC and CPC1-2 rates were similar in both groups. Conclusion: Our data suggest that VLs offer a slight advantage with a higher success rate and lower complication rate. Further discussion is warranted regarding the preferential use of VLs and the development of emergency medical services intubation devices.