UK ambulance service resuscitation management of pulseless electrical activity: a systematic review protocol of text and opinion
Black, Sarah Endacott, Ruth
Black, Sarah
Endacott, Ruth
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Abstract
Abstract published with permission.
Background: Out-of-hospital cardiac arrest patients with pulseless electrical activity are treated
by paramedics using basic and advanced life support resuscitation. When resuscitation fails to
achieve return of spontaneous circulation, there are limited evidence and national guidelines
on when to continue or stop resuscitation. This has led to ambulance services in the United
Kingdom developing local guidelines to support paramedics in the resuscitative management
of pulseless electrical activity. The content of each guideline is unknown, as is any association
between guideline implementation and patient survival. We aim to identify and synthesise local
ambulance service guidelines to help improve the consistency of paramedic-led decision-making
for the resuscitation of pulseless electrical activity in out-of-hospital cardiac arrest.
Methods: A systematic review of text and opinion will be conducted on ambulance service
guidelines for resuscitating adult cardiac arrest patients with pulseless electrical activity. Data will be
gathered direct from the ambulance service website. The review will be guided by the methods of
the Joanna Briggs Institute (JBI). The search strategy will be conducted in three stages: 1) a website
search of the 14 ambulance services; 2) a search of the evidence listed in support of the guideline;
and 3) an examination of the reference list of documents found in the first and second stages and
reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Each
document will be assessed against the inclusion criteria, and quality of evidence will be assessed
using the JBI Critical Appraisal Checklist for Text and Opinion. Data will be extracted using the
JBI methods of textual data extraction and a three-stage data synthesis process: 1) extraction
of opinion statements; 2) categorisation of statements according to similarity of meaning; and
3) meta-synthesis of statements to create a new collection of findings. Confidence of findings will
be assessed using the graded ConQual approach.