Can a Motorcycle Paramedic Increase the Survival of Patients after OHCA?—20 Years of Experience in Ljubljana

Background and Objectives: Despite advancements in modern medicine, the survival rate of patients after out-of-hospital cardiac arrest (OHCA) remains low. The proportion of OHCA patients that could be saved under ideal circumstances is unknown. A significant portion of patients experience cardiac arrest due to irreversible conditions. The survival of patients with reversible causes de-pends on the prompt initiation of basic life support (BLS) and early defibrillation. In order to in-crease the chances of survival, the motorcycle paramedic project was implemented in Ljubljana in 2003. The motorcycle paramedic is equipped with an AED. In the case of OHCA with a shockable rhythm, he performs defibrillation before the arrival of the emergency medical team (EMT). The purpose of the research is to determine whether the motorcycle paramedic, by reducing the re-sponse time to patients experiencing OHCA, increases the survival rate of these patients. Materials and methods: A retrospective analysis of OHCA within the area covered by Ljubljana Emergency Medical Service (EMS) was conducted for the period from January 2003 to December 2022. Results: Between January 2003 and December 2022 EMT performed resuscitation on 3352 patients. The motorcycle paramedic was simultaneously activated and arrived at the scene before the EMT in 316 cases. In 16 patients, Return of Spontaneous Circulation (ROSC) was achieved before the arrival of the EMT. The group in which the motorcycle paramedic arrived at the scene before the EMT showed a higher ROSC compared to the other group (44.3 % vs 36.9%) and a larger proportion of patients were discharged from the hospital (18.7% vs 13.0%). The proportion of patients with favorable neurological outcomes was also statistically significantly higher (15.9% vs 10.6%, p=0.004). Con-clusion: The study has demonstrated that the implementation of the motorcycle paramedic into the EMS in Ljubljana has increased the survival rate of OHCA patients.