Is Paramedic ALS Better Than BLS for Cardiac Arrest After Blunt Trauma?

Using Japan's nationwide registry of out-of-hospital cardiac arrests, investigators compared advanced life support (ALS) and basic life support (BLS) for patients with cardiac arrest after blunt trauma from motor vehicle collision. Outcomes were compared in three groups of patients who received life support in the prehospital setting: BLS by an emergency medical services (EMS) professional (1963 patients); ALS by an EMS professional (1591 patients); and ALS by a prehospital physician (828 patients).

Overall, 96 patients (2%) survived to 1 month. In analyses adjusted for potential confounders, prehospital return of spontaneous circulation was more common with ALS than with BLS, whether ALS was provided by a paramedic or a physician. However, …