Matthew Huei-Ming Ma

Matthew Huei-Ming Ma
National Taiwan University | NTU

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228
Publications
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Publications

Publications (228)
Article
Introduction: The preventable death rate (PDR) is an important parameter in the quality assurance of traumatic care. Medical errors or untimely management may occur during stressful trauma care, resulting in preventable deaths. We aimed to develop an applicable PDR model in a trauma center in middle Taiwan. Materials and methods: We identified a...
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Background Termination-of-resuscitation rules (TORRs) in out-of-hospital cardiac arrest (OHCA) patients have been applied in western countries; in Asia, two TORRs were developed and have not been externally validated widely. We aimed to externally validate the TORRs using the registry of Pan-Asian Resuscitation Outcomes Study (PAROS). Methods PARO...
Article
Objective: To evaluate the subjective and objective resuscitation performance of emergency medical technicians (EMTs) using mechanical cardiopulmonary resuscitation (MCPR) devices. Design and setting: This was a cross-sectional simulation-based study where participants installed the MCPR device on a training manikin. Participants: We assessed...
Article
Background: Early recognition of severely injured patients in prehospital settings is of paramount importance for timely treatment and transportation of patients to further treatment facilities. The dispatching accuracy has seldom been addressed in previous studies. Objective: In this study, we aimed to build a machine learning-based model throu...
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Background Return of spontaneous circulation (ROSC) before arrival at the emergency department is an early indicator of successful resuscitation in out-of-hospital cardiac arrest (OHCA). Several ROSC prediction scores have been developed with European cohorts, with unclear applicability in Asian settings. We aimed to develop an interpretable prehos...
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Background: We aimed to identify distinct trajectories of end-tidal carbon dioxide (EtCO2) during cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest (OHCA) and to investigate the association between EtCO2 trajectories and OHCA outcomes. Methods: This was a secondary analysis of a prospectively collected database on adu...
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Background The association between out-of-hospital cardiac arrest patient survival and advanced life support response time remained controversial. We aimed to test the hypothesis that for adult, non-traumatic, out-of-hospital cardiac arrest patients, a shorter advanced life support response time is associated with a better chance of survival. We an...
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Objective Injury is a major cause of morbidity and mortality in children. However, the epidemiology and prehospital care for pediatric unintentional injuries in Asia are still unclear.MethodsA total of 9,737 pediatric patients aged <18 years with unintentional injuries cared for at participating centers of the Pan-Asian Trauma Outcome Study (PATOS)...
Article
Background To mitigate uncertainty that may arise in the judgment of emergency medical technicians when relying on a prehospital stroke scale at the scene, we propose a hospital selection protocol that considers the uncertainty of a prehospital stroke scale and the actual door‐to‐treatment durations, and we have developed a web‐based system to be u...
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Prehospital fluid resuscitation with crystalloids in patients following trauma remain controversial. This study aimed to investigate the association between prehospital fluid resuscitation and outcomes of trauma patients in Asia. We conducted a retrospective cohort study of trauma patients between 2016 and 2018 using data from the Pan-Asia Trauma O...
Article
Background The study aimed to explore the characteristics, predictors, and chronological trends of outcomes for adult out-of-hospital cardiac arrests (OHCAs) with shockable rhythms. Methods A 7-year, community-wide observational study using an Utstein-style registry was conducted. Patients who were not transported, those who experienced trauma and...
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Objective A strengthened chain of survival benefits patient outcomes after out-of-hospital cardiac arrest (OHCA).² Over the past decade, the Taipei Fire Department (TFD) has continuously implemented system-wide initiatives on this issue. We hypothesised that for adult, non-trauma OHCA patients, the bundle of these system-wide initiatives are associ...
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Background Dispatcher-assisted CPR (DA-CPR) has the potential to deliver early bystander CPR (BCPR) and improve out-of-hospital cardiac arrest (OHCA) survival. This study in the Asia-Pacific evaluated the impact of a DA-CPR program on BCPR rates and survival. Methods This was a three-arm, prospective, multi-national, population-based, community-le...
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There are only a few models developed for risk-stratifying COVID-19 patients with suspected pneumonia in the emergency department (ED). We aimed to develop and validate a model, the COVID-19 ED pneumonia mortality index (CoV-ED-PMI), for predicting mortality in this population. We retrospectively included adult COVID-19 patients who visited EDs of...
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Introduction: There are only scarce models developed for stratifying the risk of cardiac arrest from COVID-19 patients presenting to the ED with suspected pneumonia. By using the machine learning (ML) approach, we aimed to develop and validate the ML models to predict in-hospital cardiac arrest (IHCA) in patients admitted from the ED. Hypothesis: W...
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Background/purpose: Recently optimized models for selecting the locations of hospitals capable of providing endovascular thrombectomy (EVT) did not consider the accuracy of the prehospital stroke scale assessment and possibility of secondary transport. Our study aimed to propose a new model for selecting existing hospitals with intravenous thrombo...
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Aim This study aimed to develop an AI model for detecting a caller’s emotional state during out-of-hospital cardiac arrest calls by processing audio recordings of dispatch communications. Methods Audio recordings of 337 out-of-hospital cardiac arrest calls from March-April 2011 were retrieved. The callers’ emotional state was classified based on t...
Preprint
BACKGROUND Early recognition of severely injured patients in prehospital settings is of paramount importance for timely treatment and patient transport. The accuracy of dispatching has seldom been addressed in previous studies. OBJECTIVE In this study, we aimed to build a machine learning-based model through text mining of emergency calls for auto...
Article
Injury is a leading cause of death among young adults. An accurately implemented fi led triage scheme (FTS) by emergency medical technicians (EMTs) is the first step for delivering right patients to the right hospital. However, the training effect of FTS on EMTs with different levels and backgrounds has scarcely been reported. We evaluated training...
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Aim To conduct a systematic review evaluating improvement in team and leadership performance and resuscitation outcomes after such a training of healthcare providers during advanced life support (ALS) courses. Methods This systematic review asked the question of whether students taking structured and standardised ALS courses in an educational sett...
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Background Out-of-hospital cardiac arrest (OHCA) is a critical condition with poor outcomes. Although the survival rate increases in those who undergo defibrillation, the utility of on-time defibrillation among bystanders remained low. An evaluation of the deployment strategy for public access defibrillators (PADs) is necessary to increase their us...
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Our study aimed to compare the effect of self-instruction with manikin feedback to that of instructor-led method on cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) skill performance. In our randomized non-inferiority trial, 64 non-healthcare providers were randomly allocated into self-instruction and instructor-led gr...
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Objectives To set up a prediction model for the 7-day in-hospital mortality of patients admitted from the emergency department (ED) because it is high but no appropriate initial alarm score is available. Design This is a prospective cohort study for prediction model development. Setting In a tertiary referred hospital in northern Taiwan. Partici...
Article
Aim The aim of our review was to understand the effect of interventions to improve system-level performance on the clinical outcomes of patients with cardiac arrest. Methods We searched PubMed, Ovid EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify randomised controlled trials and non-randomised studies...
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Background The current COVID-19 pandemic is highlighting gaps around the world in the design and workflow of Emergency Departments (ED). These gaps have an impact on both patient care and staff safety and represent a risk to public health. There is a need for a conceptual framework to guide ED design and workflow to address these challenges. Such a...
Article
Background: Bystander-initiated cardiopulmonary resuscitation (CPR) and the use of automated external defibrillation (AED) is pivotal in the community chain of survival, but little is known regarding the bystander experience of performing CPR and AED, and their psychological infl uence from the incidents in the Asian community. This qualitative st...
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Background After years of setting up public automated external defibrillators (AEDs), the rate of bystander AED use remains low all over the world. This study aimed to assess the public awareness and willingness of bystanders to use AEDs and to investigate the awareness on the Good Samaritan Law (GSL) and the factors associated with the low rate of...
Article
Introduction Cardiac arrest is a time-sensitive condition requiring urgent intervention. Prompt and accurate recognition of cardiac arrest by emergency medical dispatchers at the time of the emergency call is a critical early step in cardiac arrest management allowing for initiation of dispatcher-assisted bystander CPR and appropriate and timely em...
Article
For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of R...
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Background: Whether rapid transportation can benefit patients with trauma remains controversial. We determined the association between prehospital time and outcome to explore the concept of the "golden hour" for injured patients. Methods and findings: We conducted a retrospective cohort study of trauma patients transported from the scene to hosp...
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Background/purpose The study aim was to develop a model for predicting patients with emergency medical service (EMS) witnessed out-of-hospital cardiac arrest (OHCA). Methods We used fire-based EMS data from Taipei city to develop the prediction model. Patients included in this study were those who were initially alive, non-traumatic, and age ≧20 y...
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Background: The effect of paramedic crew size in the resuscitation of patients with out-of-hospital cardiac arrest (OHCA) remains inconclusive. We hypothesised that teams with a larger crew size have better resuscitation performance including chest compression fraction (CCF), advanced life support (ALS), and teamwork performance than those with a...
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Objective: To investigate variations in the effects of prehospital advanced airway management (AAM) on outcomes of out-of-hospital cardiac arrest (OHCA) patients according to regional emergency medical service (EMS) systems in four Asian cities. Methods: We enrolled adult patients with EMS-treated OHCA of presumed cardiac origin between 2012 and...
Article
Aim: Survival is the most consistently captured outcome across countries for out-of-hospital cardiac arrests (OHCA), with return of spontaneous circulation (ROSC) representing the earliest endpoint for 'unbiased' initial resuscitation success. The ROSC after cardiac arrest (RACA) score was developed to predict ROSC and has been validated in severa...
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Introduction: Following cardiac arrest, return of spontaneous circulation (ROSC) in patients may be followed by spontaneous neurological recovery, which may decrease the potential adverse effects of treatments in post-cardiac arrest care, including those of Targeted Temperature Management (TTM). We investigated the percentage of post-arrest patien...
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The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science Wit...
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Utstein-style reporting templates provide a structured framework with which to compare systems of care for cardiac arrest. The 2004 Utstein reporting template encompassed both out-of-hospital and in-hospital cardiac arrest. A 2015 update of the Utstein template focused on out-of-hospital cardiac arrest, which makes this update of the in-hospital te...
Article
Introduction The shorter the time between the onset of symptoms and reperfusion using endovascular thrombectomy, the better the functional outcome of patients. A training program was designed for emergency medical technicians (EMTs) to learn the gaze-face-arm-speech-time test (G-FAST) score for initiating a prehospital bypass strategy in an urban c...
Article
Background A bypass strategy for large vessel occlusion (LVO) benefits patients receiving endovascular thrombectomy (EVT), but may delay some patients from receiving IV thrombolysis. However, patient centralization has been shown to improve outcomes. Objective To understand the current coverage of medical services for patients with stroke, and to...
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Aim: Cardiopulmonary resuscitation (CPR) quality affects survival after cardiac arrest. We aimed to investigate if a smartwatch with real-time feedback can improve CPR quality by healthcare professionals. Methods: An app providing real-time audiovisual feedback was developed for a smartwatch. Emergency Department (ED) professionals were recruite...
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Aim As a population ages, it can impact on the characteristics and outcomes of cardiogenic out‐of‐hospital cardiac arrest (OHCA) patients. This study aimed to evaluate the relationship between the age incidence of cardiogenic OHCA and population aging. Methods This was a post‐hoc analysis of the Pan Asian Resuscitation Outcomes Study (PAROS) datab...
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Studies are divided on the effect of day-night temporal differences on clinical outcomes in out-of-hospital cardiac arrest (OHCA). This study aimed to elucidate any differences in OHCA survival between day and night occurrence, and the factors associated with differences in survival.This was a prospective, observational study of OHCA cases across m...
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Introduction: Out-of-hospital cardiac arrest (OHCA) survival varies greatly between communities. The Utstein template was developed and promulgated to improve the comparability of OHCA outcome reports, but it has undergone limited empiric validation. We sought to assess how much of the variation in OHCA survival between emergency medical services...
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Background: Performing high-quality bystander cardiopulmonary resuscitation (CPR) improves the clinical outcomes of victims with sudden cardiac arrest. Thus far, no systematic review has been performed to identify interventions associated with improved bystander CPR quality. Methods: We searched Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL, Ovid Psyc...
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Background/purpose: This study was conducted to assess: 1) the impact of the HFS curriculum on residents' knowledge and skills, and 2) the correlation between learning outcomes and the clinical performance. Methods: An HFS-based curriculum was implemented for junior residents prior to their ICU rotations. Residents completed written tests before...
Article
Introduction: In-hospital early warning system scores for prediction of clinical deterioration have been well-developed. However, such prediction tools in prehospital setting remain unavailable. Hypothesis: To develop a model for predicting patients with emergency medical technicians witnessed out-of-hospital cardiac arrest (EMT-witnessed OHCA) . M...
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Background: A low bystander cardiopulmonary resuscitation (CPR) rate is one of the factors associated with low cardiac arrest survival. This study aimed to assess knowledge, attitudes, and willingness towards performing CPR and the barriers for implementation of bystander-initiated CPR. Methods: Telephone interviews were conducted using an autho...
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Introduction: High-quality cardiopulmonary resuscitation (CPR) is a key factor affecting cardiac arrest survival. Accurate monitoring and real-time feedback are emphasized to improve CPR quality. The purpose of this study was to develop and validate a novel depth estimation algorithm based on a smartwatch equipped with a built-in accelerometer for...
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Aim: Animal studies have demonstrated that hemodynamic-directed cardiopulmonary resuscitation (CPR) improves outcomes following cardiac arrest compared with the "one-size-fits-all" algorithm. We investigated whether body size of patients is correlated with outcomes of in-hospital cardiac arrest (IHCA). Methods: A retrospective study in a single...
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Aim: Our study aimed to compare cardiopulmonary resuscitation (CPR) performance among laypeople with different retraining intervals. Methods: Ninety-six non-medical university students were randomly allocated into 3 groups after receiving initial CPR and automated external defibrillator (AED) training. Sixty participants completed the study. The...
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Background: We previously developed a US-CAB protocol for evaluation of circulatory-airway-breathing status during cardiopulmonary resuscitation (CPR). This study aimed at validating its application in real CPR scenarios and the potential impact on CPR outcomes. Methods: The US-CAB protocol was implemented at the emergency department of National...
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Data presented in this article relates to the research article entitled “US-CAB protocol for ultrasonographic evaluation during cardiopulmonary resuscitation: validation and potential impact” (Lien et al., in press). The article provides data regarding proficiency of the 10 emergency residents attending the US-CAB curriculum. Assessments included i...