Wen-Chu Chiang's research while affiliated with Taipei Medical University and other places

Publications (164)

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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...
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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 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)...
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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...
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Importance: Prehospital advanced airway management with either initial endotracheal intubation (ETI) or initial supraglottic airway (SGA) insertion in patients with out-of-hospital cardiac arrest (OHCA) remains controversial. Objective: To compare the effectiveness of ETI and SGA in patients with nontraumatic OHCA. Design, setting, and particip...
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The response efficiency of Emergency Medical Service (EMS) is related to the survival rate of patients in Mass Casualty Incidents (MCIs). This study aims to reduce delays caused by congestions in the transportation network and also that in hospitals. A patient transportation and assignment model is proposed considering routing of ambulances and ope...
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The assessment of cardiopulmonary resuscitation and teamwork quality in prehospital settings has always been challenging. Currently, commercialized quality-monitored chest pads and single-angle cameras are being used to monitor prehospital the resuscitation quality in patients following out-of-hospital cardiac arrest (OHCA). However, both these met...
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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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PurposeThis study examined the association between lapsed time and trauma patients, suggesting that a shorter time to definitive care leads to a better outcome.Methods We used the Pan-Asian Trauma Outcome Study registry to analyze a retrospective cohort of 963 trauma patients who received surgical intervention or transarterial embolization within 2...
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Introduction: Emergency response to a road traffic injury (RTI) plays a crucial role in patient survival, and the quality of the emergency response should be consistent regardless of the time of day. The aim of this study was to investigate prehospital care and survival outcomes compared between emergency response to RTI during the day and emergenc...
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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...
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Prehospital spinal immobilization is a widely used procedure in the emergency medical service (EMS) system worldwide, while the incidence of patients with spinal injury (SI) is relatively low, and unnecessary prehospital spinal immobilization is associated with patient complications. This study aimed to determine the association between prehospital...
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...
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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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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...
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Background It is suggested that a prehospital scale should be utilized to identify patients with emergent large vessel occlusion (ELVO). We aimed to perform external validation of nine ELVO scales. Methods This single center retrospective observational study included patients with ischemic stroke visiting the emergency department (ED) within 6 h o...
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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...
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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: To investigate the association of clinical and hematological parameters with return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA). Methods: Clinical data of successive non-traumatic adult OHCA patients with available laboratory data of complete blood count and peripheral blood smear at emergency departmen...
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Background: The in-hospital mortality of patients admitted from the emergency department (ED) is high, but no appropriate initial alarm score is available. Methods: This prospective observational study enrolled ED-admitted patients in hospitalist-care wards and analyzed the predictors for seven-day in-hospital mortality from May 2010 to October 201...
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Objective: This study aimed to compare the demographic characteristics and trauma service structures and processes of hospitals in 15 countries across the Asia Pacific, and to provide baseline data for the integrated trauma database: the Pan-Asian Trauma Outcomes Study (PATOS). Methods: Medical directors and emergency physicians at PATOS-partici...
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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...
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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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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: Public access defibrillation (PAD) increases survival in out-of-hospital cardiac arrest (OHCA) patients. However, native reports on PAD survival in Taiwan has not yet been described. Public automated external defibrillators (AED) installation at places with high incidence of cardiac arrests were required by law since 2013. A compulsory...
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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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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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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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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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Aim: This study aimed to conduct a systematic review and meta-analysis comparing the effect of video-assistance and audio-assistance on quality of dispatcher-instructed cardiopulmonary resuscitation (DI-CPR) for bystanders. Methods: Five databases were searched, including PubMed, Cochrane library, Embase, Scopus and NIH clinical trial, to find r...
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Background/purpose: Details of the communication between the caller and dispatcher have not been reported previously in Taiwan. This study aimed to: (1) understand the details of the communication between the caller and dispatcher among the calls for stroke patients, (2) identify factors associated with stroke recognition by dispatchers, and (3) e...
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Aim: The effect of the number and level of on-scene emergency medical technicians (EMTs) on the outcomes of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. We aimed to test the association between the number and level of EMTs and the outcomes of patients with OHCA. Methods: We analysed Utstein-based registry data on OHCA in...
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Study objective: The effect of out-of-hospital intubation in patients with out-of-hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out-of-hospital intubation among Asian areas. This study evaluates the association between successful intubation and out-of-hospital cardiac arrest surviv...
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Background: Trauma is a major health burden and a time-dependent critical emergency condition among developing and developed countries. In Asia, trauma has become a rapidly expanding epidemic and has spread out to many underdeveloped and developing countries through rapid urbanization and industrialization. Most casualties of severe trauma, which...
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Introduction: Stroke patients recognized by dispatchers have an increased chance of receiving prehospital care with advanced life support and arrive at hospital earlier. There is limited research on factors associated with dispatcher recognition of stroke. This study aimed to: (1) understand the details of the dispatcher-caller communication among...
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Objective: Knowledge on the current trauma systems in Asian countries is limited. The objective of this study was to describe the emergency medical services (EMS) and trauma care systems among countries participating in the Pan-Asian Trauma Outcomes Study (PATOS) Clinical Research Network. Methods: The PATOS network consists of 33 participating...
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Background The sooner thrombolytic therapy is given to acute ischemic stroke patients, the better the outcome. Prehospital notification may shorten the time between hospital arrival and brain computed tomography (door-to-CT) and the door-to-needle (DTN) time. This study investigated the effect of prehospital notification on acute stroke care in an...
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Objective: The prehospital termination of resuscitation (TOR) guidelines for traumatic cardiopulmonary arrest (TCPA) was proposed in 2003. Its multiple descriptors of cases where efforts can be terminated make it complex to apply in the field. Here we proposed a simplified rule and evaluated its predictive performance. Methods: We analysed Utste...
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Aim: The efficacy of learning BLS through self-instruction is not clearly understood. The aim of our review was to compare the effect of self-instruction with that of traditional instruction on learners taking basic life support (BLS) courses. Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycI...
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Background: Prehospital resuscitation for patients with major trauma emphasizes a load-and-go principle. For traumatic cardiac arrest (TCA) patients, the administration of vasopressors remains under debate. This study evaluated the effectiveness of epinephrine in the prehospital setting for patients with TCA. Methods: We conducted a retrospectiv...
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Background/purpose: Protocols for managing patients with out-of-hospital cardiac arrest (OHCA) may vary due to legal, cultural, or socioeconomic concerns. We sought to assess international variation in policies and protocols related to OHCA. Methods: A brief survey was developed by consensus. Elicited information included protocols for managing...