Abstract
Background and Rationale: Having a list of essential emergency medicines and management
guidelines requires clear evidence approach. Based on the hospital’s potential, this study intended to
update a list of essential medicines for managing out-of-hospital cardiac arrest (OHCA) patients for appropriate cadres of emergency responders in the emergency care system (ECS) Chiang Mai case study.
Methodology: The study was divided into two parts. The meta-analysis started from literature
search then data extraction by two independent researchers. The PICO (patient, intervention, comparison,
outcome) keyword search for full-text studies published in English between 1990 and 2021 in electronic
databases such as PubMed, Medline, Embase, Cochrane, including references was undertaken. The search
yielded 2,096 papers, 866 duplicate articles were eliminated, as well as 1,199 papers with unrelated
titles and abstracts. Thirty-one papers were good for meta-analysis and reached recommendations on
an essential emergency medicine list for OHCA patients. The second step was a consensus conclusion
based on evidence gathered from in-depth interviews with 12 academic professionals and 12 emergency
medical practitioners.
Results and Conclusion: The list of drugs for OHCA patients was developed through a thorough
analysis and the inputs from experts. Dopamine, norepinephrine, and epinephrine injections are three
items required at the advanced life support (ALS) level. OHCA patients who received epinephrine within
ten minutes of calling the ECS had a high survival rate and clinical prognosis. The emergency and pharmacy
departments should have the emergency medicine kits handy. After the ECS dispatch, pharmacists should
monitor the use of and refill the emergency drugs ensuring preparedness of the kit for next emergency
incident.
