Purpose of the study: The French emergency system follow the “stay and play” model. This system is two-tiered with a prompt intervention provided by firefighters and the advanced life support (ALS) by mobile medical team (MMT). MMT follow international guidelines for out-of-hospital cardiac arrest care. This study aim was to describe ALS in France between 2012 and 2018.
Materials and methods: The French national OHCA registry recorded 62,474 medical OHCA adult victims between 01/01/12 and 09/01/18.
Results: In France, 72.5% of victims were resuscitated by MMT. Between 2012 and 2018, the Boussignac tube use decreased (2.6% of use in 2012 vs. 0.2% in 2018) contrary to "Cardio-Pulmonary Ventilation" (0.6% of use in 2017 and 1.6% in 2018). Facemask, tracheal tube coupled with self-inflating bag or assisted controlled volume use were constant (7.1%, 66.7% and 32%, respectively). Regarding injection routes, the peripheral venous access was used consistently, while intraosseous access use increased (2.9% of use in 2012 vs. 8.3% in 2018). The central venous access and the endotracheal were less and less used (respectively 1.3% in 2012 vs. 0.5% in 2018 and 2.3% vs. 0.6%). Regarding drug strategies, for patients with a shockable rhythm, epinephrine and amiodarone were consistently used over the years (respectively 86.9% and 68.7%). Adrenaline and amiodarone median doses were 6 mg and 300 mg per treatment. The use of other drugs: fibrinolytics, aspirin, bicarbonates and atropine, decreased between 2012 and 2018. Regarding nonshockable rhythms, the use of adrenaline and fibrinolytics was constant (respectively 92.6% and 2.4%). The median dose of epinephrine by patient was 5 mg. Amiodarone, aspirin, bicarbonates and atropine use decreased between 2012 and 2018.
Conclusions: We still report endotracheal and central venous uses as well as atropine injections. The intraosseous route is more and more used. In France, ALS guidelines are generally respected.

2 - Advanced life support: evolution of resuscitation practices in France between 2012 and 2018