Effectiveness of Emergency Medical Motorcycles in Out-of-Hospital Cardiac Arrest Management within the Bangkok EMS System
Tanya Pitiyakulchorn, MD¹, Wanida Pawaree, BNS, MPH²
Affiliation : ¹ Emergency Medical Services Division, Bangkok Emergency Medical Center (Erawan Center), Department of Medical Service, Bangkok Metropolitan Administration (BMA), Bangkok, Thailand; ² Standards and Systems Division, Bangkok Emergency Medical Center (Erawan Center), Department of Medical Service, Bangkok Metropolitan Administration (BMA), Bangkok, Thailand
Objective: To compare the effectiveness of an emergency medical motorcycle (motorlance)-first versus ambulance-first response for out-of-hospital cardiac arrest (OHCA) in Bangkok, focusing on return of spontaneous circulation (ROSC), 48-hour survival, and response-related factors associated with outcomes.
Materials and Methods: The present cohort study used data from the prospective Bangkok Emergency Medical Services (EMS) registry. It included 3,713 adult OHCA cases managed between May 2024 and July 2025 within a 10-kilometer operational radius. Patients were categorized by initial response type as motorlance-first or ambulance-first. There were 335 motorlance-first and 3,378 ambulance-first patients. Descriptive statistics, chi-square tests, multivariable logistic regression, Kaplan-Meier survival analysis, log-rank tests, and Cox proportional hazards models were applied.
Results: Motorlance-first response was associated with a significantly higher rate of ROSC compared with ambulance-first response at 54.0% versus 37.5% (p<0.0001) and a shorter mean response time at 8.8 versus 11.8 minutes (p<0.0001). After adjustment for initial ECG rhythm and other covariates, motorlance deployment remained independently associated with reduced mortality at the scene (adjusted OR 0.48, p<0.001) and increased ROSC. AED shock delivery occurred more frequently in the motorlance group at 22.39% versus 16.04% (p=0.003). No significant difference was observed in 48-hour survival between groups (p=0.306). Time-to-event analyses demonstrated significantly shorter time to ROSC in the motorlance group (log-rank p=0.0013). Multivariable Cox regression showed that each additional minute of response time was associated with a 5.4% decrease in the likelihood of finding survivors (HR 0.946, p<0.001).
Conclusion: Motorlance-first response in the Bangkok EMS system significantly improves early resuscitation outcomes in OHCA by reducing response time and increasing ROSC, although no difference in 48-hour survival was observed. Given the present study’s limitations, these findings should be confirmed by future randomized controlled trials.
Received 22 September 2025 | Revised 14 January 2026 | Accepted 16 January 2026
DOI: 10.35755/jmedassocthai.2026.3.03537
Keywords : Out-of-hospital cardiac arrest; OHCA; Motorlance; ROSC; Survival
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