背景:院外心脏骤停(OHCA)代表了严重的医疗紧急情况,及时的干预措施可以对患者的预后产生重大影响。尽管它们很重要,现场证人在此类事件中的作用仍未被探索。
目的:本研究旨在揭示证人的影响,尤其是家庭成员,在OHCA期间及其干预措施的效果,或不存在,关于结果。借鉴现有文献,我们的工作假设表明,证人的存在,尤其是对心肺复苏术有知识的人,可以增加获得自主循环(ROSC)恢复的可能性,有可能提高整体生存率。
方法:使用回顾性分析方法,我们彻底审查了2014-2017年卢布林省的医疗记录.在使用ICD-10诊断代码和ICD-9医疗程序代码识别的5111个事件中,选择与心脏骤停具体相关的4361例。同时,根据预定义的标准排除750个事件。
结果:基础和高级EMS团队均显示出更高的CPR启动率和获得ROSC的可能性增加。值得注意的是,训练有素的EMS专业人员作为见证人的存在显著增加了CPR启动的机会.最常见的出现节律是室性心动过速(VT)和室颤(VF)。不同的紧急代码与不同的ROSC结果直接相关。当证人,尤其是家庭成员,开始胸部按压,胺碘酮的使用率明显较高。一个重要的发现是,46.85%的OHCA患者在没有证人的情况下死亡,而23.87%的病例有家庭成员。证人采取的行动,尤其是胸部按压,通常延长了患者护理的总体持续时间。
结论:证人的关键影响,特别是家庭成员,OHCA的结果是显而易见的。因此,提高公众对心肺复苏术技术和快速干预策略的认识,以改善紧急情况下的结局.
BACKGROUND: Out-of-hospital cardiac arrests (OHCAs) represent critical medical emergencies in which timely interventions can make a significant difference in patient outcomes. Despite their importance, the role of on-scene witnesses during such events remains relatively unexplored.
OBJECTIVE: This research seeks to shed light on the influence of witnesses, especially family members, during OHCAs and the effect of their interventions, or the absence thereof, on outcomes. Drawing from existing literature, our working hypothesis suggests that the presence of a witness, particularly one who is knowledgeable about CPR, can increase the likelihood of obtaining the return of spontaneous circulation (ROSC), potentially enhancing overall survival rates.
METHODS: Using a retrospective analytical method, we thoroughly reviewed medical records from the Lublin Voivodeship between 2014-2017. Out of 5111 events identified using ICD-10 diagnosis codes and ICD-9 medical procedure codes, 4361 cases specifically related to sudden cardiac arrest were chosen. Concurrently, 750 events were excluded based on predefined criteria.
RESULTS: Both basic and advanced EMS teams showed higher rates of CPR initiation and an increased likelihood of obtaining ROSC. Notably, the presence of a trained EMS professional as a witness significantly increased the chances of CPR initiation. The presenting rhythms most often detected were ventricular tachycardia (VT) and ventricular fibrillation (VF). Different urgency codes were directly linked to varying ROSC outcomes. When witnesses, especially family members, began chest compressions, the use of amiodarone was notably higher. A significant finding was that 46.85% of OHCA patients died without witnesses, while family members were present in 23.87% of cases. Actions taken by witnesses, especially chest compressions, generally extended the overall duration of patient care.
CONCLUSIONS: The crucial influence of witnesses, particularly family members, on OHCA outcomes is evident. Therefore, it is essential to increase public awareness of CPR techniques and rapid intervention strategies to improve outcomes in emergency situations.