Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2016.57.591
Analysis of out-of-hospital cardiac arrest in Croatia – survival, bystander cardiopulmonary resuscitation, and impact of physician’s experience on cardiac arrest management: a single center observational study
Anita Lukić
orcid.org/0000-0003-4466-8988
; Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Varaždin General Hospital, Varaždin, Croatia
Ileana Lulić
; Department of Anesthesiology Reanimatology and Intensive CareMedicine, Clinical Hospital Centre Zagreb, Zagreb, Croatia
Dinka Lulić
; Department of Emergency Medicine, Clinical Hospital Centre Zagreb, Zagreb, Croatia
Zoran Ognjanović
; Institute of Emergency Medicine Varaždin, Varaždin, Croatia
Davorin Cerovečki
; Institute of Emergency Medicine Varaždin, Varaždin, Croatia
Siniša Telebar
; Institute of Emergency Medicine Varaždin, Varaždin, Croatia
Ivica Mašić
; Institute of Emergency Medicine Varaždin, Varaždin, Croatia
Sažetak
Aim To analyze the initial rhythm, bystander cardiopulmonary
resuscitation (CPR) rate, and survival after out-of-hospital
cardiac arrests (OHCA) in Varaždin County (Croatia), and to
investigate whether physician’s inexperience in emergency
medical services (EMS) has an impact on resuscitation management.
Methods We reviewed clinical records and Revised Utstein
cardiac arrest forms of all out-of-hospital resuscitations performed
by EMS Varaždin (EMSVz), Croatia, from 2007-2013.
To analyze the impact of physician’s inexperience in EMS (<1
year in EMS) on resuscitation management, we assessed physician’s
turnover in EMSVz, as well as OHCA survival, airway
management, and adherence to resuscitation guidelines in
regard to physician’s EMS experience.
Results Of 276 patients (median age 68 years, interquartile
range [IQR] 16; 198 male; 37% ventricular fibrillation/ventricular
tachycardia, bystander CPR rate 25%), 80 were transferred
to hospital and 39 were discharged (median survival after discharge
23 months, IQR 46 months). During the 7-year study
period, 29 newly graduated physicians inexperienced in EMS
started to work in EMSVz (performing 77 resuscitations), while
48% of them stayed for less than one year. Airway management
depended on physician’s EMS experience (P = 0.018):
inexperienced physicians performed bag-valve-mask ventilation
(BMV) more than the experienced, with no impact on
survival rate. Physician’s EMS experience did not influence adherence
to resuscitation guidelines (P = 0.668), survival to hospital
discharge (P = 0.791), or survival time (P = 0.405).
Conclusion OHCA survival rate of EMSVz resuscitations was
higher than in Europe, but bystander CPR needs to be improved.
Compared to experienced physicians, inexperienced
physicians preferred BMV over intubation, but with similar adherence
to resuscitation guidelines and survival after OHCA.
Ključne riječi
Hrčak ID:
181399
URI
Datum izdavanja:
15.12.2016.
Posjeta: 1.005 *