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Experience of Belgrade’s Emergency Medical Service in the implementation of cardiopulmonary resuscitation guidelines issued in 2010
SLAĐANA ANĐELIĆ
orcid.org/0000-0002-5233-8287
; Aleksinackih rudara 25/4, 11070 New Belgrade, Serbia
NENAD IVANČEVIĆ
; Aleksinackih rudara 25/4, 11070 New Belgrade, Serbia
NADA EMIŠ-VANDLIK
; Aleksinackih rudara 25/4, 11070 New Belgrade, Serbia
SNEŽANA BOGUNOVIĆ
; Aleksinackih rudara 25/4, 11070 New Belgrade, Serbia
NINOSLAV LEŠJANIN
; Aleksinackih rudara 25/4, 11070 New Belgrade, Serbia
Sažetak
Introduction. Implementation of cardiopulmonary resuscitation (CPR) is defined by the unified 2010 Guidelines for CPR. Objective. This paper presents the experience of Belgrade’s Emergency Medical Services (EMS) in the implementation of out-of-hospital (OH) CPR according to the new, 2010 Guidelines. Methods. A retrospective study design was used. We recorded OH CPR and analyzed four variables: patient gender and age, arrest location, bystander witnessed arrest, and arrest rhythm (shockable – group I, non-shockable – group II). The study also looked at implementation and follow-up of CPR, therapy, CPR duration, EMS reaction time, and patient outcome (Return of Spontaneous Circulation [ROSC] or death). Results. Of 794 OH CPR attempts, 136 (17%) patients with field ROSC were transported to hospital admission (HA) (22% group I, 78% group II). ROSC at HA was sustained in 64 (47%), and unsustained in 72 (53%) patients. Among the patients with ROSC on HA, 47% had spontaneous breathing and 5% fully regained consciousness. The ROSC rate was higher after arrest occurring at home (P<0.001). No statistical significance between the groups regarding the following analyzed variables was found: patient gender, age, onset time (day or night shift), bystander witnessed arrest, ROSC, breathing and consciousness at HA. In all patients, intravenous (IV) access was established. Atropine was administered in 28 (21%) group II patients. Adrenaline was administered in 71% of patients and withheld in 29% of patients due to hospital closeness or sustained ROSC. By HA, 46% were successfully intubated. The average response time in group I was 8.1±4.0 minutes, in group II 6.8 ± 4.4 minutes. A highly significant association (p<0.01) was found between CPR duration and ROSC at HA (26.23 min – ROSC vs. 14.46 min – no ROSC). Conclusion. Study results indicate the significance of the new Guidelines for CPR in the everyday practice of Belgrade’s EMS teams. Continual training increases the quality of administered CPR measures and the rate of patients with ROSC at HA. New studies would contribute to the disclosure of weak links in the survival chain after OH CPR in Belgrade.
Ključne riječi
out-of-hospital resuscitation; experience; Belgrade Emergency Medical Service; new guidelines for CPR
Hrčak ID:
108795
URI
Datum izdavanja:
1.4.2013.
Posjeta: 1.429 *