BACKGROUND:Out-of-hospital cardiac arrest (OHCA) is a common reason for calls for intervention by emergency medical teams (EMTs) in Poland. Regardless of the mechanism, OHCA is a state in which the chance of survival is dependent on rapid action from bystanders and responding health professionals in emergency medical services (EMS). We aimed to identify factors associated with return of spontaneous circulation (ROSC). METHODS:The medical records of 2137 EMS responses to OHCA in the city of Wroclaw, Poland between July 2017 and June 2018 were analyzed. RESULTS:The OHCA incidence rate for the year studied was 102 cases per 100,000 inhabitants. EMS were called to 2317 OHCA events of which 1167 (50.4%) did not have resuscitation attempted on EMS arrival. The difference between the number of successful and failed cardiopulmonary resuscitations (CPRs) was statistically significant (p < 0.001). Of 1150 patients in whom resuscitation was attempted, ROSC was achieved in 250 (27.8%). Rate of ROSC was significantly higher when CPR was initiated by bystanders (p < 0.001). Patients presenting with asystole or pulseless electrical activity (PEA) had a higher risk of CPR failure (86%) than those with ventricular fibrillation/ventricular tachycardia (VF/VT). Patients with VF/VT had a higher chance of ROSC (OR 2.68, 1.86-3.85) than those with asystole (p < 0.001). The chance of ROSC was 1.78 times higher when the event occurred in a public place (p < 0.001). CONCLUSIONS:The factors associated with ROSC were occurrence in a public place, CPR initiation by witnesses, and presence of a shockable rhythm. Gender, age, and the type of EMT did not influence ROSC. Low bystander CPR rates reinforce the need for further efforts to train the public in CPR.

译文

背景:院外心脏骤停(OHCA)是波兰紧急医疗小组(EMT)呼吁进行干预的常见原因。无论采用哪种机制,OHCA的生存机会都取决于旁观者和应急医疗服务(EMS)中响应卫生专业人员的迅速行动。我们旨在确定与自然循环恢复(ROSC)相关的因素。
方法:分析了2017年7月至2018年6月在波兰弗罗茨瓦夫市发生的2137例OHCA对EMS的EMS病历。
结果:本研究年度的OHCA发病率为每100,000居民102例。 EMS被召集到2317 OHCA事件中,其中1167(50.4%)没有在EMS到达时进行复苏尝试。心肺复苏成功次数与失败次数之间的差异具有统计学意义(p <0.001)。在尝试进行复苏的1150例患者中,有250例达到了ROSC(27.8%)。由旁观者发起心肺复苏术时,ROSC率显着更高(p <0.001)。表现为无搏动或无脉搏电活动(PEA)的患者发生CPR失败的风险(86%)高于发生室颤/室性心动过速(VF / VT)的患者。 VF / VT患者的ROSC发生机率(OR 2.68,1.86-3.85)高于无搏动的患者(p <0.001)。当事件发生在公共场所时,ROSC的机会要高1.78倍(p <0.001)。
结论:与ROSC相关的因素包括在公共场所发生,证人进行心肺复苏术以及出现令人震惊的心律。性别,年龄和EMT类型不会影响ROSC。旁观者的心肺复苏术率低,这表明需要进一步努力对公众进行心肺复苏术培训。

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