院外心脏骤停时旁观者的可用性、心肺复苏术的吸收和AED的使用

IF 2.1 Q3 CRITICAL CARE MEDICINE
David B. Sidebottom , Robyn Painting , Charles D. Deakin
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引用次数: 0

摘要

背景:旁观者心肺复苏(CPR)和震荡心律除颤可提高院外心脏骤停(OHCA)后的生存率。在真正的心脏骤停呼叫中,关于旁观者参与的数据很少。方法:这是对英国OHCA呼叫单一救护车服务期间旁观者参与的前瞻性审计。从2022年3月到2023年4月,OHCA连续呼叫的方便样本由呼叫处理人员审计,其中确认有一名成人心脏骤停并建议进行心肺复苏术。排除了不尝试心肺复苏术的有效病例。在R (v4.2)中提取和分析关键时间间隔和旁观者参与的数据。结果共分析病例451例。到发现心脏骤停的中位时间为42秒(IQR 94.7秒),到开始心肺复苏的中位时间为161秒(IQR 124秒)。单独旁观者162例(35.9%),两名旁观者149例(33.0%),三人及以上旁观者140例(31.0%)。382例(84.7%)患者由旁观者尝试心肺复苏术。身体无力、拒绝和无法正确定位患者是不进行心肺复苏术的常见原因。36例(8%)患者在紧急医疗服务到达之前取出了除颤器,9例(2%)患者接受了电击,另有20例(4%)患者未建议进行电击。结论心脏骤停诊断迅速,但心肺复苏术启动延迟。在超过三分之一的病例中有一个单独的旁观者在场,消除了在没有第一响应者的情况下旁观者除颤的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bystander availability, CPR uptake, and AED use during out-of-hospital cardiac arrest

Background

Bystander cardiopulmonary resuscitation (CPR) and defibrillation of a shockable rhythm improve survival following out-of-hospital cardiac arrest (OHCA). Little data exists on bystander participation during genuine cardiac arrest calls.

Method

This was a prospective audit of bystander participation during OHCA calls to a single ambulance service in the United Kingdom. A convenience sample of consecutive OHCA calls from March 2022 until April 2023, where an adult cardiac arrest was confirmed and CPR was advised, was audited by a call handler. Cases with a valid do not attempt CPR decision were excluded. Data on key time intervals and bystander participation were extracted and analysed in R (v4.2).

Results

In total, 451 cases were analysed. Median time until cardiac arrest recognition was 42 s (IQR 94.7 s) and until the initiation of CPR was 161 s (IQR 124 s). A lone bystander was present in 162 (35.9%) cases, two bystanders in 149 (33.0%) cases, and three or more bystanders in 140 (31.0%) cases. CPR was attempted by a bystander in 382 (84.7%) cases. Physical inability, refusal, and inability to correctly position patient were common reasons for not performing CPR. A defibrillator was retrieved before the arrival of emergency medical services in 36 (8%) cases and a shock was administered in 9 (2%) cases, while a shock was not advised in 20 (4%) further cases.

Conclusion

Cardiac arrest was identified rapidly but there was a delay to initiation of CPR. A lone bystander was present in over one third of cases, eliminating the possibility of bystander defibrillation in the absence of a lay first responder.
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来源期刊
Resuscitation plus
Resuscitation plus Critical Care and Intensive Care Medicine, Emergency Medicine
CiteScore
3.00
自引率
0.00%
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0
审稿时长
52 days
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