院外心脏骤停急诊次数与胸外按压质量的关系

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-06-06 DOI:10.1016/j.jemermed.2025.05.021

Sang A. Yoon EMT , Ki Hong Kim MD, PhD , Jeong Ho Park MD, PhD , Tae Han Kim MD , Stephen Gyung Won Lee MD , Ki Jeong Hong MD, PhD , Young Sun Ro MD, DrPH , Kyoung Jun Song MD, PhD , Sang Do Shin MD, PhD

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引用次数: 0

摘要

院外心脏骤停（OHCA）是世界范围内一个重要的公共卫生问题，而心肺复苏（CPR）的质量对患者的预后至关重要。目的本研究旨在评估急诊医疗服务（EMS）人员数量与OHCA患者CPR质量的关系。方法：本回顾性研究利用了大都会EMS心脏骤停登记处的数据。纳入了2020年12月至2022年10月在急诊科（EDs）就诊的成年心脏骤停患者。主要结果是心脏按压达到适当速率（100-120次/分钟）和深度（5-6厘米）的比例超过CPR持续时间的40%，血流时间超过80%。第一批到达的救护车上的急救人员分为两组或三人组。采用多因素logistic回归计算校正优势比（AORs）和95%置信区间（CIs）。结果共纳入2777例患者。与两名EMS人员组相比，三人EMS人员组有更高的概率实现适当的胸部按压率：AOR 1.43, 95% CI 1.15-1.77。与达到足够的胸压深度或胸压流时间没有显著关联：AOR分别为1.00,95% CI 0.80-1.24和1.12,95% CI 0.92-1.35。结论与两人EMS组相比，三人EMS组在第一个到达的救护车上更有可能提供足够的胸部按压率。在适当的胸按压深度或血流时间方面没有显著差异。

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Association Between the Number of Emergency Medical Services and the Chest Compression Quality in Out-of-Hospital Cardiac Arrest

Background

Out-of-hospital cardiac arrest (OHCA) is a critical public health issue worldwide, and the quality of cardiopulmonary resuscitation (CPR) is essential for patient outcomes.

Objectives

The aim of this study was to evaluate the association between the number of emergency medical services (EMS) personnel and the quality of CPR in OHCA patients.

Methods

This retrospective study utilized data from a metropolitan EMS cardiac arrest registry. Adult cardiac arrest patients who visited emergency departments (EDs) from December 2020 to October 2022 were included. The primary outcome was the proportion of cardiac compressions that achieved an adequate rate (100–120 beats/min) and depth (5–6 cm) for more than 40% of the CPR duration, and flow time for more than 80%. The number of EMS personnel in the first-arrived ambulance was categorized into two- or three-member groups. Multivariate logistic regression was used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs).

Results

In total, 2777 patients were included. Compared with two-member EMS groups, three-member EMS personnel groups had a higher probability of achieving an adequate chest compression rate: AOR 1.43, 95% CI 1.15–1.77. There was no significant association with achieving an adequate chest compression depth, or chest compression flow time: AOR 1.00, 95% CI 0.80–1.24 and AOR 1.12, 95% CI 0.92–1.35, respectively.

Conclusion

Compared with a two-member EMS group, a three-member EMS group in the first-arrived ambulance was more likely to provide adequate chest compression rates. There were no significant differences in adequate chest compression depth or flow time.

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine