院前心脏骤停复苏做法在全球各地有所不同

IF 2.4 Q3 CRITICAL CARE MEDICINE
Jeannett Kjær , Louise Milling , Anne Craveiro Brøchner , Freddy Lippert , Stig Nikolaj Blomberg , Helle Collatz Christensen , Robyn Holgate , Laurie J. Morrison , Abdullah Bakhsh , Søren Mikkelsen
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引用次数: 0

摘要

院外心脏骤停(OHCA)是一个重大的公共卫生问题。本研究旨在描述非创伤性OHCA成人患者(≥18岁)在开始、终止和避免复苏方面的国际差异。方法采用横断面在线调查进行探索性描述性研究。受访者采用滚雪球抽样技术进行招募。框架分析用于确定答复中的关键主题,并使用描述性统计汇总数据趋势。该研究收集了来自59个国家的反馈。我们的研究结果显示,来自59.3%的国家的受访者报告说,他们在所有患者没有表现出明显的不可逆转死亡迹象或没有确认的预先指示的情况下启动复苏。来自15.3%国家的答复者报告说,院前复苏尝试一旦开始,就不会终止。来自20.3%的国家的院前答复者报告说,他们完全依靠特定标准来决定何时终止复苏努力,而在45.8%中,这些决定由提供者自行决定。大多数国家(91.5%)的答复者报告说,在出现明显的不可逆转死亡迹象时,他们不愿进行复苏。来自57.6%国家的受访者报告说,如果患者确认不尝试心肺复苏(dacpr),他们就不会进行复苏,而15.3%的受访者提到工作人员的安全是放弃尝试复苏的原因。结论本研究揭示了EMS复苏实践的全球差异,反映了资源、医疗基础设施、EMS系统设计、社区接受程度、文化和社会规范以及立法等方面的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prehospital cardiac arrest resuscitation practices differ around the globe

Background

Out-of-hospital cardiac arrest (OHCA) is a major public health problem. This study aims to describe the international variations in the practices related to the initiation, termination, and refraining from resuscitation of adult patients (≥18 years) with a non-traumatic OHCA.

Methods

An exploratory descriptive study was conducted using a cross-sectional online survey. The respondents were recruited using snowball sampling technique. Framework analysis was used to identify key themes in responses, with descriptive statistics summarising data trends.

Results

The study collected responses from 59 countries. Our findings reveal that respondents from 59.3% of countries reported that they initiate resuscitation in all cases where the patients do not show obvious signs of irreversible death or do not have confirmed advance directives. Respondents from 15.3% of countries reported that once started, prehospital resuscitation attempts are not terminated. Prehospitally respondents from 20.3% of the countries reported that they rely exclusively on specific criteria to decide when to terminate resuscitation efforts while in 45.8%, these decisions are made at the discretion of the provider. Respondents from most countries (91.5%) reported that they refrain from resuscitation in the presence of obvious signs of irreversible death. Respondents from 57.6% of countries, reported that they refrained from resuscitation if the patient had a confirmed do-not-attempt-cardiopulmonaryresuscitation (DNACPR), while 15.3% mentioned staff safety as a reason to abstain from attempting resuscitation.

Conclusion

This study reveals global variation in EMS resuscitation practices, reflecting disparities in resources, healthcare infrastructure, EMS system design, community acceptability given cultural and societal norms, and legislation.
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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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