新冠肺炎在韩国爆发后,创伤性心脏骤停的院前治疗并未减少

Journal of Trauma and Injury Pub Date : 2023-09-01 Epub Date: 2023-08-02 DOI:10.20408/jti.2023.0009
Ju Heon Lee, Hyung Il Kim
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引用次数: 0

摘要

目的:尽管进行了抢救,但院外创伤性心脏骤停(TCA)的预后往往很差。尽管院外心脏骤停的发病率和死亡率有所上升,但在新冠肺炎大流行期间,一些国家的副标准心肺复苏术(CPR)有所下降。在院前环境中,需要在不知道患者新冠肺炎状态的情况下立即治疗心脏骤停。由于新冠肺炎通常通过呼吸道传播,气道管理可能会使医务人员面临感染风险。本研究探讨了在韩国新冠肺炎大流行期间,TCA患者的心肺复苏现场治疗是否发生了变化。方法:本回顾性研究使用了2019年1月至2021年12月江原道紧急医疗服务(EMS)运行表中的数据。最初问题是心脏骤停并接受心肺复苏术的患者也包括在内。2019年的数据被归类为新冠肺炎前数据,所有后续数据(2020年和2021年)被归类为新冠肺炎后数据。研究了年龄、性别、心脏骤停的可能原因和治疗方法,包括气道操作、口咽气道(OPA)或i-gel插入、气管插管(ETI)、袋阀面罩(BVM)通气、静脉(IV)线建立、颈环应用和止血伤口敷料。结果:在研究期间,2007名患者接受了心肺复苏术,其中596名患者患有TCA,367名患者死于疾病引起的心脏骤停(DCA)。在TCA患者中,192例(32.2%)为新冠肺炎前,404例(67.8%)为新冠肺炎后。TCA组的院前治疗没有减少。气道操作的平均频率为59.7%,OPA为47.5%,BVM为57.4%,颈领应用为51.3%。ETI、i-gel插入和IV系建立的比率增加。TCA的治疗率明显高于DCA。结论:在新冠肺炎大流行期间,EMS工作人员对TCA患者的院前治疗没有减少。相反,ETI、i-gel插入和IV系建立的比率增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
No frequency change of prehospital treatments by emergency medical services providers for traumatic cardiac arrest patients before and after the COVID-19 pandemic in Korea: an observational study.

Purpose: Out-of-hospital traumatic cardiac arrest (TCA) often has a poor prognosis despite rescue efforts. Although the incidence and mortality of out-of-hospital cardiac arrest have increased, bystander cardiopulmonary resuscitation (CPR) has decreased in some countries during the COVID-19 pandemic. In the prehospital setting, immediate treatment of cardiac arrest is required without knowing the patient's COVID-19 status. Because COVID-19 is usually transmitted through the respiratory tract, airway management can put medical personnel at risk for infection. This study explored whether on-scene treatments involving CPR for TCA patients changed during the COVID-19 pandemic in Korea.

Methods: This retrospective study used data from emergency medical services (EMS) run sheets in Gangwon Province from January 2019 to December 2021. Patients whose initial problem was cardiac arrest and who received CPR were included. Data in 2019 were classified as pre-COVID-19 and all subsequent data (from 2020 and 2021) as post-COVID-19. Age, sex, possible cause of cardiac arrest, and treatments including airway maneuvers, oropharyngeal airway (OPA) or i-gel insertion, endotracheal intubation (ETI), bag-valve mask (BVM) ventilation, intravenous (IV) line establishment, neck collar application, and wound dressing with hemostasis were investigated.

Results: During the study period, 2,007 patients received CPR, of whom 596 patients had TCA and 367 had disease-origin cardiac arrest (DCA). Among the patients with TCA, 192 (32.2%) were pre-COVID-19 and 404 (67.8%) were post-COVID-19. In the TCA group, prehospital treatments did not decrease. The average frequencies were 59.7% for airway maneuvers, 47.5% for OPA, 57.4% for BVM, and 51.3% for neck collar application. The rates of ETI, i-gel insertion, and IV-line establishment increased. The treatment rate for TCA was significantly higher than that for DCA.

Conclusions: Prehospital treatments by EMS workers for patients with TCA did not decrease during the COVID-19 pandemic. Instead, the rates of ETI, i-gel insertion, and IV-line establishment increased.

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