Out-of-hospital cardiac arrest (OHCA) attended by mobile emergency teams with a physician on board. Results of the Spanish OHCA Registry (OSHCAR).

Autor: Rosell-Ortiz F; Empresa Pública de Emergencias Sanitarias, Almería, Andalucía, Spain. Electronic address: frosell@al.epes.es., Escalada-Roig X; Sistema Emergencies Mediques, Catalunya, Spain., Fernández Del Valle P; Hospital Virgen del Rocío, Sevilla, Andalucía, Spain., Sánchez-Santos L; Fundación Pública Urxencias Sanitarias 061, Galicia, Spain., Navalpotro-Pascual JM; SUMMA112, Madrid, Spain., Echarri-Sucunza A; Servicio de urgencias extrahospitalarias de Navarra, Navarra, Spain., Adsuar-Quesada JM; SAMU, Emergencias Sanitarias, Comunidad Valenciana, Spain., Ceniceros-Rozalén I; SAMU 061 Baleares, Islas Baleares, Spain., Ruiz-Azpiazu JI; Servicio de Urgencias y Emergencias 061, La Rioja, Spain., Ibarguren-Olalde K; Emergentziak-Emergencias, Osakidetza, Euzkadi, Spain., López-Cabeza N; Emergencias Sanitarias, Castilla y León, Spain., Mier-Ruiz MV; Servicio de Emergencias 061 Cantabria, Cantabria, Spain., Martín-Sánchez E; Servicio de Urgencias Canario, Islas Canarias, Spain., Martínez Del Valle M; SAMU-Asturias, Asturias, Spain., Inza-Muñoz G; 061 e Instituto de Ciencias de la Salud, Aragón, Spain., Cordero Torres JA; Emergencias sanitarias de Extremadura, Extremadura, Spain., García-Ochoa MJ; SAMUR Protección Civil, Madrid, Spain., Cortés-Ramas JA; Servicio de Bomberos de Zaragoza, Aragón, Spain., Canabal-Berlanga R; Servicio de Urgencias y Emergencias, Castilla La Mancha, Spain., Zoyo López-Navarro R; Servicio de Emergencias 061, Murcia, Spain., López-Messa JB; Unidad de Cuidados Intensivos, Hospital Río Carrión, Palencia, Spain., García Del Águila J; Empresa Pública de Emergencias Sanitarias, Andalucía, Spain., Alonso-Moreno D; Emergentziak-Emergencias, Osakidetza, Euzkadi, Spain., Pozo-Pérez C; Emergencias Sanitarias, Castilla y León, Spain., Bravo-Castello J; Emergencias sanitarias de Extremadura, Extremadura, Spain., Ramos-García N; Servicio de Urgencias y Emergencias, Castilla La Mancha, Spain., Gómez-Larrosa I; Servicio de Emergencias 061, Murcia, Spain., Mellado-Vergel FJ; Hospital el Toyo, Almería, Spain.
Jazyk: angličtina
Zdroj: Resuscitation [Resuscitation] 2017 Apr; Vol. 113, pp. 90-95. Date of Electronic Publication: 2017 Feb 13.
DOI: 10.1016/j.resuscitation.2017.01.029
Abstrakt: Most survival outcomes in out-of-hospital cardiac arrest (OHCA) are provided by emergency medical services (EMS) without a doctor on board. Our objective was to determine such outcomes in a whole country with public physician-led EMS.
Methods: We analyzed data from a nationwide prospective registry of OHCA cases attended by 19 public EMS in Spain, covering the period from 1-October 2013 to 30-October 2014.
Results: Advanced life support (ALS) was initiated in 9347 cases (incidence 18.6 cases/10 5 inhabitants per year). Resuscitation was considered futile in 558 cases (5.9%), and ALS was continued in 8789 cases (94.1%); mean age 63.5±17 years, 72.1% men. Initial rhythm was shockable in 22.1% of cases. Basic life support (BLS) was provided by bystanders in 1602 (24%) cases (635 of them with telephone assistance from the dispatch center). Of 8789 patients receiving ALS, 72.1% men, 2669 (30.4%) patients had return of spontaneous circulation on hospital arrival, 50.6% when the initial rhythm was shockable. Hospital discharge with good neurological status (CPC 1-2 ) was found in 11.1% of the study population and in 27.6% when considering the Utstein comparator group of patients. A total of 216 (2.5%) patients arrived at the hospital with ongoing resuscitation, of whom only one survived with CPC 1-2 , and 165 (1.9%) patients were included in non-heart-beating donation programs.
Conclusions: In Spain with physician-led EMS, OHCA survival with CPC 1-2 reached a reasonable percentage despite only a modest contribution of bystander BLS. Ongoing resuscitation strategy seems to be futile except when considering non-heart beating donation programs.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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