engleski

Out-of-hospital CPR in Rijeka in 1993 - Utstein style presentation

OBJECTIVE - To determine survival from out-of-hospital non-traumatic cardiac arrest in Rijeka (Croatia) and to determine problems in education, medical documentation and general organisation of EMS system. PARTICIPANTS - Data from treatment 161 consecutive out-of-hospital non-traumatic cardiac arrests occurring between January 01, 1993, and December 31, 1993. MAIN OUTCOME MEASURES - Core and some supplementary data conformed to Utstein recommendations. The end point was death or discharge alive home. RESULTS - In 1993, EMS of Rijeka had done 7106 emergency interventions in out-of-hospital setting. Non-traumatic cardiac arrest occurred in 161 cases. In 82 cases resuscitation attempts had not been performed because of ongoing biological death or the patients were being in terminal malignant illness. In 79 cases CPR procedures were started and 23 patients had been transported to hospital, but 6 were died during transport. In emergency department 2 patients were died and 2 more in ICU during 1st 24 hours. Six patients were died until discharge. Five patients were discharged home alive. In 9 cases EMS personnel witnessed arrest: 4 patients were expiried in field, and 5 patients were transported to hospital ; 2 of them died in transport, and 3 in hospital until discharge. CONCLUSIONS - Survival from out-of-hospital cardiac arrest in Rijeka is poor. Bystander CPR does not occur causing prolonged interval from collapse to appropriate professional treatment. In arrests witnessed by EMS personnel call-response interval is not critical, but there was no survivals. That indicates poor education level of personnel, but there is no organized education program. Probably bystander’ s recognition of arrest is bad, and we assume that to much time is being loosen until call for help, althouth there was survivals only in bystander’ s and profesional’ s witnessed arrests. Bystander CPR was not occurred, and profesional’ s CPR occured in 2 cases was determined as inapropriate. EMS vechiles start point is set on one place, too much far from some city areas. Medical documentation is poor, although provides some data. We strongly hope that improvements on education, organisation and documentation will reflect in better outcome.

cardiac arrest; out of hospital; resuscitation; Utstein

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