QUALITY OF BYSTANDER CARDIOPULMONARY-RESUSCITATION INFLUENCES OUTCOME AFTER PREHOSPITAL CARDIAC-ARREST
QUALITY OF BYSTANDER CARDIOPULMONARY-RESUSCITATION INFLUENCES OUTCOME AFTER PREHOSPITAL CARDIAC-ARREST
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DOI：
10.1016/0300-9572(94)90064-7
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发表时间：
1994-12-01
期刊：
影响因子：
6.5
通讯作者：
BIRCHER, NG
中科院分区：
文献类型：
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作者：
WIK, L;STEEN, PA;BIRCHER, NG
为了评价旁观者心肺复苏（CPR）质量对院前心脏骤停结局的影响，我们连续纳入了1985年至1989年挪威奥斯陆社区救护系统中由护理人员治疗的院前心脏骤停患者。良好的心肺复苏术定义为可触及颈动脉或股动脉脉搏，间歇性胸部扩张并尝试充气。结果指标为出院率。334例患者中有149例（45%）接受了旁观者CPR。BCPR良好后的出院率（23%）高于BCPR不佳后（1%，P < 0.0005）或BCPR不佳后（6%，P < 0.0005）。不好和没有复原局没有区别（P = 0.1114），两组间的急救反应时间无差异，但从意识丧失开始到开始CPR的平均时间在接受良好的旁观者心肺复苏术的组中，（2.5 min，95%置信区间（CI）：1.7-3.3 min）比无良好CPR（6.6 min，CI：5.2-8.0 min）或无旁观者CPR（7.8 min，CI：7.2-8.4 min）更有效。旁观者在公共场所比在患者家中更频繁地开始CPR（58%比34%，P < 0.0005）。与没有良好的BCPR或没有BCPR相比，良好的旁观者CPR与更短的CPR骤停间隔和更高的出院率相关。
To evaluate the influence of quality of bystander cardiopulmonary resuscitation (CPR) on outcome in prehospital cardiac arrest we consecutively included patients with prehospital cardiac arrest treated by paramedics in a community run ambulance system in Oslo, Norway from 1985 to 1989. Good CPR was defined as palpable carotid or femoral pulse and intermittent chest expansion with inflation attempts. Outcome measure was hospital discharge rate. One hundred and forty-nine of 334 patients (45%) received bystander CPR. The discharge rate after good BCPR (23%) was higher than after no good BCPR (1%, P < 0.0005) or after no BCPR (6%, P < 0.0005). There was no difference between no good and no BCPR (P = 0.1114), There were no differences in paramedic response interval between the groups, but the mean interval from start of unconsciousness to initiation of CPR (arrest-CPR interval) was significantly shorter in the group receiving good bystander CPR (2.5 min, 95% confidence interval (CI): 1.7-3.3 min) than no good CPR (6.6 min, CI: 5.2-8.0 min) or no bystander CPR (7.8 min, CI: 7.2-8.4 min). Bystanders started CPR more frequently in public than in the patient's home (58 vs. 34%, P < 0.0005). Good bystander CPR was associated with a shorter arrest-CPR interval and improved hospital discharge rate as compared to no good BCPR or no BCPR.