CARDIAC-ARREST AND RESUSCITATION - A TALE OF 29 CITIES
CARDIAC-ARREST AND RESUSCITATION - A TALE OF 29 CITIES
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DOI：
10.1016/s0196-0644(05)81805-0
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发表时间：
1990-02-01
影响因子：
6.2
通讯作者：
HEARNE, TR
中科院分区：
文献类型：
--
作者：
EISENBERG, MS;HORWOOD, BT;HEARNE, TR
已发表的院外心脏骤停报告给出了广泛不同的结果。每种系统内存活率的差异部分是由于定义的差异。为了确定存活率差异的其他原因，我们回顾了1967年至1988年对29个不同地区的39个紧急医疗服务项目进行的已发表研究。这些程序可以分为五种类型的院前系统的基础上提供心肺复苏术，除颤，药物，气管插管的人员;这五个系统是三种类型的单响应系统（基本急救医疗技术人员[EMT]，EMT-D]和护理人员）和两个双响应系统（EMT/护理人员和EMT-D/护理人员）。报告的所有心律的放电率范围为2%至25%，室颤的放电率范围为3%至33%。最低的存活率发生在单反应系统和最高的比率在双反应系统，虽然有相当大的变化在每种类型的系统。假设的生存曲线表明复苏能力是时间、类型和治疗顺序的函数。在双反应系统中，存活率似乎最高，因为心肺复苏术开始得早。我们推测，早期心肺复苏术允许明确的程序，包括除颤，药物和插管，更有效。
Published reports of out-of-hospital cardiac arrest give widely varying results. The variation in survival rates within each type of system is due, in part to variation in definitions. To determine other reasons for differences in survival rates, we reviewed published studies conducted from 1967 to 1988 on 39 emergency medical services programs from 29 different locations. These programs could be grouped into five types of prehospital systems based on ther personnel who deliver CPR, defibrillation, medications, and endotracheal intubation; the five systems were three types of single-response systems (basic emergency medical technician [EMT], EMT-defibrillation [EMT-D], and paramedic) and two double-response systems (EMT/paramedic and EMT-D/paramedic). Reported discharge rates ranged from 2% to 25% for all cardiac rhythms and from 3% to 33% for ventricular fibrillation. The lowest survival rates occurred in single-response systems and the highest rates in double-response systems, although there was considerable variation within each type of system. Hypothetical survival curves suggest that the ability to resuscitate is a function of time, type, and sequence of therapy. Survival appears to be highest in double-response systems because CPR is started early. We speculate that early CPR permits definitive procedures, including defibrillation, medications and intubation, to be more effective.