Importance and Implementation of Training in Cardiopulmonary Resuscitation and Automated External Defibrillation in Schools A Science Advisory From the American Heart Association
Importance and Implementation of Training in Cardiopulmonary Resuscitation and Automated External Defibrillation in Schools A Science Advisory From the American Heart Association
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DOI：
10.1161/cir.0b013e31820b5328
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发表时间：
2011-02-15
期刊：
影响因子：
37.8
通讯作者：
Schexnayder, Stephen M.
中科院分区：
文献类型：
--
作者：
Cave, Diana M.;Aufderheide, Tom P.;Schexnayder, Stephen M.
背景心脏骤停是美国和加拿大的主要死因。据估计，每年紧急医疗服务（EMS）人员评估294 851（准置信区间，236 063至325 007）院外心脏骤停（OHCAs）在美国。生存率定义为活着出院，各地区差异很大（3.0%至16.3%;中位数为8.4%），但出院前的总体平均生存率估计为7.6%至7.9%。3，4提供旁观者CPR已知是OHCA生存的关键决定因素。4-13 SOS关东研究人员13记录了2.4的优势比（95%置信区间，1.6至3.4），与接受任何形式的旁观者心肺复苏术（有或无通气）的受害者相关的30天神经学结局有利。Sasson等人4的荟萃分析显示，根据基线生存率，旁观者CPR的相对影响可能更高。（未接受心肺复苏术的受害者）：优势比为1.23（95%置信区间，0.71 - 2.11），基线生存率最高的研究中，（95%置信区间，2.57 - 9.78）。同样的荟萃分析也表达了旁观者心肺复苏术的影响，即需要用旁观者心肺复苏术治疗以挽救一个生命的受害者数量，并且它也随基线生存率而变化：在基线生存率高的地区需要治疗24人，基线生存率最低的地区需要治疗36人。尽管这种相对简单的干预措施的潜在好处是显而易见的，但在美国和加拿大的许多地区，OHCA的受害者中只有不到三分之一的人从旁观者那里得到这种救命的帮助。3、十四
BackgroundSudden cardiac arrest is a leading cause of death in the United States and Canada. It is estimated that each year emergency medical services (EMS) personnel assess 294 851 (quasi-confidence intervals, 236 063 to 325 007) out-of-hospital cardiac arrests (OHCAs) in the United States. Survival, which is defined as being discharged alive from the hospital, varies widely by region (3.0% to 16.3%; median, 8.4%), but the overall average rate of survival to discharge from the hospital is estimated to be 7.6% to 7.9%. 3, 4 Provision of bystander CPR is known to be a critical determinant of survival from OHCA. 4– 13 The SOS Kanto investigators 13 documented an odds ratio of 2.4 (95% confidence interval, 1.6 to 3.4) for a favorable 30-day neurological outcome associated with victims who received any form of bystander CPR with or without ventilation. A meta-analysis by Sasson et al 4 shows that the relative impact of bystander CPR can be even higher, depending on the baseline survival (that of victims not receiving CPR) in a community: an odds ratio of 1.23 (95% confidence interval, 0.71 to 2.11) in the studies with the highest baseline survival rates to 5.01 (95% confidence interval, 2.57 to 9.78) in the studies with the lowest baseline rates. The same meta-analysis also expressed the impact of bystander CPR in terms of the number of victims needed to treated with bystander CPR to save one life and it too varied with baseline survival rates: needed to treated was 24 in areas with high baseline survival rates and 36 with the lowest baseline survival. Even though the potential benefit of this relatively simple intervention is clear, in many areas of the United States and Canada, fewer than 1 in 3 victims of OHCA receive this lifesaving help from a bystander. 3, 14