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2015, vol. 1, br. 1, str. 9-11
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EURECA Srbija ONE 2014 - vanbolnički srčani zastoj - mesto događaja
EURECA Serbia ONE 2014: Out of hospital cardiac arrest: Venue of accident
aZavod za hitnu medicinsku pomoć, Novi Sad bZavod za hitnu medicinsku pomoć, Kragujevac cDom zdravlja, Subotica
e-adresa: office@resuscitatio.org.rs
Sažetak
Uvod: Podaci o u uspešnosti primene naprednih mera podrške životu ukazuju da u kvalitetno organizovanim sistemima više od 35 % osoba u srčanom zastoju dožive ponovno uspostavljanje spontane cirkulacije (ROSC). Procenat uspostavljanja ROSC-a prema objavljenim podacima EURECA programa 2014 u Srbiji iznosi oko 5%. U Srbiji nema pouzdanih sistemski prikupljenih podataka o mestu dešavanja, i prisustvu svedoka događaju koji nazivamo vanbolnički srčani zastoj (OHCA). EURECA studija bi trebala da osvetli epidemiološku sliku u Republici Srbiji i omogući objektivno sagledavanje mesta događanja iznenadnog srčanog zastoja u R. Srbiji kao izuzetno važnog podatka za izradu strategije zbrinjavanja ovog oboljenja. Cilj: Utvrditi mesto dešavanja iznenadnog srčanog zastoja u skladu sa UTSTEIN protokolom. Cilj je da se utvrdi prisustvo svedoka iznenadnom srčanom zastoju i utvrdi da li prisustvo svedoka utiče na broj pokušaja reanimacije od strane sistema hitne medicinske pomoći u R. Srbiji. Metoda: Prospektivna studija koja podrazumeva prikupljanje podataka putem upitnika ustanovljenog u okviru usvojene metodologije prikupljanja podataka Clinical Trials ID: NCT02236819 - EURECA ONE 2014. Podaci iz definisanih istraživačkih centara Programa unošeni su u jedinstvenu bazu podataka formiranu na internet adresi www.eureca.rs. Rezultati: U okviru programa EURECA one 2014. u Srbiji su prikupljani podaci o 1828 srčanih zastoja koji su se dogodili izvan bolnice. 789/1828 ili 43.16 srčana zastoja odvio se u prisustvu svedoka, ostali su neosvedočeni odnosno 839 osoba je doživelo srčani zastoj u osami. Mere resuscitacije započete su od strane hitne medicinske pomoći kod 171/839 ili 20,42% pacijenata koji su doživeli srčani zastoj bez prisustva rodbine ili prolaznika. Najveći broj srčanih zastoja odvija se u kući, stanu pacijenta 1448/1828 ili 79.21% a svedok je prisutan kod 629/1448 osoba ili kod 43.44%. Prikupljeni su podaci o srčanom zastoju u domovima za stare, radnom mestu, javnom objektu, ulici, sportskim objektima. Srčani zastoj na javnom mestu - ulici ima učestalost 133/1828 ili 7.26% od svih srčanih zastoja izvan bolnice. Zaključak: Veliki broj srčanih zastoja događa se u kući, često bez svedoka ili osobe koja bi mogla aktivirati urgentnu službu. Dalje proučavanje strukture starosti, obrazovanja, brojnosti domaćinstva može dati odgovor o aktivnostima koje treba pokrenuti. Buduća istraživanja trebaju biti tako dizajnirana da osvetle ovu pojavu.
Abstract
Introduction: Data on the success of advanced support measures đivoru indicate that in well organised systems more than 35% of people in cardiac arrest experience re-establishment of spontaneous circulation (ROSC). Percentage of established ROSC according to the data published by the Eureca program in 2014 in Serbia is around 5%. In Serbia, there is no reliable system of collecting data that is linked to the place of the event and the presence of a witness to what we call Out hospital cardiac arrest. (OHCA), whether it is sudden cardiac arrest or heart failure. The EURECA study should shed light on the epidemiological picture in the Republic of Serbia and provide an objective overview of the cite of events of sudden cardiac arrest in Serbia as very important information for the development of a strategy for treating this disease. OBJECTIVE: To determine the place of event in sudden cardiac arrest in accordance with the Utstain protocol. The aim of the protocol is to determine whether the presence of a witness in sudden cardiac arrest affects the number of attempts of resuscitation by the system of Emergency Medical Assistance in Serbia. METHOD: A prospective study that includes data collected through questionnaires, established within the framework of the adopted methodology for collecting data in Clinical Trials ID: NCT02236819 - ONE Eureca 2014. Data from the program defined by the research centers was entered into a database uniquely formed on the Internet at www.eureca.rs Results: In the framework of Eureca in 2014 in Serbia data was collected for around 1828 cardiac arrests that occurred outside the hospital. 789/1828 or 48.46 cardiac arrests took place in the presence of a witness, others were unwitnessed or 839 people had suffered cardiac arrest in a remote area. Resuscitation measures were initiated by the Emergency medical unit at 171/839 or 20.42% of patients have experienced cardiac arrest without the presence of relatives or bystanders. The largest number of cardiac arrests take place in a house or an apartment of a patient 1448/1828 79.21% and with a witness present 629/1448 or in 43.41% of cases. The data collected is related to the recorded heart failures in retirement homes, workplaces, public buildings, street sports facilities. Cardiac arrest in a public place - the street is next in frequency 133/1828 or 7.27% of all cardiac arrests outside of hospitals. Conclusion: A large number of cardiac arrests occur in the home, often without a witness or a person that could activate the emergency service. Further studies of the structure of age, education, number of people in households can provide an answer about the activities that should be taken. Future studies should be designed to shed light on this phenomenon.
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