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2016, vol. 2, br. 4, str. 15-18
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EURECA 2015 Subotica - jednogodišnje praćenje pacijenata sa šokabilnim ritmom
EURECA 2015 Subotica: One year monitoring of patients with shockable rhythm
Sažetak
Cilj Praćenje pacijenata sa šokabilnim ritmom kod kojih je intervenisala SHMP Subotica tokom 2015. godine. Unapređenje kvaliteta zbrinjavanja srčanog zastoja. Metodologija rada: Prospektivni opservacioni trial Evropskog Resuscitacionog saveta. Program organizovan od strane Resuscitacionog saveta Srbije a na osnovu ovlašćenja Evropskog resuscitacionog saveta. Saradnja sa Sekcijom urgentne medicine. U studiju su uključeni svi pacijenti - i odrasli i deca, koji su zatečeni mrtvi u vanbolničkim uslovima, a kod kojih je intervenisala hitna medicinska pomoć. Podaci su prikupljani tokom jednogodišnjeg perioda (2015 godina). Popunjavanje ankete - lekara nakon izvršene intervencije na terenu. Rezultati Šokabilan inicijalni ritam je imalo 22 pacijenta (15.5/100.000). Dvadeset osoba muškog pola (14.1/100.000) i 4 žene (2.8/100.000). Tokom primene postupaka reanimacije u dva slučaja se ritam iz nešokabilnog prevodi u šokabilan. Prosečna starost pacijenata sa šokabilnim ritmom je 65.6 godina. Prosečno vreme od prijema poziva u dispečerskom centru do primene DC šoka je 9.8 min. Dispečer je tri puta uspeo telefonski da vodi KPR uz navođenje laika o postupcima osnovne životne podrške do dolaska lekarske ekipe. Ekipa je dva puta zatekla svedoka kako radi reanimaciju uz primenu 'samo kompresije', dok je u jednom slučaju laik odustao od primene KPR i taj je pacijent imao ne šokabilan inicijalni ritam. Od ukupnog broja pacijenata sa šokabilnim ritmom, ROSC je postignut kod 11 (7.8/100.000) pacijenata i oni su sa opipljivim pulsom predati Odeljenju za prijem i zbrinjavanje urgentnih stanja Opšte bolnice Subotica. Iz bolnice je otpušteno 5 (3.5/100.000) pacijenata dok se za 4 (2.8/100.000) pacijenta zna da su živi i nakon 30 dana po otpustu. Zaključak: U narednom periodu nastaviće se praćenje i analiza sopstvenih rezultata. Na ovaj način se omogućava poređenje kako rezultata unutar Službe, tako i međusobno upoređivanje sa drugim Službama. Nastojaće se na edukaciji tehničara koji rade u dispečerskom centru. U kontinuitetu će se sprovoditi edukacija građana kao i praćenje aktivnosti putem medija. Dan 'Pokrenimo srce' je unet u petogodišnji plan službe kao redovna godišnja manifestacija posvećena resuscitaciji. Sve ovo doprinosi poboljšanju kvaliteta i rada zaposlenih u Službi hitne medicinske pomoći naročito u sprovođenju karika lanca preživljavanja.
Abstract
Aim: Monitoring of patients with shockable rhythm intervened by the emergency department of Subotica in 2015. Improving the quality of treatment for out of hospital cardiac arrest. Method: Prospective observational trial European Resuscitation Council. The program has been organized by the Resuscitation Council of Serbia under the authority of the European Resuscitation Council. Cooperation with Emergency medicine section. The study has included all patients - both adults and children, who were found dead in outpatient circumstances, and intervened by the emergency medical service. Data have been collected during a one-year period in 2015. The survey were carried out after the intervention medical service. Results: The initial rhythm- shockable was registered in 22 patients (15.5 / 100,000). Twenty males (14.1 / 100,000) and 4 females (2.8 / 100,000). During the application of resuscitation procedures in two cases, the pace of non-shockable translates into shockable. The average age of patients with shockable rhythm was 65.6 years. The average time from receiving calls in the dispatch center to the application of DC shock was 9.8 min. The dispatcher has managed to lead the bystander throughout the CPR procedure until the arrival of the medical team, tree times through the phone. The dispatcher is three times managed to keep the phone CPR stating the lay of the basic life support procedures until the arrival of the medical team. The team has found witness how performs resuscitation with the use of 'only hands' twice. In one of the case the layman gave up applying CPR, and this patient had no shockable initial rhythm. Of the total number of patients with shockable rhythm, ROSC was achieved with 11 (7.8 / 100,000) patients and they were handed over to General Hospital Subotica with palpable pulse. Fife patient were discharged from the hospital 5 (3.5 / 100,000) patients while 4 (2.8 / 100,000) patients is known to be alive after 30 days on release. Conclusion: We will continue to monitor and analyze our own results in the future. This way, allows to compare results within the Department, as well as mutual comparison with other services. Efforts will be made to the improvement education of the technicians that work in dispatching center. The continuity will be conducted education of citizens as well as monitoring activities through the media. Day 'Restart a heart' is entered in the five-year service plan as a regular annual event dedicated to resuscitation. All this contributes improvement of the quality of service and the work of employees in the emergency medical services, especially as a part of implementation of the chain of survival.
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