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2017, vol. 3, br. 7, str. 29-32
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Pedijatrijski vanbolnički srčani zastoj – EuReCa Srbija
Pediatric out-of-hospital cardiac arrest: EuReCa Serbia
aDom zdravlja, Služba za hitnu medicinsku pomoć, Subotica bZavod za hitnu medicinsku pomoć, Novi Sad
e-adresa: kornelijajaksic@yahoo.com
Sažetak
Cilj: Prikupljanje demografskih podataka o pedijatrijskom vanbolničkom srčanom zastoju u Srbiji tokom dve godine: u vremenskom periodu od 01. januara 2015. do 31. decembra 2016. godine. Metod: Prospektivna, observaciona studija prikupljanja podataka putem jedinstvenog upitnika koji se bazira na Utstein smernicama i unose se u jedinstvenu bazu podataka na internet adresi www.eureca.rs. Analiza se odnosi samo na vanbolnički srčani zastoj u dečijem uzrastu, do 18 godina starosti. Rezultati: Incidenca pedijatrijskog vanbolničkog srčanog zastoja na prikupljenom materijalu je 27 (3,2/100.000 stanovnika) odn. 1% u odnosu na ukupnu incidencu srčanih zastoja u kojima je intervenisala HMP. Broj započetih kardio-pulmonalnih reanimacija je 9, odn. 1,05/100000. Srednja dob bila je 7,33 godina, 36% bilo mlađe od 18 meseci. Po etiologiji dominirali su kardiološki uzroci 4, nekardiološki 2, trauma 1, ostalo nije zabeleženo. Mesto nastanka je najčešće prebivalište N= 6. Inicijalni ritam je kod svih 9 pacijenata nešokabilni. Pedijatrijski vanbolnički srčani zastoj je osvedočen kod 6 pacijenata, a samo u 2 slučaja je započeto pružanje osnovnih mera životne podrške od strane očevica, pre dolaska ekipe hitne medicinske pomoći. Kod 1 pacijenta je vođen telefonski asistirani KPR od strane dispečera HMP. Spontana srčana cirkulacija nije uspostavljena ni kod jednog deteta, a sa merama KPR u bolničku ustanovu je preveženo 5. O otpustu iz bolnice i preživljavanju nakon 1 meseca-nema verodostojnih podataka. Zaključak: Iako je pedijatrijski vanbolnički srčani zastoj mnogo ređi u odnosu na odraslo stanovništvo, predstavlja veliki zdravstveni problem. Lanac preživljavanja se fokusira na pružanju mera osnovne životne podrške od strane svedoka-očevidaca pre dolaska ekipa hitne medicinske pomoći. KPR dece treba da znaju pre svega roditelji a i svi drugi akteri koji brinu o deci: vaspitačice, učitelji, nastavnici, treneri. Veoma je važno raditi na podizanju nivoa svesti građana uopšte da shvate značaj mera osnovne životne podrške. Neophodne su kontinuirane medicinske edukacije za osnovne i napredne mere životne podrške dece (PALS), obezbediti im redovne treninge i retreninge, a zdravstvene ustanove treba da obezbede odgovarajuću opremu za resuscitaciju prilagođeno dečijem uzrastu.
Abstract
Aims: Collection of demographic data’s of pediatric out-of-hospital cardiac arrest in Serbia for the period two years, from January 1, 2015 to December 31, 2016. Methodology: Prospective, observational study with unified data collection based on Utstein protocol via database at www.eureca.rs. This analysis only refers to the out-of-hospital cardiac arrest in children up to 18 years of age. Results: The incidence of pediatric out-of-hospital cardiac arrest for the observed period is 27 (3,2/100.000 citizens) i.e. 1% of total number of out-of-hospital cardiac arrests where EMS intervened. Cardiopulmonary resuscitation has been attempted in 9 cases i.e. 1,05/100000. Average year was 7.33, 36% were younger than 18 months. Cardiological aetiology was dominant with 4 cases, followed by 2 non-cardiology causes and 1 trauma case as other has not been recorded. Place of residence was the most common scene N=6. The initial rhythm was non-shockable in all 9 cases. Pediatric out-of-hospital cardiac arrest was witnessed in 6 cases where only in 2 patients basic life support has been attempted by the bystanders before the arrival of the emergency medical services. In 1 case CPR was dispatcher assisted. Return of spontaneous circulation has not been achieved in any case, but with ongoing CPR 5 patients was transferred to the hospital. The hospital discharge data’s including the survival related ones were not reliable. Conclusion: Despite the fact that pediatric out-of-hospital cardiac arrest is much less frequent compared to the adult population, it is a significantly burning problem. The Chain of Survival emphasize the importance of the basic life support by the bystanders and witnesses before the arrival of EMS. Children CPR should be taught in the first place to parents and to all who are taking care of children e.g.: kindergarten and school teachers, trainers, etc. It is crucial to raise the awareness of citizens about the outstanding importance of basic life support. Continuous medical educations and regular training programs are essential in children basic and advanced life support. All healthcare professionals need to be properly trained and all healthcare centers should have available and adequate equipment for pediatric resuscitation.
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