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2015, vol. 1, br. 2, str. 5-8
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EURECA Srbija One 2014. - kardiopulmonalna resuscitacija od strane svedoka
EURECA Serbia One 2014: Cardiopulmonary resuscitation by bystander
Sažetak
UVOD: Kardiopulmonalna resuscitacija (KPR) započeta od strane svedoka pre dolaska ekipe hitne medicinske pomoći je povezana sa povećanim postotkom preživljavanja kod vanbolničkih srčanih zastoja. CILJ: Ispitivanje učestalosti započinjanja mera osnovne životne podrške pre dolaska ekipa hitne medicinske pomoći od strane svedoka kod vanbolničkih srčanih zastoja. METOD: Prospektivna, opservaciona studija. Podaci korišteni iz jedinstvene baze podataka kliničkog trijala Clinical Trials ID: NCT02236819 - Eureca ONE 2014. koja je formirana na internet adresi www.eureca.rs REZULTATI: U jedinstveni registar unešeno je 1677 (63,31/100000) srčanih zastoja, od kojih je započeto 534 ( 20,16/100000) kardiopulmonalnih reanimacija od strane hitnih medicinskih pomoći. Kolaps je bio osvedočen od strane svedoka-očevidaca u 64,79 % (N=346 ;13,78/100000), a mere osnovne životne potpore od strane istih su započete pre dolaska hitne medicinske pomoći u 7,11% (N=38; 1,43/100000) bolesnika. Analizirano je 38 srčanih zastoja sa započetim merama osnovne životne podrške od strane svedoka: konvencionalni KPR kod 27 (5,47/100000), a samo kompresije grudnog koša (only hand KPR) kod 11 (2,27/100000). Etiološki faktor pretpostavljeno srčano obolenje 35 (1,32/100000), a respiratornog porekla 1 (0,04/100000) a 2 nije zabeleženo. Mesto događaja kuća 31 (1,17/100000), ulica - 3 (0,62/100000), javna zgrada -3 (0,62/100000), dom za stare - 1 (0,04/100000). Šokabilni inicijalni ritam zabeležen kod 4 bolesnika, a nešokabilni kod 34. Povratak spontane cirkulacije postignut kod 6 bolesnika (0,23/100000), sa znacima života transportovani u bolnicu 6 (0,23/100000), a preživljavanje nakon mesec dana 2 (0,08/100000). ZAKLJUČAK: Učešće građana/svedoka u započinjanju kardiopulmonalne reanimacije kod srčanog zastoja pre dolaska ekipe hitne medicinske pomoći je od izuzetnog značaja, a praktična primena u našoj zemlji je nezadovoljavajuća.
Abstract
INTRODUCTION: Cardiopulmonary resuscitation initiated by witnesses before EMS responding is related with increased survival rate in out of hospital cardiac arrest cases. AIM: Investigating the incidence of basic life support measures provided by layman witnesses before EMS arrival in out of hospital cardiac arrest OHCA cases. METHOD: Prospective, observational study. The data were used from a single data base of Clinical Trials ID: NCT02236819 - Eureca ONE 2014. which is available at www.eureca.rs RESULTS: 1677 (63,31/100 000) cardiac arrests have been entered in this single registry, and in 534 (20,16/100 000) of all EMS provided CPR. Layman witnessed the patient collapse in 64,79% (N=346; n=13,78/100 000) of all cases, and started basic life support measures before EMS arrival in 7,11% (N=38; 1,43/100 000). 38 cardiac arrests with initiated basic life support by bystanders were analyzed: conventional CPR was conducted in 27 patients (5,47/100 000), and only chest compressions (only hand CPR) were used in 11 cases (2,27/100 000). Heart condition was presumed to be the etiological factor in 35 patients (1,32/100 000), respiratory failure in 1 (0,04/100 000), and in 2 cases etiological factor wasn't recorded. OHCA happened mostly at patient's home =31 (1.17/100 000), in the street =3 (0,62/100 000), at public institutions -3 (0,62/100 000), at elderly care facilities -1 (0,04/100 000). Initial shockable rhythm was recorded 4 times, and non-shockable 34. ROSC was achieved 6 times (0,23/100 000), and 6 patients (0,23/100 000) were transported to hospital with positive vitals. One month survival was recorded in 2 cases (0,08/100 000). CONCLUSION: Citizens' involvement in initiation of cardiopulmonary resuscitation of OHCA victims before EMS arrival is of great importance, but in practice the use of this link in the chain of survival is unsatisfactory in our country.
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