scholarly journals Resuscitation Care in Out-Of-Hospital Cardiac Arrest: a Survey of the Emergency Medical Services Personnel in the Republic of Crimea

2021 ◽  
Vol 9 (4) ◽  
pp. 612-625
Author(s):  
A. A. Birkun ◽  
L. P. Frolova ◽  
G. N. Buglak ◽  
S. S. Olefirenko ◽  
L. I. Dezhurny

Introduction. The choice of the ways for optimizing management of out-of-hospital cardiac arrest by emergency medical services (EMS) should be based on the evidence from existing practice of resuscitation care. The study was aimed at evaluating personal experience of cardiopulmonary resuscitation (CPR) performance, timing of last training in resuscitation and level of self-perceived knowledge and skills of CPR among the employees of the EMS of the Republic of Crimea, as well as to assess their beliefs on significance of individual CPR procedures in terms of influence on success of resuscitation and to study their perceptions on factors that may have positive or negative impact on effectiveness of resuscitation care.Material and methods. An anonymous survey of the EMS personnel of the Republic of Crimea was conducted in July–December 2019. The questionnaire was utilized to collect demographic data, information on experience of conducting CPR for the last year, on a current practice of CPR debriefings and timing of last CPR training. The participants assessed their knowledge and skills of CPR and their perception of influence of early implementation of individual CPR procedures on success of resuscitation on a 5-point Likert scale, and indicated factors, that may limit or enhance the effectiveness of resuscitation.Results. A total of 251 specialist of the EMS participated in the survey, including 63 physicians, 129 feldshers and 4 nurses of ambulance teams, 45 dispatchers and 5 senior officers of the EMS stations, which corresponds to 28.8% of physicians, 13.0% of feldsher/nursing staff and 17.4% of dispatcher specialists of the republic. Percentage of male respondents was 35.5%, mean age — 41.5 years, mean duration of EMS work experience — 15.5 years. The mean declared number of cases of CPR conducted in the last 12 months was 2.2 (range: 0–20), and 23.5% specialists of the ambulance teams have not participated in any CPR attempt over the last year. About 60.2% respondents were trained in CPR within the last year. When compared to other specialists of ambulance teams, feldshers who work alone (without a coworker), were significantly less commonly performing a real-life resuscitation (p=0.008) or receiving training in CPR (p=0.020). Dispatchers were least covered with resuscitation training (only 33.3% were trained within the last year) and had the lowest level of CPR knowledge and skills. 25.9% of the specialists had an erroneous judgement that early drug administration and/or tracheal intubation have higher influence on success of resuscitation when compared to chest compressions and/or defibrillation. The level of knowledge and skills of CPR depend on the timing of last training (p<0.001).Conclusions. The experience of participation in real-life attempts of CPR is severely limited for considerable part of the EMS employees, and many specialists have not been trained in resuscitation for a long time. The perceptions of the EMS specialists regarding the importance of individual CPR procedures are not always compliant with the statements of current international CPR guidelines. In order to enhance the effectiveness of resuscitation care in the Republic of Crimea, it is advisable to monitor the coverage of the EMS employees with resuscitation training and the rates of their participation in resuscitation attempts, as well as to perform additional targeted training in CPR, in particular, using alternative methods of education.

2018 ◽  
Vol 25 (2) ◽  
pp. 83-90
Author(s):  
Chien Tat Low ◽  
Poh Chin Lai ◽  
Paul Sai Shun Yeung ◽  
Axel Yuet Chung Siu ◽  
Kelvin Tak Yiu Leung ◽  
...  

Introduction: Temperature is a key factor influencing the occurrence of out-of-hospital cardiac arrest, yet there is no equivalent study in Hong Kong. This study reports results involving a large-scale territory-wide investigation on the impacts of ambient temperature and age–gender differences on out-of-hospital cardiac arrest outcome in Hong Kong. Methods: This study included 25,467 out-of-hospital cardiac arrest cases treated by the Hong Kong Fire Services Department between December 2011 and November 2016 inclusive. Simple correlation and regression analyses were used to examine the relationships between out-of-hospital cardiac arrest cases and temperature, age and gender. Calendar charts were used to visualise temporal patterns of pre-hospital emergency medical services related to out-of-hospital cardiac arrest cases. Results: A strong negative curvilinear relationship was found between out-of-hospital cardiac arrest and daily temperature (r2 > 0.9) with prominent effects on elderly people aged ≥85 years. For each unit decrease in mean temperature in °C, there was a maximum of 5.6% increase in out-of-hospital cardiac arrest cases among all age groups and 7.3% increase in the ≥85 years elderly age group. Men were slightly more at risk of out-of-hospital cardiac arrest compared with women. The demand for out-of-hospital cardiac arrest–related emergency medical services was highest between 06:00 and 11:00 in the wintertime. Conclusion: This study provides the first local evidence linking weather and demographic effects with out-of-hospital cardiac arrest in Hong Kong. It offers empirical evidence to policymakers in support of strengthening existing emergency medical services to deal with the expected increase in out-of-hospital cardiac arrest in the wintertime and in regions with a large number of elderly population.


2020 ◽  
Vol 9 (4_suppl) ◽  
pp. S82-S89
Author(s):  
Michael Poppe ◽  
Mario Krammel ◽  
Christian Clodi ◽  
Christoph Schriefl ◽  
Alexandra-Maria Warenits ◽  
...  

Objective Most western emergency medical services provide advanced life support in out-of-hospital cardiac arrest aiming for a return of spontaneous circulation at the scene. Little attention is given to prehospital time management in the case of out-of-hospital cardiac arrest with regard to early coronary angiography or to the start of extracorporeal cardiopulmonary resuscitation treatment within 60 minutes after out-of-hospital cardiac arrest onset. We investigated the emergency medical services on-scene time, defined as emergency medical services arrival at the scene until departure to the hospital, and its association with 30-day survival with favourable neurological outcome after out-of-hospital cardiac arrest. Methods All patients of over 18 years of age with non-traumatic, non-emergency medical services witnessed out-of-hospital cardiac arrest between July 2013 and August 2015 from the Vienna Cardiac Arrest Registry were included in this retrospective observational study. Results Out of 2149 out-of-hospital cardiac arrest patients, a total of 1687 (79%) patients were eligible for analyses. These patients were stratified into groups according to the on-scene time (<35 minutes, 35–45 minutes, 45–60 minutes, >60 minutes). Within short on-scene time groups, out-of-hospital cardiac arrest occurred more often in public and bystander cardiopulmonary resuscitation was more common (both P<0.001). Patients who did not achieve return of spontaneous circulation at the scene showed higher rates of 30-day survival with favourable neurological outcome with an on-scene time of less than 35 minutes (adjusted odds ratio 5.00, 95% confidence interval 1.39–17.96). Conclusion An emergency medical services on-scene time of less than 35 minutes was associated with higher rates of survival and favourable outcomes. It seems to be reasonable to develop time optimised advance life support protocols to minimise the on-scene time in view of further treatments such as early coronary angiography as part of post-resuscitation care or extracorporeal cardiopulmonary resuscitation in refractory out-of-hospital cardiac arrest.


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