4.6 Article

Cardiac arrests in general practice clinics or witnessed by emergency medical services: a 20-year retrospective study

期刊

MEDICAL JOURNAL OF AUSTRALIA
卷 215, 期 5, 页码 222-227

出版社

WILEY
DOI: 10.5694/mja2.51139

关键词

Defibrillator; Emergency services; medical; General practice; Myocardial infarction

资金

  1. National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Pre-hospital Emergency Care Australia and New Zealand (PEC-ANZ)
  2. Ziad Nehme an NHMRC Early Career Fellowship [APP1146809]
  3. Peter A Cameron a Medical Research Future Fund practitioner fellowship [MRF1139686]

向作者/读者索取更多资源

Comparing the frequency and outcomes of cardiac arrests in general practice clinics with those of paramedic-witnessed cardiac arrests, the study found that survival rates were higher in cases witnessed by paramedics. It was suggested that prompt alerting of emergency medical services and availability of automated external defibrillators in general practice clinics could significantly reduce the risk of death for cardiac arrest patients.
Objective To compare the frequency and outcomes of cardiac arrests in general practice clinics with those of paramedic-witnessed cardiac arrests. Design, setting Retrospective study; analysis of Victorian Ambulance Cardiac Arrest Registry data, 1 January 2000 - 30 December 2019. Participants Patients with non-traumatic cardiac arrests whom emergency medical services staff attempted to resuscitate. Main outcome measures Survival to hospital discharge. Results 6363 cases of cardiac arrest were identified: 216 in general practice clinics (3.4%) and 6147 witnessed by paramedics (96.6%). The proportion of patients presenting with initial shockable rhythms was larger in clinic (126 patients, 58.3%) than paramedic-witnessed cases (1929, 31.4%). The proportion of general practice clinic cases in which defibrillation was provided in the clinic increased from 2 of 37 in 2000-2003 (5%) to 19 of 57 patients in 2016-2019 (33%); survival increased from 7 of 37 (19%) to 23 of 57 patients (40%). For patients with initial shockable rhythms, 57 of 126 in clinic cases (45%) and 1221 of 1929 people in paramedic-witnessed cases (63.3%) survived to hospital discharge; of 47 general practice patients defibrillated by clinic staff, 27 survived (57%). For patients with initial shockable rhythms, the odds of survival were greater following paramedic-witnessed events (adjusted odds ratio [aOR], 3.39; 95% CI, 2.08-5.54) or general clinic arrests with defibrillation by clinic staff (aOR, 2.23; 95% CI, 1.03-4.83) than for general practice clinic arrests in which arriving paramedics provided defibrillation. Conclusion Emergency medical services should be alerted as soon as possible after people experience heart attack warning symptoms. Automated external defibrillators should be standard equipment in general practice clinics, enabling prompt defibrillation, which may substantially reduce the risk of death for people in cardiac arrest.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据