BACKGROUND: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). METHOD: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. RESULTS: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17-1.83). CONCLUSION: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both.
BACKGROUND: The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander. METHODS: This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge. RESULTS: All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively). CONCLUSION: In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation.
- MeSH
- kardiopulmonální resuscitace * MeSH
- lidé MeSH
- prospektivní studie MeSH
- registrace MeSH
- urgentní zdravotnické služby * MeSH
- zástava srdce mimo nemocnici * epidemiologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- MeSH
- lidé MeSH
- porodní bolesti terapie MeSH
- porodnická analgezie * metody MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
- MeSH
- lidé MeSH
- porodní bolesti terapie MeSH
- porodnická analgezie * metody MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
- MeSH
- dostupnost zdravotnických služeb statistika a číselné údaje MeSH
- lékařská praxe - způsoby provádění statistika a číselné údaje MeSH
- lidé MeSH
- péče o pacienty v kritickém stavu statistika a číselné údaje MeSH
- průzkumy a dotazníky MeSH
- týmová péče o pacienty organizace a řízení MeSH
- urgentní zdravotnické služby statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- Geografické názvy
- Evropa MeSH
These European Board of Anaesthesiology (EBA) recommendations for safe medication practice replace the first edition of the EBA recommendations published in 2011. They were updated because evidence from critical incident reporting systems continues to show that medication errors remain a major safety issue in anaesthesia, intensive care, emergency medicine and pain medicine, and there is an ongoing need for relevant up-to-date clinical guidance for practising anaesthesiologists. The recommendations are based on evidence wherever possible, with a focus on patient safety, and are primarily aimed at anaesthesiologists practising in Europe, although many will be applicable elsewhere. They emphasise the importance of correct labelling practice and the value of incident reporting so that lessons can be learned, risks reduced and a safety culture developed.
- MeSH
- anestezie škodlivé účinky metody MeSH
- anesteziologie normy MeSH
- bezpečnost pacientů normy MeSH
- lidé MeSH
- medikační omyly prevence a kontrola MeSH
- péče o pacienty v kritickém stavu normy MeSH
- řízení bezpečnosti metody normy MeSH
- řízení rizik metody normy MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- značení léčiv normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
Úvod: Kraniocerebrálne poranenie (KCP) je definované ako poškodenie lebky a mozgu vplyvom vonkajšej mechanickej sily, ktoré má za následok dočasné alebo trvalé poškodenie funkcií centrálneho nervového systému, spojených s rôznym stupňom poruchy vedomia. Závažné kraniocerebrálne poranenie je vedúcou príčinou mortality a invalidizácie u detí a mladých dospelých. Cieľom práce je analýza kvality poskytovania prednemocničnej neodkladnej zdravotnej starostlivosti pri kraniocerebrálnych poraneniach posádkami Falck Záchrannej a.s. Metódy: Ide o retrospektívnu štúdiu zásahov posádok Falck Záchranná a.s. v roku 2015. Analyzované boli indikátory kvality činnosti posádok na scéne. Autori vychádzali z usmernenia Slovenskej spoločnosti pre urgentnú medicínu a medicínu katastrof z r. 2015. Autori analyzovali aj časové indikátory – dojazdový čas a čas odovzdania pacienta v cieľovom zdravotníckom zariadení. Tieto časy boli stratifikované do časových intervalov. Výsledky: Pre stanovenie indikátorov kvality výkonov na scéne bolo analyzovaných 1579 zásahov v roku 2015. Analyzované boli indikátory stanovenia presného mechanizmu a okolností vzniku KCP, prevencia a korekcia hypoxie, prevencia a liečba systémovej hypotenzie, monitoring vitálnych funkcií, imobilizácia krčnej chrbtice a smerovanie pacienta. Analýza časových parametrov bola pre medián dojazdového času 8:20 min pre RLP posádky a 9:42 min pre RZP posádky. Čas od dosiahnutia pacienta po odovzdanie v zdravotníckom zariadení bol v čase „zlatej hodiny“ dodržaný v 76,5% pacientov. Záver: Z množstva výsledkov, ktorými autori disponujú, prezentujú iba vybranú skupinu dát. Výsledky uvádzajú ako vzor a potenciálne východisko pri zverejňovaní ďalších dát v budúcnosti.
Introduction: Traumatic brain injury (TBI) is defined as the damage to the skull and the brain caused by external mechanical force, which results in temporary or permanent impairment of central nervous system function associated with varying degrees of disorder of consciousness. Severe TBI is the leading cause of mortality and disability in children and young adults. The aim of the work is to analyze the quality of prehospital emergency medical care in TBI patients managed by Falck rescue crews. Methods: This is a retrospective study of Falck rescue crews interventions in the year 2015. Quality indicators of crews´ activities on the scene were analyzed based on the recommendation of Slovak Society for Emergency Medicine and Disaster Medicine issued in 2015. Selected time indicators are response time and patient handover target in the hospital. These times were stratified into time slots. Results: In 2015 overall 1,549 medical reports were analyzed to determine the quality indicators of scene performances. The analyzed indicators were determining the precise mechanism and the circumstances of the TBI, correction of hypoxia, prevention and treatment of systemic hypotension, continuous monitoring of vital functions, cervical spine immobilization of the patient and his transport to proper facilities. Analysis of time indicators showed the response time median 8:20 minutes for doctor crews and 9:42 minutes for paramedic crews. The patient delivery to a hospital from the scene was achieved within 60 minutes (golden hour) for 76.5% patients. Discussion: Authors present the selected group of data which could be used as a potential model basis for health policy authorities. Similar analyses are needed for the other First hour quintet diagnoses.
- MeSH
- čas zasáhnout při rozvinutí nemoci normy statistika a číselné údaje MeSH
- kraniocerebrální traumata diagnóza epidemiologie ošetřování MeSH
- lidé MeSH
- neodkladná péče o pacienty s traumatem metody MeSH
- skóre závažnosti úrazu MeSH
- transport pacientů metody normy statistika a číselné údaje MeSH
- ukazatele kvality zdravotní péče MeSH
- urgentní zdravotnické služby * organizace a řízení statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Slovenská republika MeSH
INTRODUCTION: The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe. METHODS: This was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries. RESULTS: Data on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge. CONCLUSION: The results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe. EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events.
- MeSH
- analýza přežití MeSH
- incidence MeSH
- kardiopulmonální resuscitace statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- registrace MeSH
- senioři MeSH
- urgentní zdravotnické služby statistika a číselné údaje MeSH
- zástava srdce mimo nemocnici mortalita terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
