緊急医療システムの蘇生中に胸部圧迫の中断

Terence D Valenzuela¹, Karl B Kern, Lani L Clark

¹Emergency Medicine Research Center, University of Arizona, Tucson, AZ, USA.

Circulation

|August 24, 2005

まとめ

病院外での心停止再蘇生の努力中に胸圧縮の頻繁な中断は,患者の生存を大幅に妨げます. 圧縮継続性の改善は,緊急心疾患のケアにおいてより良い結果を得るために極めて重要です.

科学分野:

緊急医療緊急医療
心臓病学心臓病学
蘇生科学蘇生科学とは

背景:

チューソンの病院外心停止 (OOHCA) の生存率は,1992年から2001年の間に6%で停滞していました.
10年にわたる平らな生存率は,蘇生プロトコルの潜在的な問題を示唆しています.

研究の目的:

胸部圧縮の頻繁かつ長期の中断が,OOHCAの低水準の蘇生に寄与するという仮説を検証する.
生存を阻害するかもしれない蘇生プロセス内の特定の要因を特定する.

主な方法:

2001年11月から2002年11月にかけて,トゥッソン消防局で治療を受けた61人の成人OOHCA患者の遡及的レビュー.
自動外部除細動器 (AED) のデータと緊急通話記録を分析して,蘇生パフォーマンスを評価する.
胸部圧縮の性能を決定するための方法論の検証は,ポストホックで行われました.

主要な成果:

9-1-1の呼び出しから患者の到着までの平均応答時間は6分27秒でした.
胸部圧縮は,総蘇生時間の43%しか行われませんでした.
病院退院までの生存率は7%で,過去の対照群 (P=0.74) との有意な差異は示されなかった.

結論:

胸部圧縮の繰り返し中断は,OOHCA蘇生中に循環器のサポートなしの長期間につながります.
これらの中断は,病院外での心停止症例で観察される継続的に低い生存率に貢献する重要な要因です.

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