根据医疗急救服务响应时间,旁观者减动和存活在非医院心脏骤停后:全国性的基于注册的队列研究
Mathias Hindborg1, Harman Yonis1, Filip Gnesin1
1Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark.
Prehospital emergency care
|March 26, 2025
概括
旁观者自动化外部除器 (AED) 的使用显着改善了公共场所的非医院心脏骤停患者的30天存活率,当紧急医疗服务 (EMS) 响应时间为7-9分钟时. 在住宅环境或有不同的响应时间的情况下,没有观察到这种好处.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
背景情况:
- 将旁观者自动外部除器 (AED) 的使用整合到紧急医疗服务 (EMS) 响应系统中,对于改善医院外心脏骤停 (OHCA) 存活率至关重要.
- 关于EMS响应时间对旁观者使用AED有效性的确切影响仍然是一个需要进一步研究的领域.
研究的目的:
- 对接受旁观者与非旁观者除治疗的患者的不同EMS反应时间的30天生存概率进行调查.
- 为了确定特定的EMS响应时间间隔,旁观者除动器可明显提高30天生存率.
主要方法:
- 来自丹麦心脏骤停登记处 (2016-2022) 的数据分析,对旁观者目击的OHCAs进行初始可震动节律和旁观者心肺复苏.
- 利用目标最大概率估计来估计30天的生存概率在不同的EMS响应时间间隔,并比较结果和没有旁观者除,调整混因素.
- 对住宅和公共OHCA地点进行了分层分析.
主要成果:
- 该研究包括3,924名OHCA患者;旁观者除在公共场所 (64.1%) 比住宅 (35.9%) 更常见.
- 在公共OHCAs中,旁观者除与更高的30天生存概率 (生存率1.24 [95% CI: 1.03; 1.49]) 相关,EMS反应时间为7-9分钟.
- 通常观察到更高的30天生存率与更短的EMS响应时间,无论旁观者除.
结论:
- 在公共OHCAs中,通过旁观者除获得了显著的30天生存益处,EMS反应时间为7-9分钟.
- 在住宅环境中或在其他EMS响应时间间隔中对旁观者除没有观察到生存益处.
- 这些发现强调了公共场所及时使用AED进行旁观者干预的重要性,以增加OHCA患者的EMS响应.
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