Evaluation of Emergency Medical Services for Out-of-hospital Cardiopulmonary Arrest Patients Using the Quantification Theory to Assess Outcome.
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概要
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To evaluate the emergency medical services (EMS) for out-of-hospital cardiopulmonary arrest (oh-CPA) in Japan, we analyzed 1, 042 oh-CPA cases that had been transported to our hospital between 1989 and 1998 using a multivariate analysis, quantification method II. Prognostic factors influencing the outcomes (spontaneous circulation, survival, and good recovery) of CPA cases were evaluated by the explanatory variates of etiology, age, witnessed arrest, bystander CPR, crew of EMS (medical doctor, emergency life guard (ELG), or ambulance personnel), time interval from collapse to arrival, and arrival status (CPA or out-of-hospital return of spontaneous circulation). In addition, of the 1, 042 oh-CPA cases, we examined the same factors in 211 cardiogenic oh-CPA cases. In the cardiogenic CPA cases, influential factors for survival included arrival status, etiology, time interval and age. Factors for good recovery included arrival status, bystander CPR and etiology. EMS was not an influential factor in any case. However, among the cardiogenic oh-CPA cases, EMS positively influenced both the survival and good recovery. Moreover, Japanese ELGs improved the survival rate of cardiogenic oh-CPA cases. These findings suggest that to improve the outcome of oh-CPA patients, spontaneous circulation should be established in the prehospital setting, the frequency of bystander CPR should be increased, and the time interval from collapse to hospital arrival reduced.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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