Result of Treatment of Out-of-Hospital Cardiac Arrest by a Doctor Car.
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概要
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The city of Funabashi has operated a doctor car that can be dispatched to the scene on a 24-hours-a-day, 365-days-a-year basis since April 1993. The purpose of this report is to verify the usefulness of the doctor car in the treatment of out-of-hospital cardiopulmonary arrest (OHCPA). To elucidate problems in pre-hospital care, an Utstein style analysis was conducted of the outcome of 986 cases of OHCPA over a 4-year period in which the doctor car was dispatched, CPA was due to a witnessed heart disease in 247 of the 986 cases. On-scene ECGs in these 247 cases showed asystole in 154, VF/VT in 58, other findings in 33, and findings in 2 cases being unknown. As the result of advanced cardiac life support at the scene, a pulse returned in 45.7% of the cases, and 23.1% were admitted, 8.5% discharged, 6.9% survived 1 year, and 6.5% returned to a normal life or became independent within their households. In the cases of OHCPA in which the patients recovered to the point of returning to a normal life or independence, 72.7% were due to heart disease, and witnessed VF/VT accounted for 68.8% of them. Thus, witnessed VF/VT was found to be the largest target in OHCPA. The 1-year survival rate and rate of return to a normal life of witnessed VF/VT were 20.1% and 17.2%, respectively. These results compare favorably with the results in medium sized cities in the United States, and the doctor car has been found to be useful in the treatment of OHCPA. Stationing of emergency life-saving technicians in all rescue squads that arrive first, and efforts to increase bystander CPR by ordinary citizens are needed to further increase the resuscitation rate and rate of return to a normal life. The incidence of VF/VT encountered at the scene, however, is much lower than in the United States, suggesting a difference in disease structure in the two countries. It seems that a multi-regional epidemiological survey will be needed to resolve this point.
- 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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