Lui J C
Department of Anaesthesia, Caritas Medical Centre, Kowloon, Hong Kong, China.
Resuscitation. 1999 Jul;41(2):113-9. doi: 10.1016/s0300-9572(99)00058-1.
A retrospective 6-month audit of out-of-hospital cardiac arrests in Hong Kong following the introduction of automatic external defibrillators is presented. During the 6-month period from 1 July 1995 to 31 December 1995, resuscitation was attempted on 754 patients. Of the 744 patients with cardiac arrest whose records were available, 53.6% had a witnessed arrest. Few cardiac arrest patients (8.9%) received bystander cardiopulmonary resuscitation (CPR) and the majority (80%) of arrests occurred at home. Six hundred and forty-three (86.4%) patients were declared dead on arrival at hospital or in the Accident and Emergency department; 89 (12%) died in hospital and only 12 (1.6%) were discharged alive. The average ambulance response interval (call receipt to arrival of ambulance at scene) was 6.42 min. The average arrest-to-first-shock interval was 23.77 min. Factors predicting survival included initial rhythm and arrest-to-first-shock interval. The survival rate of 1.6% is low by world standards. To improve the survival rates of people with out-of-hospital cardiac arrest, the arrest-to-call interval must be reduced and the frequency of bystander CPR assistance increased. Once these changes are in place, a beneficial effect from the use of pre-hospital defibrillation might be seen.
本文介绍了香港引入自动体外除颤器后对院外心脏骤停进行的为期6个月的回顾性审计。在1995年7月1日至1995年12月31日的6个月期间，对754例患者进行了复苏尝试。在有记录的744例心脏骤停患者中，53.6%的患者心脏骤停被目击。很少有心脏骤停患者（8.9%）接受旁观者心肺复苏（CPR），大多数（80%）的心脏骤停发生在家中。643例（86.4%）患者在抵达医院或急症室时被宣布死亡；89例（12%）在医院死亡，只有12例（1.6%）存活出院。救护车平均反应间隔（接到呼叫到救护车到达现场）为6.42分钟。平均心脏骤停至首次电击间隔为23.77分钟。预测生存的因素包括初始心律和心脏骤停至首次电击间隔。按照世界标准，1.6%的生存率很低。为了提高院外心脏骤停患者的生存率，必须缩短心脏骤停至呼叫的间隔时间，并增加旁观者心肺复苏协助的频率。一旦这些改变落实到位，可能会看到院前除颤的有益效果。
