Leung L P, Wong T W, Tong H K, Lo C B, Kan P G
Accident & Emergency Department, Queen Mary Hospital, Pokfulam, Hong Kong.
Prehosp Emerg Care. 2001 Jul-Sep;5(3):308-11. doi: 10.1080/10903120190939887.
To evaluate the effectiveness of the local emergency medical services system in resuscitation of out-of-hospital cardiac arrest and identify areas for improvement.
This was a prospective descriptive study of adults with nontraumatic out-of-hospital cardiac arrest treated in the three accident & emergency departments that serve the whole of Hong Kong Island from March 15, 1999, to October 15, 1999. Patient characteristics, circumstances of cardiac arrest, final outcomes, and response times of the ambulance service were recorded according to the Utstein style.
Three hundred twenty patients were included. There was male predominance, and the mean age was 71.5 years. The majority of cardiac arrests occurred at patients' homes. In 57.5% of cases the arrest was not witnessed. The bystander cardiopulmonary resuscitation (CPR) rate was 15.6%. The most common electrocardiographic (ECG) rhythm at scene was asystole. Ventricular fibrillation or pulseless ventricular tachycardia constituted 14.1%. The average call to dispatch interval was 1.04 minutes. The average call to CPR interval was 9.82 minutes. The average total prehospital interval was 27.55 minutes. The overall immediate survival rate was 14.1% and the rate of survival to hospital discharge was 1.25%.
The prognosis of out-of-hospital cardiac arrest in Hong Kong was dismal. Every link in the chain of survival has to be improved.
评估当地紧急医疗服务系统对院外心脏骤停复苏的有效性，并确定改进的领域。
这是一项对1999年3月15日至1999年10月15日在服务于整个香港岛的三个急症科接受治疗的非创伤性院外心脏骤停成人患者的前瞻性描述性研究。根据Utstein模式记录患者特征、心脏骤停情况、最终结局以及救护车服务的响应时间。
纳入320例患者。男性居多，平均年龄为71.5岁。大多数心脏骤停发生在患者家中。57.5%的病例心脏骤停未被目击。旁观者心肺复苏（CPR）率为15.6%。现场最常见的心电图（ECG）节律是心脏停搏。室颤或无脉性室性心动过速占14.1%。平均呼叫至调度间隔为1.04分钟。平均呼叫至CPR间隔为9.82分钟。平均总院前间隔为27.55分钟。总体即时生存率为14.1%，出院生存率为1.25%。
香港院外心脏骤停的预后不佳。生存链中的每个环节都必须改进。
