Christensen Alf Jørgen Møl, Schønemann Niels Kim, Dahl Bent Lob, Landsfeldt Uffe Steen
Arhus Universitetshospital, laegeambulancen Arhus.
Ugeskr Laeger. 2002 Mar 4;164(10):1345-8.
The Mobile Emergency Care Unit (MECU) in Arhus includes an experienced anaesthesiologist and a specially trained rescuer. It covers a radius of 25 km from the centre of Arhus with 330,000 inhabitants. Rescue workers in Denmark are permitted to give basic life support and defibrillation. The MECU carriers out advanced cardiac life support in accordance with "The 1998 Guidelines of the European Resuscitation Council".
Data collected by the MECU doctor on a standardised chart and survival data received from the Central Hospital Database were analysed retrospectively.
In 1998, 4725 emergency calls were received. Twenty-five per cent of the calls were for trauma, 515 patients had cardiac disease, 158 of whom had cardiac arrest. In 86 patients, death was determined on the spot and no treatment was given. Seventy-two patients received advanced cardiac life support. Twenty-five patients were admitted to hospital. Thirteen patients were alive one year later, which gives a survival rate of 52% of the patients admitted to hospital. Of the 25 patients who were resuscitated and admitted to hospital, 21 received defibrillation, 16 were intubated, 19 had adrenaline, 11 lidocaine, and 9 amidarone. Other drugs used were atropine, NaHCO3, sotalol, and CaCl.
These results illustrate that for patients with out-of-hospital cardiac arrest early treatment with advanced cardiac life support performed by experienced doctors probably had a positive impact on survival, as compared to basic cardiac life support.
奥胡斯的移动急救单元(MECU)包括一名经验丰富的麻醉师和一名经过专门培训的救援人员。它覆盖了距离奥胡斯市中心25公里的范围,该区域有33万居民。丹麦的救援人员被允许进行基本生命支持和除颤操作。MECU按照“欧洲复苏委员会1998年指南”开展高级心脏生命支持。
对MECU医生在标准化图表上收集的数据以及从中央医院数据库获得的生存数据进行回顾性分析。
1998年,共接到4725次急救电话。其中25%的电话是关于创伤的,515名患者患有心脏病,其中158人发生心脏骤停。86名患者在现场被判定死亡,未给予治疗。72名患者接受了高级心脏生命支持。25名患者被送往医院。13名患者在一年后仍存活,这使得入院患者的存活率为52%。在25名复苏成功并入院的患者中,21人接受了除颤,16人进行了插管,19人使用了肾上腺素,11人使用了利多卡因,9人使用了胺碘酮。使用的其他药物有阿托品、碳酸氢钠、索他洛尔和氯化钙。
这些结果表明,对于院外心脏骤停患者,与基本心脏生命支持相比,由经验丰富的医生进行高级心脏生命支持的早期治疗可能对存活率有积极影响。