Frandsen F, Nielsen J R, Gram L, Larsen C F, Jørgensen H R, Hole P, Haghfelt T
Department of Cardiology, University Hospital of Odense, Denmark.
Cardiology. 1991;79(4):256-64. doi: 10.1159/000174888.
During a period of 3 years three different types of emergency medical service (EMS) systems were evaluated in a city with about 238,000 inhabitants/population density of 570/km2. Included were 393 out-of-hospital cardiac arrest patients in whom prehospital cardiopulmonary resuscitation was provided by personnel on basic, intermediate, or advanced care training. When ordinary ambulances (basic EMS) were used, 8 (5%) patients were discharged alive. When ambulances with specially trained paramedics (intermediate EMS) were used, 2 (1%) patients were discharged. Finally medically staffed ambulances with doctors collaborating (advanced EMS) were used, and 11 (13%) patients were discharged. The intermediate EMS system was used in another area with 45,000 inhabitants/population density of 340/km2, and in this area 20 (18%) patients were discharged. Among the survivors a psychological assessment in form of a test for dementia was assessed in long-term survivors (n = 30) together with 28 patients surviving acute myocardial infarction and 11 control persons. The results of the investigation demonstrate that the more intensive the prehospital treatment of out-of-hospital cardiac arrest, the more patients survive and the more patients survive with good cerebral function. However, the ambulances with specially trained paramedics were only effective in the area with 340 inhabitants/km2.
在三年时间里，在一个约有23.8万居民/人口密度为每平方公里570人的城市中，对三种不同类型的紧急医疗服务（EMS）系统进行了评估。其中包括393例院外心脏骤停患者，他们接受了基础、中级或高级护理培训人员提供的院前心肺复苏。使用普通救护车（基础EMS）时，有8名（5%）患者存活出院。使用配备经过专门训练的护理人员的救护车（中级EMS）时，有2名（1%）患者存活出院。最后使用了有医生协作的配备医务人员的救护车（高级EMS），有11名（13%）患者存活出院。中级EMS系统在另一个有4.5万居民/人口密度为每平方公里340人的地区使用，在该地区有20名（18%）患者存活出院。在幸存者中，对长期幸存者（n = 30）以及28名急性心肌梗死幸存者和11名对照人员进行了以痴呆症测试形式的心理评估。调查结果表明，院外心脏骤停的院前治疗越强化，存活的患者就越多，且存活且脑功能良好的患者也越多。然而，配备经过专门训练的护理人员的救护车仅在每平方公里有340名居民的地区有效。
