Department of Emergency Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 841051, Israel.
Maccabi Healthcare Services, Tel-Aviv 6812509, Israel.
Int J Environ Res Public Health. 2021 Jun 19;18(12):6612. doi: 10.3390/ijerph18126612.
Out-of-hospital cardiac-arrest (OHCA) is a major public health challenge. Community health care providers (CHP) may play an important role through early identification, basic life support and defibrillation. Few studies have evaluated the incidence and characteristics of OHCAs initially cared for by CHP, most finding improved survival. This study combined CHP treated OHCA case analysis, with assessment of provider resuscitation preparedness.
An analysis of all CHP initiated resuscitations in a large Health Maintenance Organization (HMO) reported over 42 months, coupled with an online survey assessing CHP resuscitation knowledge, experience, training and self-confidence.
22 resuscitations met inclusion criteria. In 21 CHP initiated chest-compressions but in only 8 cases they utilized the clinic's automated external defibrillator (AED) prior to emergency medical services (EMS) arrival. There were 275 providers surveyed. Of the surveyed providers, 89.4% reported previous basic life support (BLS)/advanced cardiovascular life support (ALS) training, 67.9% within the last three years. Previous resuscitation experience was reported by 72.7%. The lowest scoring knowledge question was on indications for AED application -56.3%. Additionally, 44.4% reported low confidence in their resuscitation skills. CHP with previous cardiopulmonary resuscitation (CPR) experience reported higher confidence. Longer time since last CPR training lowered self-confidence.
Early AED application is crucial for patients with OHCA. All clinics in our study were equipped with AED's and most CHP received training in their use, but remained insecure regarding their use, often failing to do so.
院外心脏骤停（OHCA）是一个主要的公共卫生挑战。社区卫生保健提供者（CHP）可以通过早期识别、基本生命支持和除颤来发挥重要作用。很少有研究评估最初由 CHP 护理的 OHCA 的发生率和特征，大多数研究发现生存率有所提高。本研究将 CHP 治疗的 OHCA 病例分析与评估提供者复苏准备情况相结合。
对在 42 个月内报告的大型医疗保健组织（HMO）中所有由 CHP 启动的复苏进行分析，并结合在线调查评估 CHP 复苏知识、经验、培训和自我信心。
22 例复苏符合纳入标准。在 21 例由 CHP 启动的胸部按压中，但在紧急医疗服务（EMS）到达之前，只有 8 例使用了诊所的自动体外除颤器（AED）。共有 275 名提供者接受了调查。在接受调查的提供者中，89.4%报告以前接受过基本生命支持（BLS）/高级心血管生命支持（ALS）培训，67.9%是在过去三年内接受的。72.7%的人报告有以前的复苏经验。得分最低的知识问题是关于 AED 应用的指征-56.3%。此外，44.4%的人对自己的复苏技能缺乏信心。有以前心肺复苏（CPR）经验的 CHP 报告说信心更高。上次接受 CPR 培训的时间越长，自我信心越低。
早期应用 AED 对 OHCA 患者至关重要。我们研究中的所有诊所都配备了 AED，大多数 CHP 都接受过使用培训，但在使用 AED 方面仍不自信，往往无法使用。
