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院外心脏骤停(OHCA)中紧急医疗服务(EMS)响应时间及操作因素的评估:一项回顾性分析

Assessment of Emergency Medical Service (EMS) response times and operational factors in out-of-hospital cardiac arrests (OHCA): a retrospective analysis.

作者信息

Goniewicz Mariusz, Bednarz Kamil, Al-Wathinani Ahmed M, Goniewicz Krzysztof

机构信息

Department of Emergency Medicine, Medical University of Lublin, Poland.

Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia.

出版信息

Postepy Kardiol Interwencyjnej. 2025 Mar;21(1):25-36. doi: 10.5114/aic.2024.145345. Epub 2024 Nov 26.

Abstract

INTRODUCTION

Out-of-hospital cardiac arrests (OHCAs) require rapid emergency medical service (EMS) responses to improve patient outcomes. This study examines non-patient factors affecting EMS response times and OHCA outcomes, particularly return of spontaneous circulation (ROSC), with a focus on factors such as location, time of day, and season.

AIM

To evaluate the influence of operational and situational factors on EMS response times and their association with ROSC rates.

MATERIAL AND METHODS

A retrospective analysis was performed using EMS records from the Lublin Voivodeship, Poland, covering 2014 to 2017. A total of 4,361 OHCA cases were selected from an initial 5,111 identified cases through ICD-10 and ICD-9 codes, utilizing call-out cards and medical rescue activity cards. Statistical analyses, including χ tests and correlation coefficients, assessed the impact of socio-demographic and operational factors on ROSC outcomes.

RESULTS

Shorter EMS response times were significantly associated with higher ROSC rates, with a mean response time of 7.92 min for ROSC cases (SD = 4.86) versus 8.29 min for non-ROSC cases (SD = 4.19; = 0.0430). High-priority cases (K-1) had better ROSC outcomes (16.97%) compared to lower-priority cases (K-2: 12.30%; < 0.05). Time of day and season did not significantly impact response effectiveness.

CONCLUSIONS

Rapid EMS response and effective prioritization improve ROSC rates in OHCA incidents. The findings highlight the need to optimize EMS protocols and training, with targeted strategies that consider operational factors to enhance survival rates across varied populations.

摘要

引言

院外心脏骤停(OHCA)需要紧急医疗服务(EMS)快速响应以改善患者预后。本研究考察影响EMS响应时间和OHCA预后的非患者因素,尤其是自主循环恢复(ROSC)情况,重点关注地点、一天中的时间和季节等因素。

目的

评估操作和情境因素对EMS响应时间的影响及其与ROSC率的关联。

材料与方法

利用波兰卢布林省2014年至2017年的EMS记录进行回顾性分析。通过ICD - 10和ICD - 9编码,从最初识别的5111例病例中,利用出诊卡和医疗救援活动卡选取了4361例OHCA病例。包括χ检验和相关系数在内的统计分析评估了社会人口统计学和操作因素对ROSC结果的影响。

结果

较短的EMS响应时间与较高的ROSC率显著相关,ROSC病例的平均响应时间为7.92分钟(标准差 = 4.86),而非ROSC病例为8.29分钟(标准差 = 4.19;P = 0.0430)。高优先级病例(K - 1)的ROSC结果(16.97%)优于低优先级病例(K - 2:12.30%;P < 0.05)。一天中的时间和季节对响应效果没有显著影响。

结论

EMS快速响应和有效的优先级划分可提高OHCA事件中的ROSC率。研究结果凸显了优化EMS方案和培训的必要性,以及采用考虑操作因素的针对性策略以提高不同人群的生存率。

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