van der Hoeven J G, Waanders H, Compier E A, van der Weyden P K, Meinders A E
Department of General Internal Medicine, University Hospital, Leiden, The Netherlands.
Ann Emerg Med. 1993 Nov;22(11):1659-63. doi: 10.1016/s0196-0644(05)81303-4.
To determine who may benefit from prolonged resuscitation efforts after therapy by emergency medical services system (EMS) personnel has failed to restore vital signs.
Retrospective chart review.
Two hundred sixteen consecutive adult patients with out-of-hospital cardiac arrest who were admitted to the emergency department without vital signs.
Identification of prehospital resuscitation data, therapy in the ED, hospital course, and final outcome.
Thirty-nine patients (18.1%) were resuscitated successfully. The odds ratio of successful resuscitation in the ED for the patients with ventricular fibrillation at the scene versus those with asystole or electromechanical dissociation was 3.4 (95% confidence interval, 1.5, 7.9). All patients with asystole or electromechanical dissociation, either at the scene or in the ED, died (95% confidence interval, 0, 4.3).
Prolonged resuscitation efforts in the ED for patients with asystole or electromechanical dissociation usually are futile after previous efforts by the EMS personnel have failed to restore vital signs. Transportation to the hospital may not be indicated. However, for patients with persistent ventricular fibrillation, transport is indicated.
确定在紧急医疗服务系统（EMS）人员的治疗未能恢复生命体征后，哪些人可能从延长复苏努力中获益。
回顾性病历审查。
连续216例无生命体征被收入急诊科的院外心脏骤停成年患者。
识别院前复苏数据、急诊科治疗、住院过程及最终结局。
39例患者（18.1%）成功复苏。现场为心室颤动的患者与心搏停止或电机械分离的患者相比，在急诊科成功复苏的优势比为3.4（95%置信区间，1.5, 7.9）。所有现场或急诊科有心搏停止或电机械分离的患者均死亡（95%置信区间，0, 4.3）。
对于心搏停止或电机械分离的患者，如果EMS人员先前的努力未能恢复生命体征，在急诊科延长复苏努力通常是徒劳的。可能无需送往医院。然而，对于持续性心室颤动患者，应送往医院。
