Adams J N, Sirel J, Marsden K, Cobbe S M
Department of Medical Cardiology, Royal Infirmary, Glasgow, UK.
Heart. 1997 Oct;78(4):399-402. doi: 10.1136/hrt.78.4.399.
To assess the frequency with which paramedic skills were used in out of hospital cardiac arrest and the effect of tracheal intubation on outcome.
Retrospective analysis of ambulance service reports and hospital records.
Scottish Ambulance Service and hospitals admitting acute patients throughout Scotland.
A total of 8651 out of hospital resuscitation attempts were recorded and tracheal intubation was attempted in 3427 (39.6%) arrests. One hundred and thirty six patients (3.7%) were intubated and 476 (9.1%) of the patients who were not intubated survived to hospital discharge (p < 0.001). Among the patients who were defibrillated the proportion intubated was highest in the patients who received the greatest number of shocks (p < 0.01). Among subjects receiving similar numbers of shocks survival rates were lower for intubated patients (p < 0.01). Patients with unwitnessed arrests were most frequently intubated and survival rates were lowest in this group.
Patients who are intubated seem to have lower survival rates. This may however reflect the difficulty of the resuscitation attempt rather than the effects of intubation. The use of basic life support skills rapidly after cardiac arrest is associated with the best survival rates.
评估院外心脏骤停时护理人员技能的使用频率以及气管插管对预后的影响。
对救护车服务报告和医院记录进行回顾性分析。
苏格兰救护车服务机构以及苏格兰各地收治急症患者的医院。
共记录了8651次院外复苏尝试，其中3427例（39.6%）心脏骤停患者尝试了气管插管。136例患者（3.7%）成功插管，未插管患者中有476例（9.1%）存活至出院（p<0.001）。在接受除颤的患者中，接受电击次数最多的患者插管比例最高（p<0.01）。在接受相似电击次数的受试者中，插管患者的存活率较低（p<0.01）。未被目击心脏骤停的患者插管频率最高，且该组存活率最低。
插管患者的存活率似乎较低。然而，这可能反映了复苏尝试的难度，而非插管的影响。心脏骤停后迅速使用基本生命支持技能与最佳存活率相关。
