Tijek i ishod kardiopulmonalnih reanimacija u Kliničkom bolničkom centru Rijeka
Boban Dangubić, Kristijan Deša, Vjekoslav Tomulić, Kazimir Juričić, Janja Kuharić, Alen Protić
Abstract
Boban Dangubić, Kristijan Deša, Vjekoslav Tomulić, Kazimir Juričić, Janja Kuharić, Alen Protić
Abstract
Objective: The outcome of cardiac arrest and cardiopulmonary resuscitation measures depends on the implementation of the ERC guidelines as well as their timely enforcement. The aim of the study was to determine differences in measures of cardiopulmonary resuscitation (CPR) provided within different departments of Clinical Hospital Centre (KBC) Rijeka. Patients and methods: Prospective analysis covered 63 patients who underwent CPR following cardiac arrest in KBC Rijeka during 15-month study period (June 2011 to September 2012). Results: Return of spontaneous circulation was achieved in 23 patients (36 %), whereas 40 patients (64 %) had lethal outcome. Until the arrival of resuscitation team basic life support (BLS) was provided to all patients (100 %). In most cases (79 %) initial rhythm was non-shockable rhythm (asystole or pulseless electrical activity), while the rest (21 %) were shockable rhythms (pulseless ventricular tachycardia or ventricular fibrilation). After the return of spontaneous circulation 6 patients (26 %) had favorable neurological outcome (CPC-score 1 and 2) while 17 patients (74 %) had significant neurological disorder (CPC-score 3,4 and 5). Discussion and conclusion: In order to improve the outcome it is necessary to provide education in basic and advanced life support for all medical personnel on hospital wards as well as Intensive care units and Emergency medicine department. Rapid response team and the use of ‘track-and-trigger systems’ to detect the deteriorating patient should be organized together with equipment and material normative standards at wards and departments with high risk of cardiac arrest occurrence.
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Objective: The outcome of cardiac arrest and cardiopulmonary resuscitation measures depends on the implementation of the ERC guidelines as well as their timely enforcement. The aim of the study was to determine differences in measures of cardiopulmonary resuscitation (CPR) provided within different departments of Clinical Hospital Centre (KBC) Rijeka. Patients and methods: Prospective analysis covered 63 patients who underwent CPR following cardiac arrest in KBC Rijeka during 15-month study period (June 2011 to September 2012). Results: Return of spontaneous circulation was achieved in 23 patients (36 %), whereas 40 patients (64 %) had lethal outcome. Until the arrival of resuscitation team basic life support (BLS) was provided to all patients (100 %). In most cases (79 %) initial rhythm was non-shockable rhythm (asystole or pulseless electrical activity), while the rest (21 %) were shockable rhythms (pulseless ventricular tachycardia or ventricular fibrilation). After the return of spontaneous circulation 6 patients (26 %) had favorable neurological outcome (CPC-score 1 and 2) while 17 patients (74 %) had significant neurological disorder (CPC-score 3,4 and 5). Discussion and conclusion: In order to improve the outcome it is necessary to provide education in basic and advanced life support for all medical personnel on hospital wards as well as Intensive care units and Emergency medicine department. Rapid response team and the use of ‘track-and-trigger systems’ to detect the deteriorating patient should be organized together with equipment and material normative standards at wards and departments with high risk of cardiac arrest occurrence.
Key concepts: Return of spontaneous circulation, Cardiopulmonary resuscitation, Medicine, Asystole, Pulseless electrical activity, Basic life support, Advanced cardiac life support, Resuscitation