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Abstracts / Resuscita

P027

statistical study of the utstein registers in extra hospital service

ésar Fernández, González Riscos

Consorci Sanitari Del Garraf, Spaineywords: Utstein; Survival Chain; Desfibrillation; Statistical

Purpose: - To determinate the number of people attended by sex, age and the placef intervention. - To determinate the importance of the chain of survival corrrect apli-ation, the lowest time needed to begin the basic techniques, the advanced and theesfibrillation, taking in consideration the witnessed cases, the beginning rhythms andhe desfibrillations cases; following the ERC recommendations.

Methodology: - A retrospective analysis of the Utsteins registers made by our medicalervices assistant extra hospital during 2009 (and expandable in 2010).

Results: - They were registered 61 cases with a 11.5% of recuperation index. - Theumber of men attended was higer than the number of women, with a proportion of 3:1.The middle age for men was 59 whereas for women was 69. - The 57% of the cases were

n a domiciliary area. - The 56% of the cases were witnessed, while the 20% were attendedy profesional health workers. - The 85% were rhythms without desfibrillation. - Of theetrieved cases: the 100% were witnessed and the 71% with beginning desfibrillationshythms. The basic techniques were applied before 4’ in the 86%, with desfibrillationefore 8’ in the 80% and advanced techniques in the 100%.

Conclusions: - There were more incidence in men than women. The men were 10ears younger than women. Almost all the cases were domiciliary. - It was proved themportance of the correct and quickly application of the Survival Chain for achiving higerndex of retrievered cases, as the ERC said. Being determinant the witnessed cases andhe desfibrillation rhythms.

oi:10.1016/j.resuscitation.2010.09.172

P028

pidemiology of out-of-hospital cardiac arrests in Wroclaw region vs. requirementsor the location of automated external defibrillators

hecinski I. 1, Zysko D. 1, Smereka J. 1, Gajek J. 2, Wroblewski P. 1, Terpilowski L. 1

Teaching Department for Emergency Medical Service, Wroclaw Medical University, PolandDepartment of Cardiology, Wroclaw Medical University, Wroclaw, Poland

The purpose of the study was to analyse the epidemiology of out-of-hospital cardiacrrests in Wroclaw region and to assess which locations of cardiac arrests could meet theequirements for installing automated external defibrillators.

Materials and methods: Retrospective analysis of EMS medical records of 734 patientsith out-of-hospital non-trauma cardiac arrest in 2007 in Wroclaw region. Patients wereivided into 2 groups excluding cases with end-stage cancer disease and trauma cases.roup I (640 pts, 87% males) consisted of patients with cardiac arrest occurring at homend group II (94 pts, 54% males) cardiac arrests in other locations. Analysed data included:ge, sex, arrival time, time of cardiac arrest, witnessed cardiac arrest, bystander CPR andatients’ location.

Results: Majority of cardiac arrest cases occurred at patients’ homes (640 vs. 94). CPRn group I was successful in 28 cases whereas in group II in 8 cases. Mean age in group I was1.8 ± 16.5ys and was significantly higher than group II 59.4 ± 13.0ys CPR in group II wasorrelated with higher probability of ROSC. Group II patients were analysed to verify if thelace the cardiac arrest occurred could have been theoretically equipped with automatedxternal defibrillator. It was assumed that public places: churches, shops, post offices, busnd railway terminals as well as workplaces and every type of health care facility coulde equipped with AED. The analysis revealed that in group II in 33 cases the location coulde theoretically equipped with AED. Majority of out-of-hospital cardiac arrest cases (701f 734–95.5%) occurred in locations that have not met the requirements to be equippedith AED.

Conclusions:

. Majority of out-of-hospital cardiac arrests in Wroclaw region occurs at patients’ homes.

. There is relatively small group of patients with cardiac arrest occurring in public places.

oi:10.1016/j.resuscitation.2010.09.173

1S (2010) S1–S114 S41

AP029

Bystander CPR in copenhagen – An increasing figure

Krogh C.L. 1, Nielsen S.L. 1, Lippert F.K. 2

1 Mobile Emergency Care Unit, The Capital Region of Denmark, Copenhagen, Denmark2 Emergency Medical Services, Head Office, The Capital Region of Denmark, Copenhagen,Denmark

Prognosis for Out-of-Hospital Cardiac Arrest (OHCA) has recently been described asunchanged for decades.1 Bystander cardio-pulmonary-resuscitation (CPR) is essential tooutcome.2 Previous published data from Copenhagen document bystander CPR in 28% in2002–2004, 24% in 2004–2005 and 28% in 2006–2007.3,4

Purpose: This study describes survival rates for OHCA and the frequency of bystanderCPR in Copenhagen in the year 2009.

Materials and methods: The Emergency Medical Services System (EMS) of Copenhagenis a two tiered system with Emergency Medical Technicians (EMT) based ambulances in arendez-vous with a physician manned mobile emergency care unit (MECU). All OHCA dataare routinely collected by the MECU according to Utstein recommendations, including30-days survival.3,4

Results: In 2009 resuscitation was attempted in totally 700 OHCA. Bystander CPRwas initiated in 285 (41%) patients. Return of spontaneous circulation (ROSC) on arrivalto hospital was achieved in 265 cases (38%). In 145 (55%) of those bystander CPR hasbeen started. Survival for 30 days was in total 107 (15%). In those 107 patients who weresuccessfully resuscitated and survived 30 days, bystander CPR had been observed in 72cases (67%).

Conclusion: The overall 30-days survival for OHCA in Copenhagen was 15% in 2009.The percentage of patients receiving bystander CPR in Copenhagen has increased from28% in 2004 to 41% in 2009 – the highest number documented in Copenhagen the last 10years. Of those who survive 30 days, 67% had received bystander CPR.

References

1. Sasson C, et al. Circ Cardiovasc Qual Outcomes 2010;3:63–81.2. Holmberg M, et al. Resuscitation 2000;47:59–70.3. Horsted TI, et al. Resuscitation 2007;72:214–8.4. Steinmetz J, et al. Acta Anaesthesiol Scand 2008;52:908–13.

doi:10.1016/j.resuscitation.2010.09.174

AP030

Outcome following physician supervised prehospital resuscitation

Brochner A.C. 1,3, Hatting N.P. 2,3, Mikkelsen S. 3

1 Department of Anaesthesiology, Lillebaelt Hospital, Kolding, Denmark2 Department of Anaesthesiology, Lillebaelt Hospital, Vejle, Denmark3 Mobile Emergency Care Unit, Department of Anaesthesiology and Intensive Care Medicine,Odense University Hospital, Odense Denmark

Purpose: To investigate the impact of physician supervised prehospital medical treat-ment on survival of patients.

Materials and methods: The Mobile Emergency Care Unit (MECU) in Odense, Denmark,services a population of 300,000 people. All MECU runs are registered in a database bythe attending physician, who rates the outcome of the combined prehospital effort.

In a study period of 4 years, all procedures rated life-saving by the attending anaes-thesiologist were subjected to an audit in order to validate this rating and to establishwhether the presence of a physician improved the outcome.

Explicit criteria included intubation, advanced medical treatment in case of cardiacarrest, and defibrillation when indicated by the attending physician.

Implicit criteria were advanced medical treatment in severe shock states exceedingthe competences of the attending paramedic.

The outcome of each patient following admission to hospital was sought by manuallysearching medical files.

Results: 17980 MECU runs were registered. 16040 patients were treated by the MECU.In 392 cases, the outcome was registered as life saving, enabling the patient to reach

the hospital alive.69 patients were resuscitated within the competences of the paramedics and thus

excluded.Of the 323 patients resuscitated by the attending phycisian, 128 lived to be discharged

to their homes.17 were transferred to rehabilitation without cerebral sequelae. 19 patients suffered

moderate to severe cerebral sequelae.148 died at the hospital.11 patients were lost to follow-up.

Conclusion: Patients resuscitated by physicians are distributed in primarily two

groups: One group (39%), discharged to home, and another group (45%), who dies at thehospital. Only a limited number (6%) suffers severe cerebral sequelae or other sequelae(5%) following resuscitation.

doi:10.1016/j.resuscitation.2010.09.175