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首页> 外文期刊>Prehospital emergency care >Time to first compression using medical priority dispatch system compression-first dispatcher-assisted cardiopulmonary resuscitation protocols
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Time to first compression using medical priority dispatch system compression-first dispatcher-assisted cardiopulmonary resuscitation protocols

机译：使用医疗优先分配系统进行首次压缩的时间压缩优先调度员辅助的心肺复苏方案

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Introduction. Without bystander cardiopulmonary resuscitation (CPR), cardiac arrest survival decreases 7%-10% for every minute of delay until defibrillation. Dispatcher-assisted CPR (D-CPR) has been shown to increase the rates of bystander CPR and cardiac arrest survival. Other reports suggest that the most critical component of bystander CPR is chest compressions with minimal interruption. Beginning with version 11.2 of the Medical Priority Dispatch System (MPDS) protocols, instructions for mouth-to-mouth ventilation (MTMV) and pulse check were removed and a compression-first pathway was introduced to facilitate rapid delivery of compressions. Additionally, unconscious choking and third-trimester pregnancy decision-making criteria were added in versions 11.3 and 12.0, respectively. However, the effects of these changes on time to first compression (TTFC) have not been evaluated. Objective. We sought to quantify the TTFC of MPDS versions 11.2, 11.3, and 12.0 for all calls identified as cardiac arrest on call intake that did not require MTMV instruction. Methods. Audio recordings of all D-CPR events for October 2005 through May 2010 were analyzed for TTFC. Differences in TTFC across versions were compared using the Kruskal-Wallis test. Results. A total of 778 cases received D-CPR. Of these, 259 were excluded because they met criteria for MTMV (pediatric patients, allergic reaction, etc.), were missing data, or were not initially identified as cardiac arrest. Of the remaining 519 calls, the mean TTFC was 240 seconds, with no significant variation across the MPDS versions (p = 0.08). Conclusions. Following the removal of instructions for pulse check and MTMV, as well as other minor changes in the MPDS protocols, we found the overall TTFC to be 240 seconds with little variation across the three versions evaluated. This represents an improvement in TTFC compared with reports of an earlier version of MPDS that included pulse checks and MTMV instructions (315 seconds). However, the MPDS TTFC does not compare favorably with reports of older, non-MPDS protocols that included pulse checks and MTMV. Efforts should continue to focus on improving this key, and modifiable, determinant of cardiac arrest survival.
机译：介绍。如果没有旁观者心肺复苏（CPR），则在除颤之前每分钟的延迟，心脏骤停存活率会降低7％-10％。调度员辅助的心肺复苏（D-CPR）已被证明可以提高旁观者心肺复苏和心脏骤停生存率。其他报告表明，旁观者心肺复苏术最关键的组成部分是胸部按压，而干扰最小。从医疗优先分派系统（MPDS）协议的11.2版开始，删除了口对口通气（MTMV）和脉搏检查的说明，并引入了压缩优先的途径以促进快速递送压缩。此外，版本11.3和12.0中分别添加了无意识的窒息和妊娠中期决策标准。但是，尚未评估这些变化对首次压缩时间（TTFC）的影响。目的。我们试图对所有不需要MTMV指令的，被识别为心脏骤停的呼叫量化MPDS版本11.2、11.3和12.0的TTFC。方法。对TTFC分析了2005年10月至2010年5月所有D-CPR事件的音频记录。使用Kruskal-Wallis测试比较了不同版本之间的TTFC差异。结果。共有778例接受了D-CPR。其中有259例被排除在外，因为它们符合MTMV的标准（小儿患者，过敏反应等），缺少数据或最初并未被确定为心脏骤停。在其余的519个呼叫中，平均TTFC为240秒，在MPDS版本之间没有显着差异（p = 0.08）。结论。在删除了有关脉冲检查和MTMV的说明以及MPDS协议中的其他较小更改之后，我们发现总体TTFC为240秒，在所评估的三个版本中变化很小。与包含脉冲检查和MTMV指令（315秒）的MPDS早期版本的报告相比，这代表了TTFC的改进。但是，MPDS TTFC不能与较旧的非MPDS协议（包括脉冲检查和MTMV）进行比较。应继续集中精力改善这一关键的，可改变的决定心脏骤停生存的因素。

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