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首页> 外文期刊>Prehospital emergency care >Prompt advanced life support improves survival from ventricular fibrillation.
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Prompt advanced life support improves survival from ventricular fibrillation.

机译：及时的高级生命支持可改善心室纤颤的存活率。

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OBJECTIVE: To determine whether the interval between the arrival of basic life support (BLS) providers and the arrival of advanced life support (ALS) providers is associated with patient outcome after cardiac arrest. METHODS: We conducted a retrospective cohort study of all witnessed, out-of-hospital ventricular fibrillation (VF) cardiac arrests between January 1, 1991, and December 31, 2007. Eligible patients (n = 1,781) received full resuscitation efforts from both BLS and ALS providers. RESULTS: The BLS-to-ALS arrival interval was a significant predictor of survival to hospital discharge (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93-0.99); the likelihood of survival decreased by 4% for every minute that ALS arrival was delayed following BLS arrival. Other significant predictors of survival were whether the arrest occurred in public (OR 1.48, 95% CI 1.19-1.85), whether a bystander administered cardiopulmonary resuscitation (CPR) (OR 1.34, 95% CI 1.07-1.68), and the interval between the 9-1-1 call and BLS arrival (OR 0.78, 95% CI 0.73-0.83). CONCLUSIONS: We found that a shorter BLS-to-ALS arrival interval increased the likelihood of survival to hospital discharge after a witnessed, out-of-hospital VF cardiac arrest. We conclude that ALS interventions may provide additional benefits over BLS interventions alone when utilized in a well-established, two-tiered emergency medical services (EMS) system already optimized for rapid defibrillation. The highest priorities in any EMS system should still be early CPR and early defibrillation, but timely ALS services can supplement these crucial interventions.
机译：目的：确定基本生命支持（BLS）提供者到高级生命支持（ALS）提供者到来之间的间隔是否与心脏骤停后患者的预后相关。方法：我们对1991年1月1日至2007年12月31日期间所有见证的院外心室纤颤（VF）心脏骤停进行了回顾性队列研究。符合条件的患者（n = 1,781）接受了两个BLS的全面复苏努力和ALS供应商。结果：从BLS到ALS的到达间隔是出院生存的重要预测指标（赔率[OR]为0.96，95％置信区间[CI]为0.93-0.99）; BLS到达之后，ALS到达被延迟的每一分钟，生存的可能性降低了4％。存活的其他重要预测指标是逮捕是否在公共场所发生（OR 1.48，95％CI 1.19-1.85），旁观者是否进行了心肺复苏（CPR）（OR 1.34，95％CI 1.07-1.68），以及两者之间的间隔9-1-1通话和BLS到达（或0.78，95％CI 0.73-0.83）。结论：我们发现较短的从BLS到ALS的到达间隔增加了目击者院外VF心脏骤停后存活到医院的可能性。我们得出的结论是，当在已经针对快速除颤进行了优化的完善的两级紧急医疗服务（EMS）系统中使用ALS干预措施时，与单纯的BLS干预措施相比，ALS干预措施可能会提供更多好处。在任何EMS系统中，最高优先级仍然应该是早期CPR和早期除颤，但是及时的ALS服务可以补充这些关键的干预措施。

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