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首页> 外文期刊>Prehospital emergency care >Physician and nonphysician health-care provider perspectives on resuscitation of suspected drug-related out-of-hospital cardiac arrest
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Physician and nonphysician health-care provider perspectives on resuscitation of suspected drug-related out-of-hospital cardiac arrest

机译：医生和非自理医疗保健提供者关于复苏疑似毒品与医院内心脏骤停的重点观点

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Introduction. In the United States, out-of-hospital cardiac arrest from drug overdose (OD-OHCA) caused over 38,000 deaths in 2010. A study in Pittsburgh found that OD-OHCA patients differed demographically and in the resuscitation treatments they received, despite identical AHA resuscitation guidelines. We hypothesized that health-care provider perceptions affect decision-making in the treatment of OD-OHCA versus non-OD OHCA.Methods. We conducted this survey at the National Association of EMS Physicians 2013 Scientific Assembly. Physicians and non-physician health-care providers were given one of two surveys containing 19 questions pertaining to the respondents' affiliated EMS agencies, the estimated proportion of OD-OHCA as well as the drugs involved, and the respondents' belief about the treatments for OD versus non-OD OHCA.Results. One hundred ninety-three respondents participated in this survey. Of the 193, 144 (75%) were physicians and 49 (25%) were nonphysicians. Seventy-nine percent of physicians identified current status as a medical director and 76% of nonphysicians identified as a paramedic. Participants estimated the average monthly proportion of all OHCA due to OD to be 9.4%. Participants ranked opioids, alcohol, antidepressants, and benzodiazepines as the most commonly utilized agents in OD-OHCA. The majority of physicians (42%) felt that the incidence of OD-OHCA was not changing while the majority of nonphysicians (53%) felt the incidence was increasing. Eighty-four percent of all respondents reported the use of naloxone during OD-OHCA resuscitation, while 13% reported administering naloxone during non-OD OHCA resuscitation. Eighty-nine percent of physicians and 67% of nonphysicians indicated that OD-OHCA patients had different demographics than non-OD OHCA, with primary reported differences being age, comorbidities, and socioeconomic status. Sixty-three percent of physicians and 71% of nonphysicians felt that OD-OHCA patients should be treated differently, with primary differences being the incorporation of etiology-specific treatments, performing different CPR with a focus on airway support, and transporting earlier.Conclusions. When surveyed, physicians and nonphysician providers report perceiving OD-OHCA treatment, outcomes, and patient demographics differently than non-OD OHCA and making different treatment decisions based on these perceptions. This may result in etiology-oriented resuscitation in the out-of-hospital setting, despite the lack of OD-specific resuscitation guidelines.
机译：介绍。在美国，在2010年毒品过量（OD-OHCA）的医院外卡骤停血在2010年引起超过38,000人死亡。匹兹堡的一项研究发现，尽管AHA相同复苏指南。我们假设医疗保健提供者的看法影响OD-OHCA与非ODOHCA的治疗中的决策。我们在全国EMS医师2013年科学大会进行了这项调查。医生和非医生医疗保健提供者获得了两个调查中的一个，其中包含了与受访者的附属EMS机构有关的19个问题，估计OD-OHCA以及所涉毒品的估计比例，以及受访者对治疗的信念od与非od ohca.results。一百九十三名受访者参加了这项调查。在193,144中（75％）是医生，49名（25％）是非心理学。 799％的医生确定了作为医疗主任的现状，76％的非心学家被确定为护理人员。参与者估计由于OD为9.4％，所有OHCA的平均每月比例。参与者将阿片类药物，酒精，抗抑郁药和苯并二氮卓类作为OD-OHCA中最常用的药剂。大多数医生（42％）认为OD-OHCA的发病率在大多数非心理学（53％）感觉率增加时不会发生变化。所有受访者中八十四个百分之八十四个受访者报告了在OD-OHCA复苏期间使用纳洛酮，而13％报告在非OD OHCA复苏期间施用纳洛酮。百分之八十九九的医生和67％的非心学人员表明，OD-Ohca患者的人口统计数据不同于非OD OHCA，主要报告的差异是年龄，合并症和社会经济地位。六十三名的医生和71％的非心理学家认为OD-OHCA患者应不同地治疗，主要差异是掺入病因特异性治疗，以焦点对气道支撑并提前运输的不同CPR。当被调查时，医生和非物理学提供者报告的od-ohca治疗，结果和患者人口统计数据不同于非OD OHCA，并根据这些看法进行不同的治疗决策。尽管缺乏特定的复苏准则，这可能导致住院内的病因型复苏。

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