ABSTRACT
Objective To investigate the independent factors influencing the efficacy of pre-hospital CPR effect. Method The data base with 1376 cases was set up with EpiData software by means of questionnaires and the information was provided by the survivals from cardiopulmonary arrest( CA)saved with cardiopulmonary resuscitation(CPR), and the data were analyzed with SPSS 13.0 software to carry out binary logistic regression. Through single factor analysis, the factors with emerged statistical significance were chosen as variances. Results With regard to the restoration of spontaneous circulation(ROSC), the rescue did by the first witness was the protective factor(PF)( OR = 2.21, P = 0.001, 95.0% CI=1.356-3.602); the male was the risk factor(RF) contrasted with the female( OR = 0. 515, P =0. 006, 95.0%0 CI = 0.320 - 0. 26) ; ages between 20 and 29 years old had higher likelihood of ROSC than group ≥81 years old( OR = 3.241, P = 0.026, 95.0%CI = 1.146 -9.138); the length of CA time before CPR was RF(OR = 0.913, P = 0.000, 95.0%CI = 0.887-0.948);ventricular fibrillation(VF) was PF compared with asystole( OR = 5.092, P = 0.000, 95.0%CI=2.927 -8.861); electric shock was PF(OR = 3.384, P = 0.000, 95.0%CI = 2.033 - 5.635); epinephrine dosage 0 - 4 mg had higher likelihood of ROSC than > 5 nag dosage( OR = 3. 255, P = 0. 001, 95.0% CI = 1. 606 -6.597). In respect of probability about victims at the tittle reached hospital alive, ages of 2- 12 and 13 - 19 years old had higher rations than ≥81 years old( OR = 12.818, P = 0.029, 95.0% CI = 1.299 - 126.508)( OR = 10.505, P = 0.036, 95.0% CI = 1.161-95.058); the length of CA time before CPR was RF(OR =0.862, P = 0.000, 95.0%CI = 0.821-0.906); VF was PF compared with asystole(OR = 7.330, P =0.000, 95.0%CI = 3.962 - 13.560). Conclusions ECG change before CPR, rescue by the first witness,electric shock, the length of CA time before CPR, epinephrine dosage, gender and age were independent influencing factors of pre-hospital CPR for the emergency of ROSC. Age, the length of CA time before CPR and ECG before CPR were influencing factors of pre-hospital CPR for patients at the time transferred to hospital alive.
ABSTRACT
Objective To understand time-effect relationship in prehospital emergency care of trauma patients so as to cut down mortality. Methods The data of pre-hospital deaths of trauma pa-tients were collected from 67 Shenzhen Emergency Network Hospitals during 2002-2004 and input into a database established by using Foxpro 6.0.Then, the data were analyzed by software SPSS 11.0. Re-sults A total of 161 364 trauma patients received prehospital emergency call service during 2002-2004 and 3 967 patients died prehospital or in hospital.There were 360.528 and 645 trauma patients died pre-hospitsl in 2002, 2003 and 2004 respectively, accounting for 32.57%, 37.69% and 44.25% respec-tively of whole trauma emergency patients in corresponding year.In 2002, 2003 and 2004 respectively, pre-hospital mortality was 1.15%, 0.88% and 0.99%, ratio of male to female 79.17/20.83, 77.65/22.35 and 71.63/28.37, the death age(29.04 ±13.98), (27.84±18.54)and(29.25±17.06)years old, ratio of traffic trauma to non-traffic trauma 48.33/51.67.26.14/73.86 and 37.98/62.02, the median response time of ambulance in hospital 2, 2 and 1 minute, the median time of ambulance arri-ving at the accident scene 5, 8.5 and 7 minutes and the median time of ambulance to and fro was 15.35 and 30 minutes. Conclusions There is a tendency that the number of the pre-hospital deaths of trauma patients increases, but that the ratio of traffic to non-traffic trauma and mortality decrease.The average age of dead trsuma patients is 10 years younger than that of whole emergency patients in the city of Shenz-hen.The response time of ambulance in hospital shortens, but the time of ambulance arriving accident 8cene and to and fro time of ambulance prolong.
ABSTRACT
Objective To identify problems and reduce death and disability rates in emergency care so as to provide basis for upgrading the emergency care network. Methods Questionnaires were filled out with information from the medical records of 1446 cases that had been admitted for emergency care to 60 hospitals of the city's emergency care network and that had died in 2002, a database was set up with Profox 6 0, and a statistical analysis was made with SPSS 11 0. Results The median time for various emergency care procedures was: 5 minutes for the issuing and execution of the first medical order respectively and also for the arrival of a senior doctor; 10 minutes for the arrival of the doctor on call; 120 and 180 minutes after admission respectively for case discussion and intra-hospital consultation; 60 minutes after admission for the start of blood transfusion. It was found that some doctors had a poor grasp of emergency care techniques and procedures, the entry of time was not detailed enough in some medical documents, and some rules and regulations failed to be carried out. In addition, differences existed in the spectrum of causes of post-emergency hospitalization death and pre-hospitalization death. Conelusion Improvements need to be made in such aspects of emergency hospitalization care as the detailing of time, the grasp of techniques and the guarantee of quality. And more attention needs to be attached to emergency care.