[Advanced prehospital care in patients with life-threatening conditions--survival rate, health status and functional level]. / Laegelig praehospital indsats ved livstruende tilstande--overlevelse, helbredstilstand og funktionsniveau.

INTRODUCTION: In Aarhus, Denmark, advanced prehospital care was carried out by anaesthetists working in a rendezvous model with ordinary ambulances. The effect on the patient was evaluated by the physician on scene. The purpose of the study was to evaluate survival rate, health status and functional level in patients after lifesaving prehospital care. MATERIALS AND METHODS: Consecutive data were reported to a prehospital database and the National Patient Registry. Data on survival from 1998 to 2000 were retrieved. Functional level was studied in lifesaving cases in the year 2000. We interviewed the general practitioners (GPs) involved according to EuroQol. The EuroQol interview concerned health status and function level. RESULTS: In 1998-2000, prehospital anaesthetists attended a total of 11,684 patients. Treatment was described as lifesaving in 238 (2%) of the cases, and 63% of the patients (151/238) were alive one year later. In the year 2000, 79 patients were identified as having had lifesaving treatment, and 48 were alive one year later; 67% (32/48) were without functional impairment according to EuroQol. The most frequent diagnoses were self-intoxication and cardiovascular and respiratory diseases. CONCLUSION: Lifesaving prehospital care, as evaluated by the prehospital physician on scene, was performed in 2 percent of all cases attended by a prehospital anaesthetist. Of these patients, the majority were alive after one year and without functional impairment, according to their GP. The diagnoses were varied.

[Advanced prehospital treatment of heart arrest by the mobile emergency unit in Aarhus. 1-year survival after out-of-hospital heart arrest--with focus on response time, survival, the given treatment and admission]. / Avanceret praehospital hjertestopbehandling ved laegeambulancen Arhus. 1-års overlevelse efter hjertestop praehospitalt--med fokus på responstider, overlevelse, den givne behandling og indlaeggelsesdage.

INTRODUCTION: The Mobile Emergency Care Unit (MECU) in Arhus includes an experienced anaesthesiologist and a specially trained rescuer. It covers a radius of 25 km from the centre of Arhus with 330,000 inhabitants. Rescue workers in Denmark are permitted to give basic life support and defibrillation. The MECU carriers out advanced cardiac life support in accordance with "The 1998 Guidelines of the European Resuscitation Council". MATERIAL AND METHODS: Data collected by the MECU doctor on a standardised chart and survival data received from the Central Hospital Database were analysed retrospectively. RESULTS: In 1998, 4725 emergency calls were received. Twenty-five per cent of the calls were for trauma, 515 patients had cardiac disease, 158 of whom had cardiac arrest. In 86 patients, death was determined on the spot and no treatment was given. Seventy-two patients received advanced cardiac life support. Twenty-five patients were admitted to hospital. Thirteen patients were alive one year later, which gives a survival rate of 52% of the patients admitted to hospital. Of the 25 patients who were resuscitated and admitted to hospital, 21 received defibrillation, 16 were intubated, 19 had adrenaline, 11 lidocaine, and 9 amidarone. Other drugs used were atropine, NaHCO3, sotalol, and CaCl. DISCUSSION: These results illustrate that for patients with out-of-hospital cardiac arrest early treatment with advanced cardiac life support performed by experienced doctors probably had a positive impact on survival, as compared to basic cardiac life support.