Basic and advanced life support practices in out-of-hospital cardiopulmonary arrest developing patients: analysis of 27 months

Yıl 2013, Cilt: 19 Sayı: 1, 13 - 17, 01.02.2013

Behçet Al Suat Zengin Sinem Kabul Remzi Güzel Emine Sarcan Cuma Yıldırım

Öz

Our aim is evaluating of basic and advanced life support interventions at the cardiopulmonary arrest patients that brought to our emergency department by 112 emergency services. Sixty-one cardiopulmonary arrest patients who brought to Emergency Department of Medicine School in Gaziantep University by 112 emergency services between 30 January 2009 and 15 March 2011 were included in the study. Gender, age and diagnosis of patients; accompanied by person, basic and advanced life support such as endotracheal intubation and cardiopulmonary resuscitation status were evaluated, and the results were recorded prospectively. Of patients, 60.7% (n=37) were male and 39.3% (n=24) were female. The mean age was 65.5 (18-90). The majority patient group (n=23) was coronary artery disease. Of patients, 34.4% were accompanies by doctor, and 65.6% were accompanied by paramedics. As basic life support, just only intravenous access and supplemental oxygen were performed. The ratio of patients who had experienced cardiopulmonary arrest and not intubated was 86.9% (n=53). Being all by paramedic, endotracheal intubations were performed to 8 (13.1%) patients. Cardiopulmonary resuscitation and defibrillation was not performed to any patients. Pulse, blood tension, cardiac beat were not determined in any patients on admission to emergency department. Cardiopulmonary resuscitation was performed to all patients in emergency department; just only one patient replied positive. He was died at the 20th day of admission to the intensive care unit. The care staff team that served in 112 emergency health services has not has not adequate experiences and knowledge to provide basic and advanced life supports. Statistically, paramedics were more successful to provide endotracheal intubations in cardiopulmonary arrest patients.

Anahtar Kelimeler

Basic and advanced life support; cardiopulmonary arrest out of hospital, endotracheal intubation.

Hastane dışı kardiyopulmoner arrest gelişen hastalarda temel ve ileri yaşam destek uygulamaları: 27 aylık analiz

Öz

Bu çalışmada acil servisimize 112 acil servis aracılığı ile getirilen hastane dışı kardiyopulmoner arrest hastalarda temel ve ileri yaşam destek müdahalelerinin değerlendirilmesi amaçlanmıştır. 30 Ocak 2009 ve 15 Mart 2011 tarihleri arasında Gaziantep Üniversitesi Tıp Fakültesi Hastanesi Acil Tıp Anabilim Dalına 112 Acil Servis ekibi tarafından kardiyopulmoner arrest olarak getirilen 61 hasta çalışmaya dâhil edildi. Hastaların cinsiyeti, yaşı, tanısı; doktor eşliğinde olup olmadığı, endotrakeal entübasyon ve kardiyopulmoner resusitasyon gibi temel ve ileri yaşam desteğinin yapılıp yapılmadığı değerlendirildi ve sonuçlar prospektif olarak kayıt edildi. Hastaların %60.7'si (n=37) erkek, %39.3'ü (n=24) kadın idi ve ortalama yaşları 65.5 (yaş aralığı 18–90) idi. En fazla hasta grubu (n=23) koroner arter haslığı olanlar oluşturuyordu. Hastaların %34.4'ü doktor eşliğinde, %65.6'sı paramedik eşliğinde acil servise getirildi. Temel yaşam desteği olarak sadece hastaların damar yolu açılmış ve oksijen verilmişti. Kardiyopulmoner arrest olup endotrakeal entübasyon yapılmadan getirilen hastaların oranı %86.9 idi (n=53). Tamamı paramedikler tarafından olmak üzere sadece 8 (%13.1) hastaya endotrakeal entübasyon yapılmıştı (p=0.028). Hiçbir hastaya kardiyopulmoner resusitasyon ve defibrilasyon uygulanmamıştı. Acil servise girişte hiçbir hastada nabız, tansiyon, kardiyak tepe atımı alınamamıştır. Acil serviste tüm hastalara kardiyopulmoner resusitasyon yapılmış; sadece birisinden olumlu cevap alınmış; o da yoğun bakımda 20 gün takipten sonra kayıp edilmiştir. 112 Acil Servis hizmetlerinde çalışan sağlık ekipleri temel ve ileri yaşam desteği sağlamada yeterli deneyime ve bilgi birikimine sahip değillerdir. Paramedikler hastane dışında kardiyopulmoner arrest olmuş hastaya endotrakeal entübasyon yapma konusunda doktorlara göre istatistiksel olarak daha başarılı bulunmuştur.

Anahtar Kelimeler

Doktor; endotrakeal entübasyon; hastane dışı kardiyopulmoner arrest; paramedik; temel ve ileri yaşam desteği.

Kaynakça

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