Prehospital Factors Associated with Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest Patients of One Chiayi''s Regional Teaching Hospital

• Main Authors: Hui-Chuan Chang, 張惠娟
• Other Authors: 黃偉堯
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/w5yjwp

碩士 === 長榮大學 === 醫務管理學系(所) === 104 === Background：A 4-minute prime time to rescue sudden cardiac arrest patients, every minute survival rate will be reduced by 10-12%. In order to successfully save the patient, we have to understand what is effective emergency treatment is necessary. Objective：The hospital transport and pre-hospital emergency treatment of out-of-hospital cardiac arrest (OHCA) patients affect return of spontaneous circulation (ROSC) in Chiayi region. Methods：The secondary data analysis is adopted as the basis of this study, the related medical data from January 2009 to December 2014 were collected in a regional teaching hospital emergency room OHCA patients over 20 years old situating in Chiayi region. OHCA patients were 636 people have been executed in the exclusion of non-implementation of cardiopulmonary resuscitation, trauma, drowning, poisoning, burns, ROSC transferred immediately, this study were 435 people. The ROSC as the dependent variable, hospital transport and pre-hospital emergency treatment, including automated external defibrillator, laryngeal mask airway, bystander CPR, pre-hospital shock as independent variables. Capture the pre-hospital emergency treatment, the hospital emergency treatment, hospital transport, survival situation, basic patient information as variables to do Descriptive statistics, Chi-square test, independent samples t-test, and logistic regression analysis. Results：The pre-hospital cardiopulmonary function stopping patients with an average age of 72 years old, Most accompanied by people with medical background were 380 people (87.3%), the pre-hospital emergency treatment, including using the laryngeal mask airway were 27 people(6.2%), bystander cardiopulmonary resuscitation were 34 people(7.8%), and pre-hospital electric shock were 27 people(6.2%). The chi-square test between every independent variable and ROSC show that gender (p=0.147), age(p=0.015), chronic diseases (p=0.572), automated external defibrillator(p=0.682), laryngeal mask airway(p=0.836), bystander cardiopulmonary resuscitation(p=0.263), the pre-hospital electric shock(p=0.430), transport(p=0.305), heart rhythm is shockable in hospital(p=1.000), electric shock in hospital (p=0.004), injection Epinephrine times(p=0.059), designated ambulance crew(p=0.778). The pre-hospital stopping cardiopulmonary function patients in pre-hospital emergency treatment, designated ambulance crew, and ROSC were no significant differences by logistic regression test. Conclusion：The pre-hospital emergency treatment, including patients accompanied by people with medical background to the emergency, using automated external defibrillators, using laryngeal mask airway, sent by designated ambulance crew, and shockable heart rhythm were no significant effect on ROSC in this regional teaching hospital of Chiayi.