Evaluation of intensified prehospital treatment in out-of-hospital cardiac arrest: survival and cerebral prognosis. The Odense ambulance study

F Frandsen, J R Nielsen, L Gram, C F Larsen, H R Jørgensen, P Hole, T Haghfelt

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Resumé

During a period of 3 years three different types of emergency medical service (EMS) systems were evaluated in a city with about 238,000 inhabitants/population density of 570/km2. Included were 393 out-of-hospital cardiac arrest patients in whom prehospital cardiopulmonary resuscitation was provided by personnel on basic, intermediate, or advanced care training. When ordinary ambulances (basic EMS) were used, 8 (5%) patients were discharged alive. When ambulances with specially trained paramedics (intermediate EMS) were used, 2 (1%) patients were discharged. Finally medically staffed ambulances with doctors collaborating (advanced EMS) were used, and 11 (13%) patients were discharged. The intermediate EMS system was used in another area with 45,000 inhabitants/population density of 340/km2, and in this area 20 (18%) patients were discharged. Among the survivors a psychological assessment in form of a test for dementia was assessed in long-term survivors (n = 30) together with 28 patients surviving acute myocardial infarction and 11 control persons. The results of the investigation demonstrate that the more intensive the prehospital treatment of out-of-hospital cardiac arrest, the more patients survive and the more patients survive with good cerebral function. However, the ambulances with specially trained paramedics were only effective in the area with 340 inhabitants/km2.

OriginalsprogEngelsk
TidsskriftCardiology
Vol/bind79
Udgave nummer4
Sider (fra-til)256-64
Antal sider9
ISSN0008-6312
StatusUdgivet - 1991

Fingeraftryk

Emergency Medical Services
Allied Health Personnel
Population Density
Survivors

Citer dette

Frandsen, F ; Nielsen, J R ; Gram, L ; Larsen, C F ; Jørgensen, H R ; Hole, P ; Haghfelt, T. / Evaluation of intensified prehospital treatment in out-of-hospital cardiac arrest : survival and cerebral prognosis. The Odense ambulance study. I: Cardiology. 1991 ; Bind 79, Nr. 4. s. 256-64.
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Evaluation of intensified prehospital treatment in out-of-hospital cardiac arrest : survival and cerebral prognosis. The Odense ambulance study. / Frandsen, F; Nielsen, J R; Gram, L; Larsen, C F; Jørgensen, H R; Hole, P; Haghfelt, T.

I: Cardiology, Bind 79, Nr. 4, 1991, s. 256-64.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Evaluation of intensified prehospital treatment in out-of-hospital cardiac arrest

T2 - survival and cerebral prognosis. The Odense ambulance study

AU - Frandsen, F

AU - Nielsen, J R

AU - Gram, L

AU - Larsen, C F

AU - Jørgensen, H R

AU - Hole, P

AU - Haghfelt, T

PY - 1991

Y1 - 1991

N2 - During a period of 3 years three different types of emergency medical service (EMS) systems were evaluated in a city with about 238,000 inhabitants/population density of 570/km2. Included were 393 out-of-hospital cardiac arrest patients in whom prehospital cardiopulmonary resuscitation was provided by personnel on basic, intermediate, or advanced care training. When ordinary ambulances (basic EMS) were used, 8 (5%) patients were discharged alive. When ambulances with specially trained paramedics (intermediate EMS) were used, 2 (1%) patients were discharged. Finally medically staffed ambulances with doctors collaborating (advanced EMS) were used, and 11 (13%) patients were discharged. The intermediate EMS system was used in another area with 45,000 inhabitants/population density of 340/km2, and in this area 20 (18%) patients were discharged. Among the survivors a psychological assessment in form of a test for dementia was assessed in long-term survivors (n = 30) together with 28 patients surviving acute myocardial infarction and 11 control persons. The results of the investigation demonstrate that the more intensive the prehospital treatment of out-of-hospital cardiac arrest, the more patients survive and the more patients survive with good cerebral function. However, the ambulances with specially trained paramedics were only effective in the area with 340 inhabitants/km2.

AB - During a period of 3 years three different types of emergency medical service (EMS) systems were evaluated in a city with about 238,000 inhabitants/population density of 570/km2. Included were 393 out-of-hospital cardiac arrest patients in whom prehospital cardiopulmonary resuscitation was provided by personnel on basic, intermediate, or advanced care training. When ordinary ambulances (basic EMS) were used, 8 (5%) patients were discharged alive. When ambulances with specially trained paramedics (intermediate EMS) were used, 2 (1%) patients were discharged. Finally medically staffed ambulances with doctors collaborating (advanced EMS) were used, and 11 (13%) patients were discharged. The intermediate EMS system was used in another area with 45,000 inhabitants/population density of 340/km2, and in this area 20 (18%) patients were discharged. Among the survivors a psychological assessment in form of a test for dementia was assessed in long-term survivors (n = 30) together with 28 patients surviving acute myocardial infarction and 11 control persons. The results of the investigation demonstrate that the more intensive the prehospital treatment of out-of-hospital cardiac arrest, the more patients survive and the more patients survive with good cerebral function. However, the ambulances with specially trained paramedics were only effective in the area with 340 inhabitants/km2.

KW - Brain Ischemia

KW - Denmark

KW - Emergency Medical Services

KW - Evaluation Studies as Topic

KW - Female

KW - Heart Arrest

KW - Hospitals, University

KW - Humans

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Risk Factors

KW - Survival Rate

KW - Treatment Outcome

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Journal article

C2 - 1782642

VL - 79

SP - 256

EP - 264

JO - Cardiology

JF - Cardiology

SN - 0008-6312

IS - 4

ER -