病院外心停止症例における時間的因子の検討

DOI 被引用文献3件 参考文献16件

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  • An analysis of time-related factors about out-of-hospital cardiac arrest.

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We analyzed data on out-of-hospital cardiac arrest in Hokusetu area from November 1996 to April 1998, using the Utstein style and focusing on time-related factors. In 937 cases considered for resuscitation, cardiac-originated cardiac arrests numbered 467 (49.8%). In 172 cases with cardiac etiology witnessed by bystanders, 48 were hospitalized after the return of spontaneous circulation. In these 48, the time from receipt of the emergency call to return of spontaneous circulation varied widely. In most cases, over 20 minutes passed between cardiac arrest and return of spontaneous circulation. In the only who survived, 20 minutes or less had passed. In cases considered for resuscitation, the median time from call receipt to ambulance arrival was about 4.5 minutes and that from call receipt to the start of cardiopulmonary resuscitation (CPR) was about 6.5 minutes. Only 27 among the 40 whose initial rhythm was ventricular fibrillation (Vf) were defibrillated by paramedics. The median time from call receipt to first defibrillation was 13.5 minutes. The median time from call receipt to physician-attended ambulance arrival at the scene was about 20 minutes and that from call receipt to emergency medical technician (EMT) ambulance hospital arrival was about 22 minutes. The time from cardiac arrest to return of spontaneous circulation is thus crucial to life saving in out-of-hospital cardiac arrest. The time from call receipt to both first defibrillation and to other definitive cares were markedly long even when EMT defibrillation and a physician-attended ambulance were available. We will continue collecting data to ascertain whether shortening such time actually improves survival.

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