87 www.iakardiologie.cz PŮVODNÍ PRÁCE / ORIGINAL PAPER Out-of-Hospital Cardiac Arrest in the Karlovy Vary Region in 2023: An Utstein-Style Report re providers through status updates in car computers and were verified in Fleetware software (Radium s.r.o., CZ) using GPS location and timestamps. The Cardiac Arrest Registry of the Emergency Medical Services in the Karlovy Vary Region is a closed database with restricted access. All data protection regulations are strictly adhered to, and reports like this one are presented without any patient-identifying information. Results In 2023, the Emergency Medical Services of the Karlovy Vary Region received 392 calls indicating signs of cardiac arrest, of which 172 patients (43.9 %) were resuscitated. The incidence was 133 cardiac arrests per 100,000 inhabitants. The most common reasons for not continuing layperson CPR were signs of death (33.2 %, n = 130), the decision of the physician on site (15.1 %, n = 59), and the presence of signs of life (7.4 %, n = 29). For further details, refer to the Utstein OHCA flowchart for system effectiveness (attempted resuscitation) in Figure 1 and the Utstein OHCA flowchart for system efficacy (Utstein comparator) in Figure 2. Layperson CPR was initiated in 94.8 % (n = 163) of cases, with dispatcher-assisted CPR provided in 59.5 % (n = 97). In 101 cases (62 %), chest-only CPR was administered, while full CPR was provided in 58 cases (35.6 %). Data on the type of CPR provided is missing for 4 cases. The reasons for not providing telephone-assisted CPR are detailed in Table 1. Of the patients, 64.5 % were male, with a median age of 68 years (IQR 1,3: 56; 75). Patient characteristics are further described in Table 1. Fifty-four percent (n = 93) of OHCAs occurred at home, and 62.2% (n=107) were witnessed by someone. The primary outcome of OHCA, defined as survival to hospital admission, was 36 % (n = 62; 0 missing data). The secondary outcomes, defined as survival to discharge or 30 days, were 15.1 % (n = 26; missing data in 11 cases). A good neurological outcome at discharge or 30 days (CPC 1 or 2) was recorded in 12.2 % (n = 21; missing data in 15 cases). Detailed results of the core and supplementary items of the 2024 Utstein protocol are provided in Table 1. Tab. 1. Results presented as core and supplementary items of the 2024 Utstein template Dispatch core Dispatcher OHCA recognition yes no unknown not recorded 154 4 14 0 Dispatcher CRP instructions yes no unknown not recorded 97 73 2 0 Reasons dispatcher instructions NOT provided CA occurred later CPR in progress landline non cooperating not recognized other EMS third party trapped willing but unable not recorded 22 5 1 4 2 24 5 1 7 2 Dispatch supplemental Time to dispatcher OHCA recognition (not recorded in 60 cases) 1:59 (1 : 21; 3 : 10) Patient core Age 68 (56; 75) Sex male female 111 61 Witnessed arrest yes, bystander EMS no unknown 65 42 22 43 Arrest location residence public building street work/office long-term-care sport facility EMS ambulance prison other unknown not recorded 93 9 28 3 13 4 9 2 7 3 1 Bystander CPR CCO CPR full CPR any bystander w/o additional information no CPR unknown 101 58 4 8 1 Bystander AED use AED used shock delivered/AED used no shock delivered/AED used unknown shock/AED not used/not recorded 11 7 4 161 First arresting rhythm VF pulseless VT PEA asystole not recorded 48 1 44 74 5 Presumed cause medical trauma drowning/electrocution asphyxia Not recorded 153 7 1 8 3 Patient supplemental CPR first bystander person sent to help EMS not recorded 96 16 59 1 / Interv Akut Kardiol. 2024;23(2-3):85-90 / INTERVENČNÍ A AKUTNI KARDIOLOGIE
RkJQdWJsaXNoZXIy NDA4Mjc=