title: Emergency system prospective performance evaluation for cardiac arrest in Lombardia, an Italian region.
abstract: BACKGROUND
  The aim of this research is to evaluate quality of out-of-hospital medical services in our country, using performance indicators and a new computerised database.
  
  
  METHODS
  (a)
  
  
  METHODS
  Data were collected prospectively in three emergency dispatch centres for 90 days. Follow-up was evaluated at 1 day and 1 month after the event. This paper presents data on the cardiac arrest cohort only. (b)
  
  
  METHODS
  Three emergency dispatch centres in Lombardia. (c)
  
  
  METHODS
  One hundred and seventy-eight patients in non-traumatic cardiac arrest were enrolled. (d)
  
  
  METHODS
  None. The study was observational only.
  
  
  RESULTS
  Mean interval between phone call and arrival on scene was 8.5+/-3.5 min. BLS manoeuvres were carried out from bystanders only in 15% of the cohort; this was associated with significant mortality reduction (85.7 versus 95.8%, chi(2) P<0.05). One hundred and thirty-three patients (75%) received assistance from BLS crews while only 45 patients (25%) were assisted by ALS medical personel, with a significant mortality reduction (ALS deaths 86.7%, BLS deaths 97%). Total 24 h survival was 9% and survival at 1 month declined to 6.17%.
  
  
  CONCLUSIONS
  Quality monitoring produces objective information on interventions and outcomes. Only with this information, is it possible to implement improvement programmes that are planned according to the data presented.
authors.affiliation: Dipartimento di Anestesia e Rianimazione, Azienda Ospedale San Gerardo di monza, Nuovo Ospedale San Gerardo, Via Donizetti, 106, 20052 Monza (MI), Italy. g.citerio@hsgerardo.org
authors.forename: G
authors.initials: G
authors.lastname: Citerio
authors.forename: D
authors.initials: D
authors.lastname: Galli
authors.forename: G C
authors.initials: GC
authors.lastname: Cesana
authors.forename: M
authors.initials: M
authors.lastname: Bosio
authors.forename: M
authors.initials: M
authors.lastname: Landriscina
authors.forename: M
authors.initials: M
authors.lastname: Raimondi
authors.forename: G P
authors.initials: GP
authors.lastname: Rossi
authors.forename: A
authors.initials: A
authors.lastname: Pesenti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011787:Quality of Health Care; D015996:Survival Rate