Emergency system prospective performance evaluation for cardiac arrest in Lombardia, an Italian region.
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.
Citerio
G
G
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
Galli
D
D
Cesana
G C
GC
Bosio
M
M
Landriscina
M
M
Raimondi
M
M
Rossi
G P
GP
Pesenti
A
A
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