title: Prospective performance evaluation of emergency medical services for cardiac arrest in Lombardia: is something moving forward?
abstract: BACKGROUND
  Limited data are available in our region on out-of-hospital treatment of cardiac arrest. The aim of this study is to evaluate whether the changes implemented in the emergency system (i.e. an increased number of basic life support and advance life support crews that were dispatched) produced the expected outcome improvements.
  
  
  METHODS
  (a)
  
  
  METHODS
  data were prospectively collected on patients with sudden out-of-hospital cardiac arrest in three emergency dispatch centers for 3 months during two study periods, year 2000 and year 2003, differentiated only by the increase of qualified crews. Outcomes and survival were evaluated at 24 h and 1 month after the event. (b)
  
  
  METHODS
  out-of-hospital treatment. (c)
  
  
  METHODS
  352 (174 in the second study period) patients suffering cardiac arrest. (d)
  
  
  METHODS
  the study was observational.
  
  
  RESULTS
  We could document, between the two study periods, stable 24 h (12.6 vs 9.1%) and 1 month survival (3.4 vs 5.8%, NS). Nevertheless, arrival time on site was significantly higher in the second period (from 8.3+/-3.3 to 10.1+/-5.4 min, P<0.05).
  
  
  CONCLUSIONS
  The strengthening of only one link of the chain-of-survival did not improve 1 month survival.
authors.affiliation: Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy. g.citerio@hsgerardo.org
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Citerio
authors.forename: Ilaria
authors.initials: I
authors.lastname: Buquicchio
authors.forename: Gian Piera
authors.initials: GP
authors.lastname: Rossi
authors.forename: Mario
authors.initials: M
authors.lastname: Landriscina
authors.forename: Maurizio
authors.initials: M
authors.lastname: Raimondi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Petrovich
authors.forename: Antonio
authors.initials: A
authors.lastname: Pesenti
mesh_terms: D022561:Advanced Cardiac Life Support; D000368:Aged; D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling; D011446:Prospective Studies; D015996:Survival Rate; D000078329:Workforce