Prospective performance evaluation of emergency medical services for cardiac arrest in Lombardia: is something moving forward?
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.
Citerio
Giuseppe
G
Department of Perioperative Medicine and Intensive Care, San Gerardo Hospital, Monza, Italy. g.citerio@hsgerardo.org
Buquicchio
Ilaria
I
Rossi
Gian Piera
GP
Landriscina
Mario
M
Raimondi
Maurizio
M
Petrovich
Lorenzo
L
Pesenti
Antonio
A
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