slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
RCP: PowerPoint Presentation
Download Presentation
RCP:

Loading in 2 Seconds...

play fullscreen
1 / 20

RCP: - PowerPoint PPT Presentation


  • 149 Views
  • Uploaded on

Il resoconto del 2004. RCP:. 1. 118 Bologna Soccorso. Elaborazione dati: Dr.Bruno Iarussi. 2. Il nuovo stile Utstein (2002 > 2004). Resuscitation not attempted All cases DNAR Considered futile . Resuscitation attempted All cases

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'RCP:' - braeden-lane


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Il resoconto del 2004

RCP:

1

118 Bologna Soccorso

Elaborazione dati: Dr.Bruno Iarussi

slide2

2

Il nuovo stile Utstein

(2002 > 2004)

Resuscitation not attempted

All cases

DNAR Considered futile

Resuscitation attempted

All cases

Any defibrillation attempt Chest compression Assisted ventilation

First monitored rhythm

Shockable VF VT Non shockable Asystole PEA

Location of arrest

Home Public place Other

Arrest witnessed/monitored

by layperson/bystandersby healthcare personnel

Arrest not witnessed

Outcome (all rhythms)

Any ROSC Yes No

Survived event

Discharged alive

Neurologic outcome at discharge

CPC 1 or 2 CPC 3 or 4 CPC 5

CPR before EMS arrival

Etiology

Presumed cardiac Trauma Submersion Respiratory Other non cardiac

slide3

3

I primi dati generali

Resuscitation not attempted

All cases 612 (66.6%)

DNAR 0Considered futile 612

(criteri temporali) 231(parametri di morte) 190(patologia) 134(trauma) 57

Resuscitation attempted

All cases 307 (33.4%)

Any defibrillation attempt 106Chest compression 302Assisted ventilation 305(IOT) 274 (89.2%)(any drugs) 290

First monitored rhythm

Shockable 75 (24.43%) VF 73 VT 2Non shockable 232 (75.57%) Asystole 125 PEA 107

Location of arrest

Home 227 (73,9%)Public place 48Other 32

Arrest witnessed/monitored 272 (88.6%)

by layperson/bystanders 217 (70,7%)by healthcare personnel 54

Arrest not witnessed 35 (11.4%)

CPR before EMS arrival 23

Etiology

Presumed cardiac 251 (81.7%)Trauma 13Submersion 1Respiratory 26Other non cardiac 16

(Emorragia) 9(Ictus) 4(Overdose) 3

slide4

4

Distribuzione per età (popolazione, constatazioni, RCP, ROSC)

slide5

5

Distribuzione sesso RCP

Luogo

slide6

6

Altri dati …

Area interventi

slide7

7

Eziologia non cardiaca

Outcome (Asystole)

ROSC 3 (9.68%)

Survived event 3 Discharged alive 0

Neurologic outcome at dischargeCPC 1 or 2 0CPC 3 or 4 0CPC 5 0

Resuscitation attempted

All cases 56 (18.2%)

Any defibrillation attempt 3Chest compression 56Assisted ventilation 56(IOT) 48 (85.7%)(any drugs) 49

Outcome (PEA)

ROSC 8 (32%)

Survived event 5 (20%)Discharged alive 2 (8%)

Neurologic outcome at dischargeCPC 1 or 2 0CPC 3 or 4 2CPC 5 0

First monitored rhythm

Shockable 0 VF 0 VT 0Non shockable 56 Asystole 31 PEA 25

Location of arrest

Home 37 (66.1%)Public place 14Other 5

Arrest witnessed/monitored 46 (82.1%)

by layperson/bystanders 28 (50%)by healthcare personnel 18

Arrest not witnessed 10 (17.9%)

Outcome (all rhythms)

Any ROSCYes 11 (19.64%) No 45

Survived event 8 (14.28%)

Discharged alive 2 (3.57%)

Neurologic outcome at discharge

CPC 1 or 2 0CPC 3 or 4 2CPC 5 0

CPR before EMS arrival 2

Etiology

Trauma 13Submersion 1Respiratory 26Other non cardiac 16

(Emorragia) 9(Ictus) 4(Overdose) 3

slide8

8

Eziologia cardiaca i non testimoniati

Outcome (Asystole)

ROSC 1 (5.88%)

Survived event 0 Discharged alive 0

Neurologic outcome at dischargeCPC 1 or 2 0CPC 3 or 4 0CPC 5 0

Resuscitation attempted

All cases 25 (8.14%)

Any defibrillation attempt 5Chest compression 25Assisted ventilation 25(IOT) 23 (92%)(any drugs) 24

First monitored rhythm

Shockable 4 VF 4 VT 0Non shockable 21 Asystole 17 PEA 4

Location of arrest

Home 15 (60%)Public place 3Other 7

Arrest witnessed/monitored

by layperson/bystanders by healthcare personnel

Arrest not witnessed 25 (9.96%)

Outcome (all rhythms)

Any ROSCYes 1 (4%) No 24

Survived event 0

Discharged alive 0

Neurologic outcome at discharge

CPC 1 or 2 0CPC 3 or 4 0CPC 5 0

CPR before EMS arrival 2

Etiology

presumed cardiac = 251 (81.7%)

slide9

9

Eziologia cardiaca i testimoniati EMS

Outcome (Asystole)

ROSC 2 (20%)

Survived event 2 Discharged alive 1 (10%)

Neurologic outcome at dischargeCPC 1 or 2 0CPC 3 or 4 0CPC 5 1

Resuscitation attempted

All cases 37 (12.05%)

Any defibrillation attempt 11Chest compression 36 *Assisted ventilation 36(IOT) 31 (83.8%)(any drugs) 36

Outcome (PEA)

ROSC 12 (57.14%)

Survived event 5 (23.80%)Discharged alive 2 (9.52%)

Neurologic outcome at dischargeCPC 1 or 2 2CPC 3 or 4 0CPC 5 0

First monitored rhythm

Shockable 6 (16.22%) VF 5 VT 1Non shockable 31 (83.78%) Asystole 10 PEA 21

Location of arrest

Home 36 (97.3%)Public place 0Other 1

Arrest witnessed/monitored

by layperson/bystanders by healthcare personnel = 37 (14.74%)

Arrest not witnessed

Outcome (all rhythms)

Any ROSCYes 17 (45.95%) No 20

Survived event 9 (24.32%)

Discharged alive 5 (13.51%)

Neurologic outcome at discharge

CPC 1 or 2 4CPC 3 or 4 0CPC 5 1

Outcome (VF/VT)

ROSC 3 (50%)

Survived event 2 (33.3%)Discharged alive 2 (33.3%)

Neurologic outcome at dischargeCPC 1 or 2 2CPC 3 or 4 0CPC 5 0

CPR before EMS arrival 0

Etiology

presumed cardiac = 251 (81.7%)

* 1 pz in ROSC dopo DC shock

slide10

10

Eziologia cardiaca i testimoniati laici

Outcome (Asystole)

ROSC 12 (17.91%)

Survived event 6 (8.95%)Discharged alive 0

Neurologic outcome at dischargeCPC 1 or 2 0CPC 3 or 4 0CPC 5 0

Resuscitation attempted

All cases 189 (61.56%)

Any defibrillation attempt 87Chest compression 186 *Assisted ventilation 188(IOT) 172 (91%)(any drugs) 181

Outcome (PEA)

ROSC 24 (42.11%)

Survived event 12 (21.05%)Discharged alive 2 (3.51%)

Neurologic outcome at dischargeCPC 1 or 2 2CPC 3 or 4 0CPC 5 0

First monitored rhythm

Shockable 65 (34.39%) VF 64 VT 1Non shockable 124 (65.61%) Asystole 67 PEA 57

Location of arrest

Home 139 (73.5%)Public place 31Other 19

Arrest witnessed/monitored

by layperson/bystanders = 189 (75.3%)by healthcare personnel

Arrest not witnessed

Outcome (all rhythms)

Any ROSCYes 68 (35.98%) No 121

Survived event 40 (21.16%)

Discharged alive 11 (5.82%)

Neurologic outcome at discharge

CPC 1 or 2 7CPC 3 or 4 1CPC 5 3

Outcome (VF/VT)

ROSC 32 (49.23%)

Survived event 22 (33.84%)Discharged alive 9 (13.85%)

Neurologic outcome at dischargeCPC 1 or 2 5CPC 3 or 4 1CPC 5 3

CPR before EMS arrival 19

Etiology

presumed cardiac = 251 (81.7%)

* 3 pz. ROSC dopo DC shock

slide11

Tempi

DP

no DP

BLS

6,5

9,55

ALS

12,56

9,49

11

VF/TV

Totale

Defibrillazione IP/soccoritori

Defibrillazione da medico

First monitored rhythm

Shockable 75 (24.43%) VF 73 VT 2

First monitored rhythm

Shockable 36 (48%) VF 36 VT 0

First monitored rhythm

Shockable 39 (52%) VF 37 VT 2

Outcome (VF/VT)

ROSC 35 (46.67%)

Survived event 24 (32.00%)Discharged alive 11 (14.67%)

Neurologic outcome at dischargeCPC 1 or 2 7CPC 3 or 4 1CPC 5 3

Outcome (VF/VT)

ROSC 17 (47.22%)

Survived event 11 (30.55%)Discharged alive 6 (16.67%)

Neurologic outcome at dischargeCPC 1 or 2 4CPC 3 or 4 0CPC 5 2

Outcome (VF/VT)

ROSC 18 (46.15%)

Survived event 13 (33.33%)Discharged alive 5 (12.82%)

Neurologic outcome at dischargeCPC 1 or 2 3CPC 3 or 4 1CPC 5 1

slide12

12

Il contributo dell’RCP da laici

Outcome (Asystole)

ROSC 2 (28.57%)

Survived event 1 (14.28%)Discharged alive 0

Neurologic outcome at dischargeCPC 1 or 2 0CPC 3 or 4 0CPC 5 0

Resuscitation attempted

All cases 23 (7.49%)

Any defibrillation attempt 16Chest compression 23Assisted ventilation 23(IOT) 20 (86.95%)(any drugs) 18

Outcome (PEA)

ROSC 4 (80%)

Survived event 3 (60%)Discharged alive 0

Neurologic outcome at dischargeCPC 1 or 2 2CPC 3 or 4 0CPC 5 0

First monitored rhythm

Shockable 11 (47.83%) VF 11 VT 0Non shockable 12 (52.17%) Asystole 7 PEA 5

Location of arrest

Home 12 (52.2%)Public place 7Other 4

Arrest witnessed/monitored 21

by layperson/bystanders 21 by healthcare personnel 0

Arrest not witnessed2

Outcome (all rhythms)

Any ROSCYes 10 (43.47%) No 13

Survived event 8 (18.6%)

Discharged alive 2 (8.69%)

Neurologic outcome at discharge

CPC 1 or 2 2CPC 3 or 4 0CPC 5 0

Outcome (VF/VT)

ROSC 4 (36.36%)

Survived event 4 (36.36%)Discharged alive 2 (18.18%)

Neurologic outcome at dischargeCPC 1 or 2 2CPC 3 or 4 0CPC 5 0

CPR before EMS arrival 23

Etiologypresumed cardiac = 21

(ipossia 1; ictus 1)

slide13

13

RCP 2004 dati generali

Outcome (Asystole)

ROSC 18 (14.40%)

Survived event 11 (8.80%)Discharged alive 1 (0.80%)

Neurologic outcome at dischargeCPC 1 or 2 0CPC 3 or 4 0CPC 5 1

Resuscitation not attempted

All cases 612 (66.6%)

DNAR 0Considered futile 612

(criteri temporali) 231(parametri di morte) 190(patologia) 134(trauma) 57

Resuscitation attempted

All cases 307 (33.4%)

Any defibrillation attempt 106Chest compression 302Assisted ventilation 305(IOT) 274 (89.2%)(any drugs) 290

Outcome (PEA)

ROSC 44 (41.12%)

Survived event 22 (20.56%)Discharged alive 6 (5.61%)

Neurologic outcome at dischargeCPC 1 or 2 4CPC 3 or 4 2CPC 5 0

First monitored rhythm

Shockable 75 (24.43%) VF 73 VT 2Non shockable 232 (75.57%) Asystole 125 PEA 107

Location of arrest

Home 227 (73,9%)Public place 48Other 32

Arrest witnessed/monitored 272

by layperson/bystanders 217 (70,7%)by healthcare personnel 55

Arrest not witnessed 35

Outcome (VF/VT)

ROSC 35 (46.67%)

Survived event 24 (32.00%)Discharged alive 11 (14.67%)

Neurologic outcome at dischargeCPC 1 or 2 7CPC 3 or 4 1CPC 5 3

Outcome (all rhythms)

Any ROSCYes 97 (31.60%) No 210

Survived event 57 (18.56%)

Discharged alive 18 (5.86%)

Neurologic outcome at discharge

CPC 1 or 2 11CPC 3 or 4 3CPC 5 4

CPR before EMS arrival 23

Etiology

Presumed cardiac 251 (81.7%)Trauma 13Submersion 1Respiratory 26Other non cardiac 16

(Emorragia) 9(Ictus) 4(Overdose) 3

slide14

14

2003 vs 2004: dati generali

2003

2004

slide15

15

Confronto dati Utstein Bo- Casalecchio- S.Lazzaro

2003

2004

slide16

Time of witnessed/monitored arrest

Time when call received

Time when first Emergency Vehicle is mobile

Time when Vehicle stops

Time of first rhytm analysis

Time of first CPR attempts

Time of first defibrillation attempt

Time when vascular access achieved

Time when medications given

Time of Return of Spontaneous Circulation

Time when CPR stopped/Death

16

Time events

Red = Core elementsBlue = Supplementary elements

slide17

17

I nostri tempi (area urbana)

Time when Vehicle stops-

Time when call received

Min.

slide18

18

…e area extraurbana

Time when Vehicle stops-

Time when call received

Min.

slide20

20

Conclusioni:

Si conferma la presentazione in FV come predittiva di esito fausto nell’ACR.

Grande importanza del fattore tempo

Possibile ruolo dell’RCP iniziata da laici > educazione sanitaria

Grande contributo del volontariato e della defibrillazione effettuata da non medici

Possibilità/necessità di un analisi più puntuale degli interventi > percorsi di retraining