Retrospektiv analyse av hjerte-lungeredning (HLR) utført av ambulansepersonell i Oslo ved hjelp av transthorakal impedansemåling.

Abstract

Retrospective Analysis of Cardiopulmonary Resuscitation Performed by Ambulance Personnel in Oslo using Transthoracic Impedance Data.

Objective:Analyse CPR performed on patients with out-of-hospital cardiac arrest with the aim of evaluating the adherence to recommended guidelines. We implemented a tool that records both chest-compressions and ventilations from changes in thoracic impedance between the defibrillator pads (Code-Stat 6.0 Beta 1, Medtronic Emergency Response Systems, WA, USA).

Background: CPR-guidelines are evidence-based. Whether these recommendations are being followed or not will influence the outcome for patients with cardiac arrest. 122 incidents of out-of-hospital cardiac arrest between may 2003 and february 2004 were analysed using the Code-Stat software. Chest-compressions and ventilations were recorded, along with ECG- and other event data from the defibrillator (LIFEPAK12, Medtronic). Both cardiac and non-cardiac causes were included; regardless of initial rhythm.

Results: 25±14% of available time was not used to perform chest compressions during CPR (No Flow Ratio, NFR). When adjusting for time spent on analysis of ECG, pulse-check and defibrillation, chest compressions were not given in 20±13% of the time available. Mean compression-rate was 87±16/ minute; correspondingly the compression-rate during active compression-performance was 117±9/ min. A mean of 14±3 ventilations/ min was recorded. Compared with the rest of the episode, NFR-rate during the first 5 minutes was significantly higher; 30±17% (p<0,001). Mean compression- and ventilation rates were significantly lower during the first 5 minutes than for the rest of the episode; 80±19/ min and 12±4/ min respectively (p<0,001 in both cases).

Conclusions: NFR was 25% and 20% adjusted with great rescuer variability.