Polish Helicopter Emergency Medical Service (HEMS) Response to Out-of-Hospital Cardiac Arrest (OHCA): A Retrospective Study

Rzońca, Patryk; Gałązkowski, Robert; Pańczyk, Mariusz; Gotlib, Joanna

doi:10.12659/msm.908962

Cited by 11 publications

(14 citation statements)

References 23 publications

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“…In a cohort study analyzing OHCA in 27 European countries, the prevalence of OHCA in a shockable rhythm was 22%, compared to 15% in our study. However, of the ROSC patients we analyzed, as many as 34% had VT/VF rhythms as the cause of OHCA; in other studies, 13 to 54% of the patients with ROSC showed shockable rhythms [9,16,23,24]. In our study, there were no statistically significant differences in ROSC according to gender, age, or the type of EMT.…”

Section: Discussioncontrasting

confidence: 67%

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

Czapla

Zielińska

Kubica-Cielińska

et al. 2020

BMC Cardiovasc Disord

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Background: Out-of-hospital cardiac arrest (OHCA) is a common reason for calls for intervention by emergency medical teams (EMTs) in Poland. Regardless of the mechanism, OHCA is a state in which the chance of survival is dependent on rapid action from bystanders and responding health professionals in emergency medical services (EMS). We aimed to identify factors associated with return of spontaneous circulation (ROSC). Methods: The medical records of 2137 EMS responses to OHCA in the city of Wroclaw, Poland between July 2017 and June 2018 were analyzed. Results: The OHCA incidence rate for the year studied was 102 cases per 100,000 inhabitants. EMS were called to 2317 OHCA events of which 1167 (50.4%) did not have resuscitation attempted on EMS arrival. The difference between the number of successful and failed cardiopulmonary resuscitations (CPRs) was statistically significant (p < 0.001). Of 1150 patients in whom resuscitation was attempted, ROSC was achieved in 250 (27.8%). Rate of ROSC was significantly higher when CPR was initiated by bystanders (p < 0.001). Patients presenting with asystole or pulseless electrical activity (PEA) had a higher risk of CPR failure (86%) than those with ventricular fibrillation/ventricular tachycardia (VF/VT). Patients with VF/VT had a higher chance of ROSC (OR 2.68, 1.86-3.85) than those with asystole (p < 0.001). The chance of ROSC was 1.78 times higher when the event occurred in a public place (p < 0.001). Conclusions: The factors associated with ROSC were occurrence in a public place, CPR initiation by witnesses, and presence of a shockable rhythm. Gender, age, and the type of EMT did not influence ROSC. Low bystander CPR rates reinforce the need for further efforts to train the public in CPR.

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Section: Discussioncontrasting

confidence: 67%

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

Czapla

Zielińska

Kubica-Cielińska

et al. 2020

BMC Cardiovasc Disord

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“…Similar results were obtained by Rzońca et al who analysed the missions of HEMS crews to out-of-hospital cardiac arrest in Poland. The study found that patients with return of spontaneous circulation were more often transported to hospitals by HEMS teams, and that the cases of death before the arrival of the HEMS team were more frequent [27]. Analysis of the authors' own research shows that the clinical status of the patients treated in rural areas was more severe than that of patients in urban areas, as indicated by the GCS scores (12.03 vs. 12.35), the RTS scores (10.14 vs. 10.60) and the NACA scores.…”

Section: Discussionmentioning

confidence: 92%

Missions of the Helicopter Emergency Medical Service in rural and urban areas in Poland – A comparative retrospective analysis

Rzońca¹,

Gałązkowski²,

Wójcik-Fatla³

et al. 2019

Ann Agric Environ Med.

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Introduction. Mortality due to various causes, despite continuous efforts to improve the quality of medical services, is a serious problem for modern healthcare systems. Ischaemic heart disease and stroke are the cause of over 15 million deaths annually, and are therefore known as the world's number one killer. Objective. The aim of this study is to characterise the missions and the most common reasons for dispatching Helicopter Emergency Medical Service (HEMS) crews, with special emphasis on the differences between urban and rural areas. Materials and method. The study was conducted using a retrospective analysis of HEMS missions, including flights to accidents and diseases carried out by HEMS crews in Poland from January 2014-December 2018. The final analysis included 35,213 cases of HEMS missions. Results. The study group consisted mainly of male patients (66.40%), aged 50-64 (22.06%), mean age of the entire analysed group-47.71 (SD: 25.96). The main reason for HEMS missions were strokes (21.63%). Analysis of patients' clinical status revealed that the clinical status of patients treated in rural areas was more severe, which was indicated by the Glasgow Coma Scale-GCS (12.03 vs 12.35) and the Revised Trauma Scale-RTS (10.14 vs 10.60) scores. When assessed by the National Advisory Committee for Aeronautics (NACA) score, body injuries and fatal diseases were observed more often in patients in rural areas (NACA 7 6.12% vs 3.46%) (p<0.05). Conclusions. Multi-organ injuries, head traumas, sudden cardiac arrest, traumatic brain injuries, collapse and epilepsy, were more frequent reasons for HEMS missions in rural areas than in urban areas.

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“…This survival chain consists of community, hospital-based services, and rapid deployment of an emergency physician and ambulances [3]. Although cardiopulmonary resuscitation is the first-and the main-line treatment for the cardiopulmonary arrest [4], the survival rate of the out-of-hospital cardiopulmonary arrest varies between 5 and 38%, and this difference is related to the way that the pre-hospital emergency medical services are managed [5]. Improving the quality as well as the effectiveness of care for the patients with the out-of-hospital cardiopulmonary arrest is addressed as one of the tasks of the emergency medical services throughout the world; however, these systems differ significantly in terms of structure and organization [5].…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to cardiopulmonary resuscitation within pre-hospital emergency medical services: a qualitative study

et al. 2021

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Background Out-of-hospital cardiopulmonary arrest is a common and fatal problem. Rescuing patients with this problem by pre-hospital emergency medical services is associated with various barriers and facilitators. Identifying these barriers as well as the facilitators in a qualitative and an information-rich way will help to improve the quality of performing the maneuver and to increase the patients’ survival. Therefore, the current study was qualitatively conducted with the aim of identifying the factors affecting the cardiopulmonary resuscitation within the pre-hospital emergency medical services. Methods This qualitative study was conducted using a content analysis approach in Iran in 2021. The participants were 16 Iranian emergency medical technicians who were selected through a purposive sampling method. For data collection, in-depth and semi-structured interviews were conducted. For data analysis, the Elo and Kyngäs method was applied. Results The mean participants’ age was 33.06 ± 7.85 years, and their mean work experience was 10.62 ± 6.63 years. The collected information was categorized into one main category called “complex context of the cardiopulmonary resuscitation” and 5 general categories with 17 subcategories. These categories and subcategories include patient condition (patient’s underlying diseases, age, high weight, number of children, and place of living), dominant atmosphere in companions at home (companions’ feeling of agitation, companions doing harm, and companions helping), policy (educational policy, human resource policy, up-to-date equipment and technology, and do-not-resuscitate policy), performance of the out-of-organizational system (disorganization in the patient handover process, and cooperation of the support organizations), and conditions related to the treatment team (conscience, cultural dominance, and shift burden). Conclusions The results showed that the conditions related to the patient and his/her companions, as well as the organizational factors such as the policies and the out-of-organizational factors act as the barriers and the facilitators to the cardiopulmonary resuscitation within pre-hospital emergency medical services. Therefore, the barriers can be modified and the facilitators can be enhanced by taking various measures such as educating, human resource policy-making, upgrading the equipment, and considering appropriate management policies.

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Polish Helicopter Emergency Medical Service (HEMS) Response to Out-of-Hospital Cardiac Arrest (OHCA): A Retrospective Study

Cited by 11 publications

References 23 publications

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

Missions of the Helicopter Emergency Medical Service in rural and urban areas in Poland – A comparative retrospective analysis

Barriers and facilitators to cardiopulmonary resuscitation within pre-hospital emergency medical services: a qualitative study

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