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Poster Presentations / Resuscitation 84S (2013) S8–S98 S71
pressions with complete release were 34 ± 15%. The overall CPRscore was 79 ± 20%, 50% (n = 12/24) performed over 90% accuracy.
Conclusions: Public and brief training in the context of anawareness campaign for general population can be effective inteaching good quality CC to lay people.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.180
AP155
Public access defibrillation (PAD) in Vienna: Anew approach in technique and funding
Mario Krammel 1,∗, David Weidenauer 2, FlorianEttl 2, Simon Orlob 3, Thomas Knogler 4, Raphaelvan Tulder 2, Wolfgang Schreiber 2
1 Department of Anaesthesiology, General IntensiveCare and Pain Management Medical University ofVienna, Vienna, Austria2 Department of Emergency, Medicine MedicalUniversity of Vienna, Vienna, Austria3 Medical University of Graz, Graz, Austria4 Department of Radiology, Medical University ofVienna, Vienna, Austria
Purpose: Cardiac arrest is one of the most urgent medicalemergencies. The outcome depends on immediate resuscitationmeasures, especially chest compression and earliest possible defi-brillation. In Vienna, however, only four percent of first aiders usedAEDs for preclinical resuscitation in 2011.1 Our objective was a city-wide PAD programme, initiated together with the city of Vienna anda local advertising company in the frame of the “Vienna becomesHEARTsafe” campaign.
Material and methods: The chosen AED offers permanentonline status reports and maintenance, GPS tracking, and estab-lishes a telephone connection with the rescue dispatch centre. Theproject was financed through advertising spaces combined withthe locations; those in public places should be mentioned here inparticular, as the climatized places of storage were integrated intoespecially developed illuminated advertising boards.
Results: 460 AEDs were installed in frequented public places,police stations, official buildings, and bus and tram stops in theVienna area. The new advertising spaces are used not only forcommercial information, but also to raise awareness of sudden car-diac death and for first aid information. Besides the advantagesregarding emergency medical care, this manner of realization offersadvertising incentives, too. Creating advertising spaces allows tocommunicate advertising messages together with a positive initia-tive.
Conclusion: This PAD programme created a win-win situationfor everyone involved, although the ratio of costs and benefits iscontroversially discussed.2 The results of the project remain to beseen, but new trails have already been blazed regarding financing,reducing administrative work, and integration into society.
References
1. Nürnberger A, Sterz F, Malzer R, et al. Out of hospital cardiac arrest in Vienna:incidence and outcome. Resuscitation 2012:1–6.
2. Winkle RA. The effectiveness and cost effectiveness of public-access defibrillation.Clin Cardiol 2010;33:396–9.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.181
AP156
Indicators of emergency response times ofBelgrade Emergency Medical Services in 2012
Sladjana Andjelic
Emergency Medical Services, Belgrade, Serbia
Introduction: Perpetual dilemma of pre-hospital emergencymedicine is: which is that ideal emergency medical services (EMS)response time in emergency situations?
Objective: Study of emergency response time indicators: acti-vation time and reaction time and pre-hospital intervention timeof the Belgrade EMS in 2012.
Methods: Retrospective analysis of received physicians’ priority1 emergency calls in 2012 was performed. Based on the determinedtime intervals I, II and III, activation time, reaction time and Bel-grade EMS pre-hospital intervention time were calculated. Timeinterval I – time interval in min elapsed from the time of receivedpriority 1 emergency call until handed to the EMS team. Time inter-val II – time interval in min elapsed from the time of receivedpriority 1 emergency call until team arrival to the patient. Timeinterval III – time interval in min elapsed from the time of teamarrival to the patient until the time of the release of the ambulancevehicle or patient’s hospital admission for priority 1 treatment.
Results: In the analyzed one-year period the total of 8815 pri-ority 1 emergency calls was received. The total of all time intervalsI was 11,603 min, time interval II – 62,114 min and time interval III– 244,777 min. The time elapsed from the time of received prior-ity 1 emergency call at the dispatcher center until handed to theEMS team for intervention (activation time) was on the average1.32 ± 1.20 min. The average time elapsed from the time when theemergency call was preceded to the EMS team until the team arrivalat the site of event (reaction time) was 7.05 ± 4.20 min. The averagetime of pre-hospital intervention (calculated from the time of teamarrival at the site of event until the time of team release or patient’shospital admission for further treatment) was 27.77 ± 19.18 min.
Conclusion: Based on the obtained results, we can conclude thatthe value of emergency response indicators of the Belgrade EMSwere satisfactory and in accordance with the data reported in otherstudies.
Keywords: Indicators; Emergency response times; EMS.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.182
AP157
BLS skills of Hungarian general practitioners
Jozsef Marton, Renata Veszpremi-Koroknai,Balazs Radnai, Krisztina Deutsch, Emese Pek ∗,Balint Banfai, Jozsef Betlehem
University of Pecs, Faculty of Health Science, Pecs,Hungary
Purpose: It is expected that a general practitioner is able toperform basic life-saving interventions (BLS). Our objective was todetermine the Hungarian General Practitioner’s knowledge aboutBLS.
S72 Poster Presentations / Resuscitation 84S (2013) S8–S98
Materials and methods: 46 GPs were participated in ourresearch. All GP’s were asked to perform BLS in two simulatedsituation: an adult patient with cardiac arrest (resuscitation task)and another adult, unconscious patient (airway task). For data col-lection a standardized BLS skill assessment sheet was used. Forstatistical analyses SPSS 15 software was used (Student’s t test,Chi-square).
Results: The maximum score was 25 points. The highest scoreachieved was 16 points, and the lowest is 0 point. Those generalpractitioners, who have already been performed CPR alone, hadaveraged 4.5 points in the CPR task, while those who have neverhad this opportunity, only 2.6 points (p = 0.043). The years spent asa general practitioner negatively influenced the outcome of eachtask (p = 0.013; p = 0.044).
Conclusions: These general practitioners did not meet the min-imum requirements that even lay rescuers can expect from alife-saving situation. Those GPs who have been performed CPR onBLS level, performed better.
Keywords: BLS; General practitioner; Emergency medicine;Resuscitation.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.183
AP158
An audit of do not attempt cardiopulmonaryresuscitation orders in a District GeneralHospital
Ruth Thomas 1,∗, Matthew Hough 2, LydiaRichardson 2, Charles Warren 2
1 Royal Bournemouth Hospital, Bournemouth,Dorset, UK2 Dorset County Hospital, Dorchester, Dorset, UK
Background: Cardiopulmonary resuscitation (CPR) has thegreat benefit of potentially prolonging a patient’s life, but the bur-dens of CPR include trauma, lack of dignity in dying, permanentneurological disability and significant worsening of their chronicmedical condition. Due to this there have been recent publicationsfrom the General Medical Council (GMC)1 and British Medical Asso-ciation (BMA)2 on Do Not Attempt Cardiopulmonary Resuscitation(DNACPR) decisions; when they should be made and how theyshould be documented.
Aims: To assess how many patients in Dorset County Hospitalhad a documented resuscitation discussion and decisions on admis-sion. Those patients with DNACPR decisions were further evaluatedto assess documentation against current standards.
Method: A 2-part questionnaire was used to audit all adult sur-gical and medical inpatients over one week in April 2011. Oncepatients were discharged, notes were reaudited with part 2. Var-ious measures were taken to improve on the results prior to theaudit being repeated in October 2012.
Results (results for the second audit are in brackets): 249(233) patients were audited with 39 (61) DNACPR orders inplace. 10.8% (20.2%) had resuscitation considered within 24 h ofadmission. Of the DNACPR patients 100% (98.3%) had a reason doc-umented; 61.5% (83.6%) patients were discharged. In 23% (26%) aconsultant did not ratify the decision during the admission. Of thosepatients that survived to discharge, 95.8% (100%) of DNACPR deci-sions were still in place but only 4.3% (18.8%) were communicatedto the General Practitioner (GP).
Conclusions: The results of both audits are again being pre-sented to raise awareness within the hospital and tackle the areasthat perform badly (documentation, communication). The Elec-tronic Discharge Summary system will hopefully be amended to
prompt communication of DNACPR status to the GP, as will themedical clerking proforma to help document consideration ofresuscitation on admission.
References
1. General Medical Council. Treatment and care towards the end of life: good practicein decision making. London: GMC; 2010.
2. British Medical Association, Resuscitation Council (UK), Royal College of Nursing.Decisions relating to cardiopulmonary resuscitation: a joint statement. London:BMA; 2007.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.184
Mechanical Devices
AP159
Mechanical chest compressions and outcome inpatients with out-of-hospital cardiac arrest: Aregistry study
Isabella Holm ∗, Hans Olson, Hans Friberg
Skåne University Hospital, Lund University, Lund,Sweden
Purpose of the study: To investigate the prevalence of reportingand registration of out-of-hospital cardiac arrest (OHCA) patients toa national cardiac arrest registry by the ambulance staff in a regionof Sweden during two years (2010–2011). We also investigatedthe use of a mechanical chest compression device and comparedsurvival rates.
Materials and methods: All ambulance records were retrospec-tively surveyed during the two-year period by examining a regionalelectronic medical record system (ISPASS) for 2010 and by man-ually scrutinizing all paper ambulance records for 2011. Patientsenrolled in the national cardiac arrest registry were divided intotwo groups, depending on whether they had received mechanicalchest compressions or not.
Results: A total of 1348 OHCA patients were identified in theregion during the study period, 693 (51%) were reported by theambulance staff and 655 (49%) were identified and registered ret-rospectively. Among all OHCA patients, 61.1% received mechanicalchest compressions in the region, as compared to 24.7% in the coun-try, but the one-month survival rates were similar; 10.2% versus10.3%. Survival rates were significantly lower in patients receiv-ing mechanical compressions, 6.5% as compared to 11.1%. Severalpatient characteristics differed between the groups. Notably, timefrom alarming the ambulance until defibrillation was significantlylonger in patients receiving mechanical CPR (p < 0.05).
Conclusions: Only half of all OHCA patients was reported bythe ambulance staff in the region, the other half was identified ret-rospectively. The use of mechanical chest compressions differedsignificantly between regions, but the overall survival rates weresimilar. The use of mechanical chest compressions may delay timeto defibrillation.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.185