Out-of-hospital cardiac arrest: Is there a need for cardiac arrest centers?
Introduction:The large "Eureca One" study, which included emergency medical services from Serbia, found that the incidence of out-of-hospital cardiopulmonary resuscitation (CPR) in Europe ranges between 19.0 and 104.0 per 100,000 inhabitants. In Sombor, the incidence of initiated CPR was r...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Serbian Medical Society, Department of Emergency Medicine, Belgrade
2024-01-01
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| Series: | ABC: časopis urgentne medicine |
| Subjects: | |
| Online Access: | https://scindeks-clanci.ceon.rs/data/pdf/1451-1053/2024/1451-10532403007P.pdf |
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| Summary: | Introduction:The large "Eureca One" study, which included emergency medical services from Serbia, found that the incidence of out-of-hospital cardiopulmonary resuscitation (CPR) in Europe ranges between 19.0 and 104.0 per 100,000 inhabitants. In Sombor, the incidence of initiated CPR was recorded at 74/100,000, while in 2018, the incidence of initiated resuscitation increased to 109.4/100,000. During the same period, return of spontaneous circulation (ROSC) was achieved in 42.9% of patients, but only 3.3% of them were discharged from the hospital. The European Resuscitation Council (ERC) guidelines clearly recommend that all patients with ROSC and STEMI etiology undergo primary percutaneous coronary intervention (PCI). It has been shown that patients who achieved ROSC and were transported to a healthcare facility capable of primary PCI had better chances of survival. The study proposes the formation of cardiac arrest centers (CAC) to improve survival rates, although currently, only major regional hospitals in Serbia meet the CAC criteria. The General Hospital in Sombor, which covers the West Bačka region, does not meet these criteria, primarily due to the lack of primary PCI capability. The authors believe that the already established STEMI networks in Serbia could also address the needs of patients with out-of-hospital cardiac arrest (OHCA). However, such centers, even though adequately equipped for diagnostics and therapy, would need further preparation in terms of personnel and space, given the multiorgan nature of OHCA patients. Case report: The study presents a case of OHCA that occurred at home. After achieving ROSC, the patient underwent an ECG, which diagnosed anterior septal STEMI. The patient was initially transported to the regional hospital, and the STEMI network was then activated, leading to the patient's transfer to the regional PCI center. Conclusion:The aim of this paper and the patient case presentation is to encourage discussion on the potential need for CAC formation and the establishment of clear procedures, similar to those in place for the STEMI network. This would allow direct transport to a CAC in clearly defined cases, bypassing regional centers that are not adequately equipped for managing OHCA patients. |
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| ISSN: | 1451-1053 2560-3922 |