Nuovo Ospedale Civile Sant’Agostino Estense - NOCSAE, Baggiovara, Modena, Italy
The province of Modena covers an area of 2688 km2, divided into 47 municipalities, and counts a resident population of 701.896 people.5 The emergency department has different resources to provide specific assistance:
- Intermediate ambulances (20 vehicles), named ILS, whose crew is made up of two professionals: a driver and a registered nurse, both employees of the Modena AUSL.
Materials and methods
Results and discussion
Of these, 57.4% were men and 42.6% were women. There is a wide age variability among people who suffered from a cardiac arrest: 4.6% of them are under 40 years old, 11.1% are between 41 and 60 years old, 36.1% of the events affect people aged between 61 and 80, while 48.1% involves patients over 81 years.
In 2017, the aetiology of OHCAs registered can be divided as follow: the cardiac cause scale up till 63.0%, the 13.9% were respiratory causes; the other non-cardiac can be summarised as: 4.6% of neurological events and 7.4% of them are associated with traumatic scenarios.
In 27.8% of the cases it is the basic crew to intervene in first instance, as often geographically closer to the place of the event especially in provincial contexts, followed by the intervention of the intermediate or advanced vehicles.
In events where CPR is attempted, the first recorded rhythm is Ventricular Fibrillation that scores the 13.4%, 0.6% of Ventricular Tachycardia, 55.2% of Asystole and 30,8% of PEA (Pulseless Electrical Activity).
We hypothesized that the low percentage of shockable rhythms at the arrival of the first crew could come from "arrival on site" timing not aligned with the standards.7 Instead, the answers we obtained comply with the recommendations: 55.9% from 0' to 6', 22.5% from 7' to 8' and 21.6% over 8', with an average time of arrival at the place of the event of 6'58".
Recently the use of drugs during CPR reanimation has come up with new evidence.7 The use of drugs during a CA showed that in 20.9% of cases 0 mg of Adrenaline are given, in 59.7% from 1 mg to 6 mg while only in 19.4% over 6 mg of Adrenaline. Atropine, on the other hand, is used only in 10.4% of reanimation.
Conflict of interest
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