Analiza sustava izvanbolničke hitne medicinske službe s obzirom na ishod reanimacijskoga postupka

doctoral thesis

• Title (english): Analysis of out-of-hospital emergency medical service system regarding the outcome of resuscitation procedure
• Author: Damir Važanić
• Mentor: Ingrid Prkačin (mentor)
• Mentor: Višnja Nesek Adam (komentor)
• Committee member: Ognjen Brborović (predsjednik povjerenstva)
• Committee member: Krešimir Bulić (član povjerenstva)
• Committee member: Vesna Degoricija (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2023-04-26, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Emergency Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Ishod izvanbolničkog srčanog zastoja ovisi o brojim čimbenicima, a važan čimbenik za uspješno provedenu kardiopulmonalnu reanimaciju s povratom spontane cirkulacije je vrijeme proteklo od nastanka srčanog zastoja do pruženih prvih osnovnih mjera održavanja života. Cilj rada bio je utvrditi utjecaj i međuovisnost čimbenika sustava HMS s obzirom na ishod kardiopulmonalne reanimacije u izvanbolničkim uvjetima. U istraživanju je sudjelovalo 7773 ispitanika. Podatci su se prikupljali u razdoblju od 01. listopada 2017. do 30. rujna 2018. godine na uzorku odraslih osoba koje su doživjele iznenadni srčani zastoj u izvanbolničkim uvjetima putem standardiziranog Utstein obrasca za prikupljanje podataka o srčanom zastoju i podatcima o vremenima iz informatičke baze HMS. Znanstveni doprinos ovog istraživanja je potvrda prvog dijela hipoteze da skraćenje vremenskih intervala od nastanka srčanog zastoja do dolaska do bolesnika na mjestu događaja utječe na ishod reanimacijskog postupka izvanbolničkog srčanog zastoja, ali drugi dio hipoteze koji se odnosi na vremenski interval od polaska s mjesta intervencije do dolaska u bolnicu nije potvrđen, odnosno statističkom analizom u našoj studiji utvrđeno je da nije bilo značajnih razlika u ishodima reanimacijskog postupka ovisno o vremenskom intervalu od polaska s mjesta intervencije do dolaska u bolnicu. Na temelju dobivenih rezultata može se zaključiti kako je potrebno uložiti dodatne napore u organizaciju, modernizaciju i logistiku izvanbolničke hitne medicinske službe kako bi vremenski intervali od upućivanja poziva do dolaska unesrećenog bili što kraći uz poštivanje sigurnosti za zdravstvene djelatnike.

Abstract (english)

The outcome of out-of-hospital cardiac arrest depends on several factors, and an important factor for successful cardiopulmonary resuscitation with recovery of spontaneous circulation is the time elapsed from the onset of cardiac arrest to the first basic life support measures provided. The aim of this study was to determine the influence and interdependence of emergency medical service system factors with regard to the outcome of cardiopulmonary resuscitation in outpatient settings. 7773 participants were included in the research. Data was collected in period from 01st of October to 30th of Spetember 2018 using the standardized Utstein form for collecting cardiac arrest data in the outpatient emergency medical service and time intervals data from the HMS IT database. The scientific contribution of this study confirms the first part of the hypothesis, that shortening the time intervals from cardiac arrest to the arrival at the out-of-hospital cardiac arrest location affects the outcome of resuscitation, but the second part of the hypothesis related to the time interval from departure to arrival to the hospital was not confirmed, i.e. statistical analysis in our study found that there were no significant differences in the outcomes of the resuscitation procedure depending on the time interval from departure from the location of intervention to arrival at the hospital. Based on the obtained results, it can be concluded that additional efforts are needed in the organization, modernization, and logistics of outpatient emergency medical services to keep the time intervals from calling to the arrival of the injured as short as possible while respecting safety for health professionals.

• Keywords: Ambulantni pacijenti; Kardiopulmonalna reanimacija; Izvanbolnički srčani zastoj; Hitne medicinske usluge
• Keywords (english): Outpatients; Cardiopulmonary Resuscitation; Out-of-Hospital Cardiac Arrest; Emergency Medical Services
• Language: croatian
• URN:NBN: urn:nbn:hr:105:719653
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 129 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-04-28 11:29:32