※ [本文转录自 civil88 看板] 作者: aed95 (welovehim) 看板: civil88 标题: ...一篇国外紧急救护之论文... 时间: Sat Jan 10 12:56:54 2004 一篇国外紧急救护之论文 http://www.taconet.com.tw/jscha/ 1.由於医护人员获知後，没有启动到院前双轨制紧急救护，严重延误张振声被电击时间！ 2.接着是紧急通报系统太差，30公尺处的体育老师叫了两次才过来， 设施不当，铁门、路障管理不善，校医太慢到场， 救护车不走近路，不送较近的医院等等，严重延误就医电击之时间！ 3.最後是最离谱的事：急救过程中，校医和护士等救护人员都不太会作CPR， 所作之CPR品质很差， 致使张振声大脑需氧量长期严重不足，脑细胞持续大量死亡！ 这些因素才是张振声成为现状之植物人之主因！！！ 下面之论文摘要供您参考： Seven years' experience with early defibrillation by police and paramedics in an emergency medical services system Abstract Primary objective: To assess the outcome of patients with out-of-hospital cardiac arrest with ventricular fibrillation as the presenting rhythm in an emergency medical services system utilizing a combined police/paramedic response to provide early defibrillation. Materials and methods: Police and paramedics were dispatched from law enforcement and ambulance communications centers, respectively. First-arriving personnel delivered initial shocks, all using automated external defibrillators. Patients were classified according to response to initial shocks: restoration of pulses with shocks only or in need of advanced life support, including epinephrine. Discharge survival was defined as return to home without disabling neurologic injury. Results: Over the 7-year period of study 131 patients presented with ventricular fibrillation; 58 were first treated by police and 73 by paramedics. Restoration of pulses with shocks only and discharge survival were not different in police and paramedic groups, with overall survival of 40% (53 of 131 patients). Among the survivors, 19% (18/95 patients) obtained a spontaneous circulation only after administration of epinephrine and other ALS interventions. Conclusion: Both restoration of a functional circulation, without need for advanced life support interventions, and discharge survival without neurologic disability are very dependent upon the rapidity with which defibrillation is accomplished, regardless of who delivers the shocks. In addition, a smaller but significant number of patients who require ALS interventions, including epinephrine, for restoration of a spontaneous circulation survive to discharge. Short time differences, on the order of 1 min, are significant determinants of both immediate response to shocks and discharge survival. Keywords: Advanced life support (ALS); Automated external defibrillator (AED); Cardiac arrest; Cardiopulmonary resuscitation; Defibrillation; Emergency medical services; First responder; Out-of-hospital CPR; Ventricular fibrillation 上面之摘要之出处和作者如下： Resuscitation 39 (1998) 145-151 Roger D. White, Daniel G. Hankins, Thomas F. Bugliosi Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA Department of Internal Medicine, Division of Emergency Medical Services, Mayo Clinic, 200 First Street SW, Rochester MN 55905, USA Gold Cross Ambulance Service, Rochester, MN, USA Received 7 July 1998; received in revised form 14 October 1998; accepted 14 Oct 1998 Elsevier Science Ireland Ltd http://www.taconet.com.tw/jscha/ --

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