※ [本文轉錄自 civil88 看板] 作者: aed95 (welovehim) 看板: civil88 標題: ...一篇國外緊急救護之論文... 時間: Sat Jan 10 12:56:54 2004 一篇國外緊急救護之論文 http://www.taconet.com.tw/jscha/ 1.由於醫護人員獲知後，沒有啟動到院前雙軌制緊急救護，嚴重延誤張振聲被電擊時間！ 2.接著是緊急通報系統太差，30公尺處的體育老師叫了兩次才過來， 設施不當，鐵門、路障管理不善，校醫太慢到場， 救護車不走近路，不送較近的醫院等等，嚴重延誤就醫電擊之時間！ 3.最後是最離譜的事：急救過程中，校醫和護士等救護人員都不太會作CPR， 所作之CPR品質很差， 致使張振聲大腦需氧量長期嚴重不足，腦細胞持續大量死亡！ 這些因素才是張振聲成為現狀之植物人之主因！！！ 下面之論文摘要供您參考： 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 上面之摘要之出處和作者如下： 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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