提高院外心脏骤停患者出院存活率:深圳宝安实践

Improved discharge survival in pre-hospital cardiac arrest patients:the Shenzhen Bao'an experience

目的心脏骤停(CA)是严重威胁人民群众生命健康的重大公共卫生问题之一。为提高院外心脏骤停(OHCA)患者出院存活率,深圳市宝安区进行了探索与实践。方法①创新急诊急救服务,构建社会急救体系、院前急救体系、院内急诊体系和重症监护治疗体系“四环一体化”急诊医疗服务体系的院外生存链;②创建了“党建引领、政府主导、部门协同、专业指引、科技支撑、社会参与”全覆盖的社会急救(培训)体系建设模式暨“宝安模式”,制定了宝安区社会急救(培训)体系建设成效的评价指标;③建立了宝安区心脏骤停注册登记系统、社会应急救护培训管理系统;④提升急诊急救专业人员救治技能与心肺脑复苏质量;⑤扎实推进“5分钟社会救援圈”建设,填补“急救空窗期”。结果宝安区公众急救技能培训率9.18%、OHCA旁观者CPR实施率26.11%、OHCA患者AED使用率4.78%、OHCA患者30 d存活率6.31%、30 d内出院存活率4.44%。结论通过上述措施,能显著提高OHCA患者出院存活率。

Objective Cardiac arrest(CA)represents a significant public health challenge,posing a substantial threat to individual health and survival.To enhance the survival rates of patients experiencing out-of-hospital cardiac arrest(OHCA),Baoan District in Shenzhen City has undertaken exploratory initiatives and practical interventions,yielding promising preliminary outcomes.Methods 1.Innovate emergency medical services by developing a“four-circle integration”system that connects to the hospital.This system encompasses the social emergency medical system,the out-of-hospital emergency medical system,the in-hospital emergency medical service system,and the intensive care treatment system.2.Develop a comprehensive model for the construction of a social emergency medical training system,characterized by party leadership,government oversight,departmental coordination,professional guidance,technological support,and community involvement,termed the“Baonan Model.”Additionally,establish evaluation criteria to assess the effectiveness of the social emergency medical training system in Baonan District;3.Develop a cardiac arrest registration system and a social emergency medical training management system for Baonan District;4.Enhance the proficiency in treatment techniques and the quality of cardiopulmonary resuscitation among emergency medical professionals;5.Strengthen and advance the development of a“five-minute social rescue network”to address the critical“emergency window period.”.Result In Baonan District,9.18%of the public is trained in emergency medical skills.The bystander CPR rate for OHCA is 26.11%,AED use is at 4.78%,the 30-day survival rate is 6.31%,and the discharge survival rate is 4.44%.Conclusion The implementation of the aforementioned measures can substantially enhance the survival rate of patients experiencing OHCA at the time of discharge.