提升OHCA案件到院前存活率研究-以豐原某消防分隊為例

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Title:	提升OHCA案件到院前存活率研究-以豐原某消防分隊為例 Study to Improve Pre-Hospital Survival of OHCA Cases-Take a Fire Brigade in Fengyuan as an Example
Authors:	曾喜晧 ZENG, SI-HOW
Contributors:	生物資訊與醫學工程學系
Keywords:	消防人員執行緊急救護勤務;高品質心肺復甦術;自動心肺復甦機;生命之鏈 Advanced Life Support Executed by Emergency Medical Technicians;High-Performance CPR;The Medical CPR Device;The Chain of Survival
Date:	2020
Issue Date:	2020-04-06 06:14:11 (UTC+0)
Publisher:	亞洲大學
Abstract:	消防人員執行緊急救護勤務，面對無呼吸無心跳之病患，正確的處置可提升病患到達醫院前之存活率。從案件報案開始，消防人員到達現場前患者所受急救資源多寡，至消防人員到達現場接手後，執行必要之救護處置，當中包含有高品質心肺復甦術、AED電擊器電擊與評估、呼吸道建立、氧氣治療等處置，最後後送至責任醫院急診室的過程，去檢視有無完成私生命之鏈之各個環節。以豐原某消防分隊線上執行緊急醫療救護案件，依照衛生福利部緊急醫療管理系統統計自2017年01月01日起至2019年07月31日止，緊急救護案件總數量17204件，有送醫院件數為13922件，其中到院前無呼吸無心跳之個案，去除無處置或現場放棄急救等案件不列入研究個案，總案件量為413件，從中探討救護人員到場前患者處置中，有無目擊者、有無旁人CPR、有無於公共場所使用PAD，以及救護人員到場接手後給予處置中，有無使用自動心肺復甦機；有無使用AED電擊治療；與分析無呼吸心跳之個案好發年齡，以老年人口與非老年人口區分，去探討最後患者有無在到達醫院前呈現恢復自主呼吸及心跳，進而去了解其差異性，研究最後發現從案件發生開始，患者能越早接受到完整的急救資源到院前存活率越高，第一時間的CPR急救不限於消防人員，任何人都是最重要的一環，所以希望能強化對於民眾的急救宣導及消防員自身技能提升去整體提升OHCA案件到院前的存活率。 The Chain of Survival plays an imoprtant role on the increasing of the survival rate of Out-Of-Hospital Cardiac Arrest (OCHA) patients. The Chain of Survival refers to a sequence of actions starting from early access to the emergency response system to emergency medical technician (EMTs) taking over and properly performing advanced life support, such as in particular the high-performance CPR (cardiopulmonary resuscitation), assessment of defibrillation with an AED (automated external defibrillator), opening and maintaining an airway, and supply of oxygen, and to transport of the critically ill or injured patients to the medical facilities. According to the data from the Ministry of Health and Welfare from January 1, 2017 to July 31, 2019, the total number of medical emergency cases was 17,204. Among them, there are 413 OCHA cases out of 13,922 patients who bave been transported to hospital. Cases of no treatment were excluded. This study focused on the effectiveness of prehospital treatments, such as CPR, public automated defibrillator (PAD), the mechanical CPR device, and AED electric shock assisted, by a bystander or EMTs in helping an OCHA patient to return the spontaneous circulation (ROSC). Moreover, we evaluated the impact of the patients’ age on the survual rate from OCHA. The results of the study demonstrated that the sooner a patient can receive a complete emergency add before arriving to hospital, the higher the survival rate. The person who gives the early CPR is not limited to EMTs, anyone can become a life saver. So that it is important to strengthen the public's first aid advocacy and improve firefighters' own skills to improve the overall survival rate of OHCA cases before transporting to hospital.
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