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Emergencies and chronic obstructive pulmonary disease in the EMS belgrade
316 external chest compression was used in the management of acute severe asthma in the prehospital setting. Materials and methods: A literature survey was made. One pilot study, four case reports and three reviews were found. A case from the G¨ oteborg EMS is reported. Results: Literature survey: Most patients with asthma and acute exacerbation respond to conventional therapy. A small percentage deteriorate and develop a condition that may even be fatal. The effect of external chest compression in patients with severe and lifethreatening asthma, is discussed. This intervention seems to be most beneficial in patients suffering from sudden onset asphyxic asthma. No adverse effects have been found. Case report: A 25 y/o male with asthma was found unconscious and with respiratory arrest at ambulance arrival. Percutaneous oxygen saturation was down to 50%. Mechanical ventilation was not possible due to high airway resistance; therefore external chest compression was applied. Parallel with mask-to-mouth ventilation, external chest compression was performed during approx. 40 min. No drugs were administrated during this period, except for oxygen (6 l). The patient was discharged from hospital fully recovered after 2 days. Conclusion: External chest compression may be a treatment strategy in patients with air trapping due to acute asthma, and may serve as a complement to pharmacological treatment. This intervention is analogoues to CPR in cardiac arrest, and has possibly the greatest impact in the prehospital setting. References [1] Fisher M, Bowey J, Ladd-Hudson K. External chest compressions in acute asthma: A preliminary study. Crit Care Med 1989;17:686—7. [2] Fisher M, Whaley A, Pye R. External chest compression in the management of acute severe asthma—–a technique in search of evidence. Prehosp Disast Med 2001;16:124—7. doi:10.1016/j.resuscitation.2006.06.081 PHYSICAL STRAIN DURING CPR-COMPARING 30:2 VERSUS 15:2 Sebastian Russo, S. Reinhard, A. Timermann, C. Eich, A. Niklas, B. Graf. Anaesthesiology, Emergency and Intensive Care Medicine, University of G¨ttingen For basic life support the new guidelines of 2005 recommend a compression-ventilation-ratio of 30:2 [1]. Previous studies have shown a decrease in quality of chest compression with longer compression periods [2]. Furthermore, physical fitness seems to
Abstracts have a significant impact on effective chest compression [3]. Therefore, we investigated the quality of chest compression and physical strain during a 9Ymin CPR interval comparing 30:2 and 15:2. Moreover, we tested in which way physical strain develops if candidates were corrected in performing chest compression according to the guidelines. Method: 30 male and 10 women experienced in CPR were tested. Before performing CPR every candidate had to perform an endurance test by cycling and rowing. Depth, compression frequency and compression point were recorded by a Laerdal Rescuci Anne Skill Reporting System to evaluate the quality of chest compression. In the course of the endurance test and during CPR the heart rate, non invasive blood pressure, capillary lactate were measured and, with a mobile spiroergometryunit, oxygen up-take and CO2 -production were recorded in order to evaluatephysical fitness and strain. Results: Final results will be presentedat the congress. Preliminary data suggest, that 30:2 is more exhausting than 15:2 especially for candidates with low physical fitness and low body weight. Candidates seem to adapt their CPR performance to their personal fitness. Correct CPR was more exhausting than non-correct. However, significant more candidates evaluated 30:2 more convenient than 15:2. References [1] Handley AJ, Koster R, Monsieurs K, Perkins GD, Davies S, Bossaert L. European Resuscitation Council Guidelines for Resuscitation 2005 Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 2005;67(Suppl. 1):S7-23. [2] Greingor JL. Quality of cardiac massage with ratio compression-ventilation 5/1 and 15/2. Resuscitation 2002;55:263-7. [3] Lucia A, de las Heras JF, Perez M, Elvira JC, Carvajal A, Alvarez AJ, Chicharro JL. The importance of physical fitness in the performance of adequate cardiopulmonary resuscitation. Chest 1999;115:158-64. doi:10.1016/j.resuscitation.2006.06.082 EMERGENCIES AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN THE EMS BELGRADE Slavoljub Zivanovic, Predrag Gajic, Dusanka Gojgic. Emergency Medical Services of the City of Belgrade Purpose of the study: To show how urgent are the calls where a patient calls the EMS for COPD. Materials and methods: We analysed 2022 interventions
Abstracts by one EMS team from 14 May 2003 until 1 November 2005. Results: In this study, 8% of calls were for COPD (out of which 53.12% were for COPD only and 46.88% were associated with other illnesses, mostly with congestive heart failure) with an age range of 21—88 years. Seventy-six percent were people over 65 years, with 58.75% being female. At the scene, 15% were real emergencies. In 28.75% of cases the patients could have treated themselves on their own, but they still called EMS. 14.37% were transported to hospitals for further treatment, not only due to COPD but also because of other associated illnesses, and the rest was treated at the scene of accident. The most frequently used treatment is aminophylline, corticosteroids, salbutamol inhalations, oxygen, or diuretics for patients with associated heart disease. 12.5% of calls were given to the EMS team for urgent execution, and 48.12% in the first 10 min. The waiting period for execution by the dispatcher before it is given to EMS team is 0—141 min. Conclusion: EMS Belgrade also takes care of calls that are rated as a second degree of emergency. Many patients call EMS for their own convenience, some call several times during a month because EMS services are free of charge. On board an EMS Belgrade vehicle there is always a physician who determines the treatment and does the triage for further transportation to hospitals. doi:10.1016/j.resuscitation.2006.06.083 DOES NON-TRAUMATIC OUT-OF-HOSPITAL CARDIAC ARREST DIFFER IN GENDER? Tanie Talom Carnot, Claessens BenoOt, Stroeijkens Gilbert, Taymans Laurent, Spoel Estelle, Mols Pierre. Service des Urgences et du SMUR, CHU Saint-Pierre, SIAMU Bruxelles Capitale, Brussels, Belgium Introduction: The nature of the CA varies according to the place it occurs. We questioned whether the gender of CA modified the presentation and treatment of OHCA. Methods: Retrospective analysis of our database of OHCA treated with AED. Period of analysis: 01/04/1989 to 31/12/1999; total cases: 4837. Excluded from the analysis: inadequate cases (349), trauma CA (1209), pediatric CA (13). Number of cases analyzed: 3266. Parameters analyzed: date & hour of CA, gender, place of CA (public, home, other), witnessed arrest, early CPR, initial rhythm (VF/pulseless VT, asystole, PEA), survival 24Yh, 1 week, 1 month, 1 year. Statistics: Chi2 for categorial variables, unpaired Student t-test for continuous variables, Kaplan Meier for survival. Results: 1030 females for 2214 males. Mean age (y): F 71 ver-
317 sus H 66 (pY
Abstracts have a significant impact on effective chest compression [3]. Therefore, we investigated the quality of chest compression and physical strain during a 9Ymin CPR interval comparing 30:2 and 15:2. Moreover, we tested in which way physical strain develops if candidates were corrected in performing chest compression according to the guidelines. Method: 30 male and 10 women experienced in CPR were tested. Before performing CPR every candidate had to perform an endurance test by cycling and rowing. Depth, compression frequency and compression point were recorded by a Laerdal Rescuci Anne Skill Reporting System to evaluate the quality of chest compression. In the course of the endurance test and during CPR the heart rate, non invasive blood pressure, capillary lactate were measured and, with a mobile spiroergometryunit, oxygen up-take and CO2 -production were recorded in order to evaluatephysical fitness and strain. Results: Final results will be presentedat the congress. Preliminary data suggest, that 30:2 is more exhausting than 15:2 especially for candidates with low physical fitness and low body weight. Candidates seem to adapt their CPR performance to their personal fitness. Correct CPR was more exhausting than non-correct. However, significant more candidates evaluated 30:2 more convenient than 15:2. References [1] Handley AJ, Koster R, Monsieurs K, Perkins GD, Davies S, Bossaert L. European Resuscitation Council Guidelines for Resuscitation 2005 Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 2005;67(Suppl. 1):S7-23. [2] Greingor JL. Quality of cardiac massage with ratio compression-ventilation 5/1 and 15/2. Resuscitation 2002;55:263-7. [3] Lucia A, de las Heras JF, Perez M, Elvira JC, Carvajal A, Alvarez AJ, Chicharro JL. The importance of physical fitness in the performance of adequate cardiopulmonary resuscitation. Chest 1999;115:158-64. doi:10.1016/j.resuscitation.2006.06.082 EMERGENCIES AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN THE EMS BELGRADE Slavoljub Zivanovic, Predrag Gajic, Dusanka Gojgic. Emergency Medical Services of the City of Belgrade Purpose of the study: To show how urgent are the calls where a patient calls the EMS for COPD. Materials and methods: We analysed 2022 interventions
Abstracts by one EMS team from 14 May 2003 until 1 November 2005. Results: In this study, 8% of calls were for COPD (out of which 53.12% were for COPD only and 46.88% were associated with other illnesses, mostly with congestive heart failure) with an age range of 21—88 years. Seventy-six percent were people over 65 years, with 58.75% being female. At the scene, 15% were real emergencies. In 28.75% of cases the patients could have treated themselves on their own, but they still called EMS. 14.37% were transported to hospitals for further treatment, not only due to COPD but also because of other associated illnesses, and the rest was treated at the scene of accident. The most frequently used treatment is aminophylline, corticosteroids, salbutamol inhalations, oxygen, or diuretics for patients with associated heart disease. 12.5% of calls were given to the EMS team for urgent execution, and 48.12% in the first 10 min. The waiting period for execution by the dispatcher before it is given to EMS team is 0—141 min. Conclusion: EMS Belgrade also takes care of calls that are rated as a second degree of emergency. Many patients call EMS for their own convenience, some call several times during a month because EMS services are free of charge. On board an EMS Belgrade vehicle there is always a physician who determines the treatment and does the triage for further transportation to hospitals. doi:10.1016/j.resuscitation.2006.06.083 DOES NON-TRAUMATIC OUT-OF-HOSPITAL CARDIAC ARREST DIFFER IN GENDER? Tanie Talom Carnot, Claessens BenoOt, Stroeijkens Gilbert, Taymans Laurent, Spoel Estelle, Mols Pierre. Service des Urgences et du SMUR, CHU Saint-Pierre, SIAMU Bruxelles Capitale, Brussels, Belgium Introduction: The nature of the CA varies according to the place it occurs. We questioned whether the gender of CA modified the presentation and treatment of OHCA. Methods: Retrospective analysis of our database of OHCA treated with AED. Period of analysis: 01/04/1989 to 31/12/1999; total cases: 4837. Excluded from the analysis: inadequate cases (349), trauma CA (1209), pediatric CA (13). Number of cases analyzed: 3266. Parameters analyzed: date & hour of CA, gender, place of CA (public, home, other), witnessed arrest, early CPR, initial rhythm (VF/pulseless VT, asystole, PEA), survival 24Yh, 1 week, 1 month, 1 year. Statistics: Chi2 for categorial variables, unpaired Student t-test for continuous variables, Kaplan Meier for survival. Results: 1030 females for 2214 males. Mean age (y): F 71 ver-
317 sus H 66 (pY