Keywords
emergency service
analysis of calls
decision algorithm
risk assessment
How to Cite
Abstract
Background. Sudden cardiac arrest (SCA) is a serious medical problem around the world, especially for emergency medical services. Adequate and urgent medical help plays a key role in the prognosis of SCA consequences. When deciding whether to give the ambulance the appropriate urgency code, it may be helpful to know the risk factors of SCA and use the proper decision algorithm. Objectives. Identification of factors affecting the occurrence of SCA (I46 according to ICD-10) based on the experience of the Emergency Medical Service in Wroclaw from 2013. Material and methods. The analysis covered data on the travels of the Ambulance Service in Wrocław, completed in the period from January 1 to March 31, 2013. In the first stage, the incidence of SCA among all calls was assessed. On this basis, a subgroup of patients with SCA and patients with non-SCA complication was identified. These groups were compared regarding the severity of potential SCA risk factors, among which three groups were distinguished: demographic factors, call characteristics and clinical factors. Results. In total in the analyzed period there were 21,219 travels, including 245 (0.9%) travels to patients diagnosed with I46. The median age of patients with SCA was 63.5 years and did not significantly differ from the group of other patients (p = 0.448). Among people with SCA, there were 64% of patients at risk group, and this percentage did not differ significantly from people who did not have SCA (p = 0.741). The percentage of women in the SCA group (58%) turned out to be significantly higher than in the remaining patients (p = 0.049). It wasn’t shown that the compared groups differed significantly in the distribution of reasons of the emergency call (p < 0.05). In the group of patients with SCA, there were more frequent diseases including such disorders as internal secretion, nutritional status and metabolic (p = 0.001) as well as from the group of external causes of illness and death (p = 0.007); on the borderline of significance were nervous system diseases (p = 0.051). Conclusions. 1. The key component to being taken into account when assessing the risk of SCA associated with a given emergency call is the patient’s external cause of illness or death or co-morbid illness. 2. The increased risk of SCA may also indicate the co-morbidity of nervous system diseases (in particular epilepsy), respiratory diseases or mental and behavioral disorders. 3. The current system assessing the urgency of emergency calls used by the Emergency Service does not take into account the above-mentioned clinical risk factors for SCA, which needs to be improved.References
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