Push hard, push fast, if you’re downtown: a citation review of urban-centrism in American and European basic life support guidelines

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Aaron M Orkin¹ 

[1] Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5S 3M2, Canada

关键词: Geographic health equity;    Guideline creation;    Pre-hospital medicine;    Rural and remote medicine;    Basic life support;    Bystander cardiopulmonary resuscitation;    Compression-only cardio-pulmonary resuscitation;    Cardiopulmonary resuscitation;   

Others  :  811259
DOI  :  10.1186/1757-7241-21-32

 received in 2012-11-19, accepted in 2013-04-07,  发布年份 2013

【 摘 要 】

Bystander cardiopulmonary resuscitation (CPR) improves out-of-hospital cardiac arrest (OHCA) survival. In settings with prolonged ambulance response times, skilled bystanders may be even more crucial. In 2010, American Heart Association (AHA) and European Resuscitation Council (ERC) introduced compression-only CPR as an alternative to conventional bystander CPR under some circumstances. The purpose of this citation review and document analysis is to determine whether the evidentiary basis for 2010 AHA and ERC guidelines attends to settings with prolonged ambulance response times or no formal ambulance dispatch services. Primary and secondary citations referring to epidemiological research comparing adult OHCA survival based on the type of bystander CPR were included in the analysis. Details extracted from the citations included a study description and primary outcome measure, the geographic location in which the study occurred, EMS response times, the role of dispatchers, and main findings and summary statistics regarding rates of survival among patients receiving no CPR, conventional CPR or compression-only CPR. The inclusion criteria were met by 10 studies. 9 studies took place exclusively in urban settings. Ambulance dispatchers played an integral role in 7 studies. The cited studies suggest either no survival benefit or harm arising from compression-only CPR in settings with extended ambulance response times. The evidentiary basis for 2010 AHA and ERC bystander CPR guidelines does not attend to settings without rapid ambulance response times or dispatch services. Standardized bystander CPR guidelines may require adaptation or reconsideration in these settings.

【 授权许可】

   
2013 Orkin; licensee BioMed Central Ltd.

【 图 表 】

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