Cardiac Arrest Occurring in High-Rise Buildings: A Scoping Review

Journal of Clinical Medicine

Karen Smith¹  Andrew Fu Wah Ho²  Marcus Eng Hock Ong²  Ming Xuan Han³  Qin Xiang Ng³  Bobo Tan³  Yu Liang Lim³  Shalini Arulanandam³  Amelia Natasha Wen Ting Yeo⁴  Norman Huangyu Lin⁵ 

[1] Department of Community Emergency Health and Paramedic Practice, Monash University, Clayton, VIC 3800, Australia;Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore;Emergency Medical Services Department, Singapore Civil Defence Force, Singapore 408827, Singapore;Engineering Product Development Pillar, Singapore University of Technology and Design, Singapore 487372, Singapore;MOH Holdings Pte Ltd., Singapore 099253, Singapore;

关键词: cardiac arrest;    cardiopulmonary resuscitation;    residential;    urban;    high-rise;   

DOI  :  10.3390/jcm10204684

来源: DOAJ

【 摘 要 】

Out-of-hospital cardiac arrests (OHCAs) occurring in high-rise buildings are a challenge to Emergency Medical Services (EMS). Contemporary EMS guidelines lack specific recommendations for systems and practitioners regarding the approach to these patients. This scoping review aimed to map the body of literature pertaining to OHCAs in high-rise settings in order to clarify concepts and understanding and to identify knowledge gaps. Databases were searched from inception through to 6 May 2021 including OVID Medline, PubMed, Embase, CINAHL, and Scopus. Twenty-three articles were reviewed, comprising 8 manikin trials, 14 observational studies, and 1 mathematical modelling study. High-rise settings commonly have lower availability of bystanders and automatic external defibrillators (AEDs), while height constraints often lead to delays in EMS interventions and suboptimal cardiopulmonary resuscitation (CPR), scene access, and extrication. Four studies found return of spontaneous circulation (ROSC) rates to be significantly poorer, while seven studies found rates of survival-to-hospital discharge (n = 3) and neurologically favourable survival (n = 4) to be significantly lower in multistorey settings. Mechanical chest compression devices, transfer sheets, and strategic defibrillator placement were suggested as approaches to high-rise OHCA management. A shift to maximising on-scene treatment time, along with bundling novel prehospital interventions, could ameliorate some of these difficulties and improve clinical outcomes for patients.

【 授权许可】

Unknown