Uloga dispečerskog centra hitne medicinske pomoći u zbrinjavanj pacijenata sa srčanim zastojem
Sažetak
CILJ: Utvrditi efikasnost dispečerskog centra (DC) bez jedinstvenog dispečerskog protokola u zbrinjavanju pacijenata u iznenadnom srčanom zastoju.
MATERIJAL I METODE: Istraživenje je retrospektivno i opservaciono. Sprovedeno je u Zavodu za hitnu medicinsku pomoć Novi Sad (ZZHMP Novi Sad) tokom jednogodišnjeg perioda. Istraživanjem su obuhvaćeni svi pacijenti kod kojih je lekarska ekipa na terenu preduzela mere kardiopulmonalne reanimacije (KPR).
REZULTATI: Lekarske ekipe ZZHMP Novi Sad u navedenom periodu su radile KPR kod 198 pacijenata. Kod 142(71,72%) poziva, dispečer je dobio podatak da je pacijent bez svesti. Prijavljeno reakciono vreme I od strane dispečera za pacijente bez svesti iznosilo je 1,37 minuta (SD±1,27, min 0, max 11, Me 1), dok je prosečno reakciono vreme I izmereno iz snimljenih razgovora dispečera sa pozivaocem bilo duže i iznosilo 138,21 sekundi (SD±103,02, min 16, max 840, Me 120) (t=-5,177, p<0,001). Prosečno vreme razgovora dispečera sa pozivaocem je bilo 61,37 sekundi (SD±31,13, min 10, max 193, Me 54). U 6 (4,22%) slučajeva, dispečer je preko radio veze uputio lekarsku ekipu ka pacijentu pre završetka razgovora sa pozivaocem. U momentu dolaska urgentne ekipe svi pacijenti su bili bez svesti, 134 (94,37%) pacijenta su bila bez pulsa, a preostalih 8 (5,63%) su doživeli iznenadni srčani zastoj u toku pregleda urgentne ekipe. Očevidac iznenadnog srčanog zastoja je u 120 (84,51%) slučajeva bio laik, a mere KPR do dolaska ekipe je preduzelo samo 13(10,83%) osoba. Preživelo je 27(19,01%) pacijenata do dolaska u bolnicu.
ZAKLJUČAK: Nedostatak dispečerskog protokola za prijem i tijažu poziva, kao i protokola za telefonski asistiranu KPR iz DC smanjuje šansu za preživljavanje pacijenata sa srčanim zastojem.
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