2012, Number 1
<< Back Next >>
salud publica mex 2012; 54 (1)
Analysis of the inclussion of police personnel on the out of hospital cardiac arrest emergency response
Aguilera-Campos A, Asensio-Lafuente E, Fraga-Sastrías JM
Language: Spanish
References: 27
Page: 60-67
PDF size: 110.46 Kb.
ABSTRACT
Objetive. Out-of-hospital cardiac arrest (OCHA) is a public health problem in which survival depends on community initial response among others. This study tries to analyze what’s the proportional cost of enhancing such response by involving the police corps in it.
Materials and Methods. We analyzed retrospectively an OCHA registry started on June 2009. We contrasted a model with limited number of ambulances and police based first response.
Results. Mortality was 100%, response times high and 10.8% of the victims were receiving cardiopulmonary resuscitation (CPR) by bystanders. In 63.7% of the events the police arrived before the ambulance, in 1.5% of these cases the police provided CPR. The cost for each saved life was of 5.8-60 million Mexican pesos per life with only ambulance model vs 0.5-5.5 million Mexican pesos on a police first response model with 12 ambulances.
Conclusions. In Queretaro interventions can be performed taking advantage of the response capacity of the existing police focused on diminishing mortality from OCHA at a lesser cost than delegating this function only to ambulances.
REFERENCES
Zipes D, Wellens H. Sudden cardiac death. Circ 1998;98(21):2334-2351.
Asensio E, Narváez R, Dorantes J, Oseguera J, Orea A, Hernández P, et al. Conceptos actuales sobre la muerte súbita. Gac Med Mex 2005;141(2):89-98.
Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, et al. Heart Disease and Stroke Statistics—2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circ 2008;117:25-146.
Rea TD, Pearce RM, Raghunathan TE, Lemaitre RN, Sotoodehnia N, Jouven X, et al. Incidence of Out-of-Hospital cardiac arrest. Am J Cardiol 2004;93(12):1455-1460.
International Lisaison Committee on Resuscitation. 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With treatment Recommendations. Circ 2005;112:1-136.
Regulación de los servicios de salud. Atención prehospitalaria de las urgencias médicas. Norma Oficial Mexicana 237, 2004. (NOM-237-SSA-2004).
Kneeland M. Análisis de los Sistemas de Urgencias en México. Presentación de resultados: Compendio de Mejores Prácticas 2008. Centro Nacional para la Prevención de Accidentes. Secretaría de Salud: COEPRAS. [consultado 2011 oct 25] Disponible en: http://www.enapra.salud.gob.mx/interior/coepras/CC_Mejores_practicas.pdf
Fraga JM, Asensio E, Illescas G. Resultados de una encuesta sobre los servicios médicos de urgencias prehospitalarias realizada en México. Gac Med Mex 2007;143(2):123-130.
Myerburg R, Castellanos A. Cardiac arrest and suden cardiac death. En: Braunwald E. Heart disease: A textbook of cardiovascular medicine. 4a. edición. Philadelphia: Philadelphia Saunders Co, 1992:756-789.
Fraga JM, Asensio E, Martínez R, Bárcenas I, Prieto J, Castillo L, et al. Out of hospital cardiac arrest: First documented experience in a Mexican Urban setting. Prehosp Disaster Med 2009;24(2):121-125.
Nichol G, Thomas E, Callaway CW, Hedges J, Powell JL, Aufderheide TP, et al. Regional Variation of Out-of-Hospital Cardiac Arrest Incidence and Outcome. JAMA 2008;300(12):1423-1431.
Field J, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, et al. Part 1: Executive Summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circ 2010;122:640-656.
Hess EP, White RD. Recurrent ventricular fibrillation in out-ofhospital cardiac arrest after defibrillation by police and firefighters: Implications for automated external defibrillator users. Crit Care Med 2004;32suppl 5:436-439.
Agarwal DA, Hess EP, Atkinson EJ, White RD. Ventricular fibrillation in Rochester, Minnesota: Experience over 18 years. Resuscitation 2009;80:1253-1258.
Sanna T, La Torre G, Waure C, Scapigliati A, Ricciardi W, Dello Russo A, et al. Cardiopulmonary resuscitaion alone vs Cardiopulmonary resuscitation plus automated external defibrillator use by non-healthcare professionals: A meta-analysis of 1583 cases of out-of-hospital cardiac arrest. Resuscitation 2008;76:226-232.
White RD. Technological advances and program initiatives in public access defibrillation using automated external defibrillators. Curr Opin Crit Care 2001;7:145-151.
Davis EA, Mosesso VN. Performance of police first responders in utilizing automated external defibrillation on victims of sudden cardiac arrest. Prehosp Emerg Care 1998;2:101-107.
Riegel B. Training nontraditional responders to use automated external defibrillators. Am J Crit Care 1998;7:402-410.
Cobb LA, Fahrenbruch CE, Walsh TR, Copass MK, Olsufka M, Breskin M, et al. Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA 1999;281:1182-1188.
Newman MM, Mosesso VN, Ornato JP, Paris PM, Andersen L, Brinsfield K, et al. Law Enforcement Agency Defibrillation (LEA-D): position statement and best practices recommendations from the National Center for Early Defibrillation. Prehosp Emerg Care 2002;6(3):346-347.
Valenzuela T, Roe D, Nichol G, Clark L, Spaite D, Hardman R. Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med 2000;343:1206-1209.
Hauswald M, Yeo E. Designing a Prehospital System for a Developing Country: Estimated Cost and Benefits. Am J Emer Med 1997;15(6):599-603.
Registro Mexicano de Paro Cardiaco Extrahospitalario. [sitio de internet] rcp.org.mx: REMEPE [consultado 2011 oct 25.] Disponible en: http://www.rcp.org.mx/remepe/
Jacobs I, Nadkarni V. Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports. Update and Simplification of the Utstein Templates for Resuscitation Registries. Circ 2004;110:3385-3397.
Eisenberg M. Resuscitate!: How Your Community Can Improve Survival from Sudden Cardiac Arrest. Seattle: University of Washington Press, 2009.
Programa “Mi Primera Licencia”. [sitio de internet] Secretaría de Seguridad Ciudadana, Poder Ejecutivo del Estado de Querétaro: Prevención [consultado 2011 octubre 25.] Disponible en: http://seguridad.queretaro.gob.mx/ssc/ssc/prevencion/programa_mi_primer_licencia
Administrador ANPC. ¡Un éxito de la capacitación masiva de RCP sólo con las manos! [sitio de internet] Asociación Nacional de Protección Civil, AC: Artículos. [ Consultado 2011 oct 25] Disponible en: http://proteccioncivil.igloocommunities.com/blogs/avisosynovedades/unxito-la-capacitacin-masiva-de-rcp-slo-con-las-m