Dresden unveils seamless rescue chain for sudden cardiac arrest patients
State capital and Dresden Cardiology Centre rescue services get new resuscitation devices
More than 250 patients with sudden cardiac arrest are reported to the emergency services in Dresden every year. Their survival hinges on whether or not life-saving measures are instituted immediately, even before the ambulance brings the patient to
an accident and emergency department.
Two thirds of Dresden’s ambulances already have new, high-performance resuscitation devices. By this coming spring, all 20 vehicles will be fitted with this equipment, putting Dresden at the forefront of the emergency services in Germany.
As Dresden University Hospital’s Cardiology Centre has been working with the automated chest compression device since April 2006, patients can be transferred from the ambulance into the emergency room without interrupting the resuscitation process. “The transportable device, known as LUCAS, boosts the effectiveness of chest compressions to 100 per cent“, notes Wladimir Haacke, Director of the Dresden Rescue Services. “This enhances the safety of the patient and of the personnel, who must work in safety at high vehicle speeds.“ The seamless medicotechnical and logistical rescue chain is in complete accordance with the resuscitation guidelines adopted by the European Resuscitation Council (ERC) in 2005.
“The LUCAS device even accompanies the patient during heart catheterisation, so that we can dilate the coronary arteries with special post-infarct therapy while continuing chest compressions“, says Prof. Ruth Strasser, Medical Director of the Dresden Cardiology Centre. Recent research findings underline the importance of chest compressions compared with artificial respiration in patients suffering sudden cardiac arrest. The ratio of chest compressions to ventilations should be 30:2 and they should be repeated at a rate of 100/min. “LUCAS has the advantage that it is not tiring and relieves the personnel of this strenuous work, enabling them to concentrate on other important life-saving tasks“, explains Prof. Strasser. Even though the hospitals and the emergency services are introducing new techniques, patient survival still depends for the most part on the commitment of the first responder. When someone suffers a cardiopulmonary arrest, the first few minutes before the arrival of the emergency services must be spent administering chest compressions. “This is something that everybody should be capable of performing. Only then does the patient have a good chance of surviving this condition unharmed “, confirms Wladimir Haacke. Prof. Strasser therefore urges everyone to acquire first-aid skills and recommends all major institutions to implement modern emergency management procedures in-house. The Dresden Cardiology Centre is setting a good example in this respect. “By the end of the year we shall have given intensive training to every one of the hospital’s 534 employees, from the administrative staff to trainees, so that they can all help to save the life of a person who suffers sudden cardiac arrest, even outside of the hospital, as first responders“, says the cardiologist and specialist in internal medicine.
What to do until the emergency services arrive:
• Talk to the patient. If he/she fails to respond, summon assistance.
• Open the airways (i.e. tilt the patient’s head back and raise the chin), check the breathing. If the patient is either breathing abnormally or not at all, get somebody to call the emergency services on 112.
• Begin chest compressions:
Place the heel of one hand over the centre of the breastbone and place the other hand over the first hand. Keeping the arms straight, press down on the breastbone 4–5 cm and then release the pressure completely (but keeping the hands in place).
• After 30 compressions, give the patient two breaths either by mouth-to mouth or mouth-to-nose ventilation.
• Continue chest compressions and ventilation using a ratio of 30:2 and a rate of 100/min until the emergency services arrive.
15 January 2007
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