Incorporação do Desfibrilador Externo Automático no Serviço de Atendimento Móvel de Urgência de Belo Horizonte, resultados preliminares.

Abstract

Cardiovascular diseases are the main cause of death in developed countries and in Brazil. Sudden death from cardiac disease is the most important cause of out-of-hospital death. Automated External Defibrillators (AED) may benefit patients suffering from lethal cardiac arrhythmias if used by basic life support providers. The mortality is directly related to the time between collapse and the return of spontaneous circulation. The Serviço de Atendimento Móvel de Urgência from Belo Horizonte, implemented the use of the external automated defibrillator to all Basic Support Ambulances (USB) in December 2007. The distribution of these ambulances follows the technical specifications of the Health Ministry and are more numerous than the Advanced Support Ambulances (USA), thus, having a smaller time-response. This study aimed to describe the care to victims of cardiac arrest in the first four months of AED implementation. Data was collected retrospectively from the pre-hospital patients files using the Utstein Style and reported using descriptive statistics. During this period, the pre-hospital system had 760 calls for cardiac arrests. Men (500; 65.8%) were twice more prone than women (253; 33.3%). A cardiac cause was the main reason registered (534; 71.4%). Age varied from 1 to 109 years, with a median of 56 years. Asystole was the main rhythm encountered (422; 86.8%). The mean time registered was 9.65 min for USB and 10.4 min for Advanced Support Ambulances (USAs). USBs arrived before USAs in 120 (93%) cases with a mean time between them of 15.48 min. From all cardiac arrest calls, 444 (58.4%) werent submitted to any cardio-pulmonary resuscitation (CPR) procedures. In the remaining 316 cases where CPR was performed most were male (202; 64%), had a presumed cardiac cause (283; 83.2%) and no defibrillator was used during CPR (185; 58.5%). From this latter group 115 (62.2%) received only basic CPR and only one patient recovered spontaneous circulation, 70 (37.8%) received some form of advanced support with 16 (22.9%) recovering spontaneous circulation. A defibrillator was used in 131 CPR cases (41.5%). Manual defibrillators were used in 36 (27.5%) cases with circulatory return in 13 (36.1%). In 95 cases where AED was used shock wasnt indicated in 83 (87.4%) and only 4 (4.2%) recovered spontaneous circulation. AED delivered shocks in 12 (12.6%) cases and more than half (7; 58,3%) recovered spontaneous circulation. In this report, 7 individuals benefited from an early defibrillation administered by basic life support personnel.