Journal Resuscitatio Balcanica (JRB) is a quarterly interdisciplinary medical journal published by the Resuscitation Council of Serbia, the leading professional organization in the field of resuscitation medicine in Serbia and the official partner of the European Resuscitation Council for Serbia. The journal is published by the Resuscitation Council of Serbia and its publication is made exclusively from the membership fee of the Council, and publication is possible only when the author or all co-authors are members of the council or a member of a partner organization from the country or abroad. Published papers relate to the etiology and prevention of cardiac arrest, resuscitation training, clinical resuscitation, rapid response systems and ethical issues in resuscitation medicine. Experimental resuscitation research papers (including animal studies) are published occasionally, only if they are of exceptional interest and directly related to clinical cardiopulmonary resuscitation. Papers related to trauma are published occasionally, but most of them concern specific traumatic cardiac arrest. Letters to the editor are welcome, especially regarding articles published in Journal Resuscitatio Balcanica. Journal Resuscitatio Balcanica does not publish case reports. Papers published in JRB are indexed by biomedical index databases: - COBIS - CrossRef - DOAI Časopos is referenced in the Serbian Citation Index where, through constant monitoring, evaluation of journals is carried out with regard to influence (impact) in the database itself and supplementary citation indexes of WoS. IMPORTANT NOTE FOR AUTHORS Each individual author (if there are two or more) of works submitted to the editorial office of the magazine must sign a statement about their contribution to the work, as well as a statement about the (non)existence of conflicts of interest (Statement of conflicts of interest). Classification: Bibliometric medicine - medicine, health sciences Frascati, modified medical sciences - medicine, health sciences Research topics: Resuscitation; CPR training; cardiopulmonary resuscitation; cardiac arrest; CPR education; Ethics The most frequently used author's keywords Adrenaline Epidemiology Erc Eureca One Eureca Serbia Emergency Medical Assistance Out-of-hospital Cardiac Arrest Cardiopulmonary resuscitation Cardiopulmonary Resuscitation Cpr Basic Life Support Measures Return Spontaneous Circulation Register Resuscitation Emergency Medical Aid Service Cardiac Arrest Witness Trauma Emergency Medicine Out-of-hospital Cardiac Arrest
Resuscitacioni savet Srbije, Novi Sad / Serbian Resuscitation Council, Novi Sad
EuReCa_Serbia 2014-2023 Time from call to arrival at the scene of the accident - impact on the initiation of CPR measures
Introduction: The rate of non-initiation of cardiopulmonary resuscitation (CPR) in patients with out-of-hospital cardiac arrest (OHCA) varies widely across countries, with limited findings in the literature addressing factors associated with higher rates of non-initiation, particularly reaction time (RT) of the emergency medical service team. The aim of this study is to analyze the data on RV length in relation to the initiation or non-initiation of CPR, including the collapse location, OHCA etiology, and the patient ageas additional factors potentially related to the frequency of CPR non-initiation. Material and Methods: In this study, data on initiation and non-initiation of CPR measures, length of RV, collapse location, OHCA etiology, and age of patients were collected and analzyedaccording to the protocol of the EuReCa study during the period October 1, 2014 - December 31, 2023. Results: A total of 10458 EuReCa events with a median RV of 9 (IQR 5-17) minutes were recorded during the follow-up period. In 6197/10458 cases (59.3%) CPR measures were not initiated. Statistically significantly longer RV was observed in the group of patients in whom CPR measures were not initiated, compared to cases where those were applied (Med = 25 (IQR 10-45) vs. Med = 6 (IQR 4-10) minutes, respectively); p<0.001). In relation to the location, both in the group with initiated and non-initiated CPR, a statistically shorter RV was observed when it occurred in a public place compared to the patient's residence (p<0.001), as well as when compared to other collapse locations (p<0.001). In terms of etiology, a significantly shorter RV was observed in the group where CPR measures were not initiated, when comparing the groups of patients with traumatic OHCA compared to cardiac OHCA (p<0.001) and traumatic OHCA compared to OHCA of other causes (p=0.001). Among individual age categories, significant differences in RV duration were observed in the group of patients where CPR measures were not initiated (H=83.553; p<0.001), but also in the group of patients where the same were initiated (H=21.260; p=0.012). Conclusion: The reaction time of the emergency medical service team is significantly longer in cases where CPR is not administered. Public place as the collapse location, certain etiological factors, and certain groups of patient age were significantly associated with shorter RV, which may indicate the presence of relation of potential factors that may contribute to it's prolongation in cases where CPR is not applied. Additional analyzes are necessary to determine the cause-and-effect relationship between RV length and the frequency of initiation and non-initiation of CPR measures, as well as the influence of other potential factors with the aim of increasing the chance of survival after OHCA.
Copyright (c) 2024 Journal Resuscitatio Balcanica
EuReCa_Serbia 2014-2021 - Influence of predictors on occurrence of shockable rhythm, any ROSC, and admission ROSC in patients with EMS-witnessed OHCA
<!-- [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:RelyOnVML/> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-US</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> <w:SplitPgBreakAndParaMark/> <w:EnableOpenTypeKerning/> <w:DontFlipMirrorIndents/> <w:OverrideTableStyleHps/> </w:Compatibility> <m:mathPr> <m:mathFont m:val="Cambria Math"/> <m:brkBin m:val="before"/> <m:brkBinSub m:val="--"/> <m:smallFrac m:val="off"/> <m:dispDef/> <m:lMargin m:val="0"/> <m:rMargin m:val="0"/> <m:defJc m:val="centerGroup"/> <m:wrapIndent m:val="1440"/> <m:intLim m:val="subSup"/> <m:naryLim m:val="undOvr"/> </m:mathPr></w:WordDocument> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="false" DefSemiHidden="false" DefQFormat="false" DefPriority="99" LatentStyleCount="371"> <w:LsdException Locked="false" Priority="0" QFormat="true" Name="Normal"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 1"/> <w:LsdException Locked="false" Priority="9" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="heading 2"/> <w:LsdException Locked="false" Priority="9" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="heading 3"/> <w:LsdException Locked="false" Priority="9" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="heading 4"/> <w:LsdException Locked="false" Priority="9" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="heading 5"/> <w:LsdException Locked="false" Priority="9" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="heading 6"/> <w:LsdException Locked="false" Priority="9" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="heading 7"/> <w:LsdException Locked="false" Priority="9" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="heading 8"/> <w:LsdException Locked="false" Priority="9" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="heading 9"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 6"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 7"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 8"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index 9"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 1"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 2"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 3"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 4"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 5"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 6"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 7"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 8"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" Name="toc 9"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Normal Indent"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="footnote text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="annotation text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="header"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="footer"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="index heading"/> <w:LsdException Locked="false" Priority="35" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="caption"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="table of figures"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="envelope address"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="envelope return"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="footnote reference"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="annotation reference"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="line number"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="page number"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="endnote reference"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="endnote text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="table of authorities"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="macro"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="toa heading"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number 5"/> <w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Closing"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Signature"/> <w:LsdException Locked="false" Priority="1" SemiHidden="true" UnhideWhenUsed="true" Name="Default Paragraph Font"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text Indent"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Continue"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Continue 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Continue 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Continue 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Continue 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Message Header"/> <w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Salutation"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Date"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text First Indent"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text First Indent 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Note Heading"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text Indent 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text Indent 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Block Text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Hyperlink"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="FollowedHyperlink"/> <w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/> <w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Document Map"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Plain Text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="E-mail Signature"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Top of Form"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Bottom of Form"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Normal (Web)"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Acronym"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Address"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Cite"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Code"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Definition"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Keyboard"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Preformatted"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Sample"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Typewriter"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Variable"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Normal Table"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="annotation subject"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="No List"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Outline List 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Outline List 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Outline List 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 6"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 7"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 8"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 6"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 7"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 8"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table 3D effects 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table 3D effects 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table 3D effects 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Contemporary"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Elegant"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Professional"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Subtle 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Subtle 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Web 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Web 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Web 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Balloon Text"/> <w:LsdException Locked="false" Priority="39" Name="Table Grid"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Theme"/> <w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/> <w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading"/> <w:LsdException Locked="false" Priority="61" Name="Light List"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/> <w:LsdException Locked="false" Priority="70" Name="Dark List"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/> <w:LsdException Locked="false" SemiHidden="true" Name="Revision"/> <w:LsdException Locked="false" Priority="34" QFormat="true" Name="List Paragraph"/> <w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/> <w:LsdException Locked="false" Priority="30" QFormat="true" Name="Intense Quote"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/> <w:LsdException Locked="false" Priority="19" QFormat="true" Name="Subtle Emphasis"/> <w:LsdException Locked="false" Priority="21" QFormat="true" Name="Intense Emphasis"/> <w:LsdException Locked="false" Priority="31" QFormat="true" Name="Subtle Reference"/> <w:LsdException Locked="false" Priority="32" QFormat="true" Name="Intense Reference"/> <w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/> <w:LsdException Locked="false" Priority="37" SemiHidden="true" UnhideWhenUsed="true" Name="Bibliography"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/> <w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/> <w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/> <w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/> <w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/> <w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/> <w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 1"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 2"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 3"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 1"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 2"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 3"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> </xml><![endif]--><!-- [if gte mso 10]> <![endif]--> Aims: This study aimed to identify predictors of prehospital outcomes, specifically initial shockable rhythms and return of spontaneous circulation, in out-of-hospital cardiac arrest cases witnessed by emergency medical services. Materials and Methods: The study utilized epidemiological data collected via EuReCa questionnaires from October 1, 2014, to December 31, 2021. It included patients treated by EMS, covering both pediatric cases and non-cardiac causes of cardiac arrest. Data from 16 municipalities in Serbia, representing 24.13% of the population, were analyzed using SPSS Statistics. Statistical significance was defined as p<0.05. Results: Among 8,349 out-of-hospital cardiac arrest cases analyzed, we found that 12.2% cases were witnessed by emergency medical teams. The likelihood of recording an initially shockable rhythm in this category of witnessed cases was 2.35 times higher for individuals older than 65 compared to younger ones (OR: 2.354; 95% CI: 1.280-4.331), 2.19 times higher in the case of incidents involving males compared to females (female gender: OR: 0.457, 95% CI: 0.242-0.864), and 22.69 times higher in the case of cardiogenic etiology (OR: 22.695; 95% CI: 3.020-170.547). The likelihood of achieving return of spontaneous circulation (ROSC) is 3.23 times higher for incidents occurring outside the residence area (within residence: OR: 0.310; 95% CI: 0.176-0.546) and 4.07 times higher in the case of initially recorded shockable rhythm (OR: 4.068; 95% CI: 2.273-7.278). If the incident occurs in a location with fewer than 100,000 residents, outside the residence area, and if the initial rhythm is shockable, the likelihood of ROSC at admission is higher, but none of these variables emerged as independent predictors. Conclusion: One of the proposed strategies to improve the survival of out-of-hospital cardiac arrest is to increase the incidence of EMS-witnessed arrests as the category of events according to the evidence with the best survival. Additional research on predictors of desired prehospital outcomes is necessary, as well as identification of risky epidemiological categories, for further planning activities and increasing survival in this group of patients, as well as in epidemiological categories with high risks and negative predictive outcomes.
Copyright (c) 2025 Journal Resuscitatio Balcanica
Predictors of occurrence of shockable rhythm and return of spontaneous circulation in patients with witnessed cardiac arrest
Introduction: Out-of-hospital cardiac arrest (OHCA) represents a major global health concern, with survival rates at hospital discharge remaining low (on average 8%). Survival outcomes depend heavily on several factors, such as the location of the arrest, time to return of spontaneous circulation (ROSC), patient demographics and the type of initial cardiac rhythm.The Aim: Given the complexities of OHCA outcomes, this study aims to identify independent predictors of shockable rhythm, any ROSC, and ROSC on hospital admission in witnessed OHCA cases. Material and Methods: EuReCa_Serbia is part of the international, prospective, multicenter EuReCa ONE study of survival (epidemiology, treatment and outcomes) of patients who experienced OHCA in Europe. The inclusion criterion was OHCA taken care of by the EMS team. Pediatric patients as well as patients with cardiac arrest of non-cardiogenic cause (including traumatic cardiac arrest) were included in the analysis. The created database consisted of information defined by the unique protocol of the EuReCa ONE study in the period from October 1, 2014 to December 31, 2021. Results: Causal-consecutive association of potential predictors of shockable initial rhythm, return of spontaneous circulation and hospital admission was examined using univariable and multivariable binary logistic regression analysis. We found that OHCAs in areas with over 100,000 inhabitants and those occurring at a patient’s residence were associated with a significantly lower likelihood of shockable rhythms (62,3% and 53,5% less likely), while older age and cardiogenic cause increased the chance of shockable rhythms (1.7 and 10.6 times more likely). The independent predictors for ROSC on hospital admission closely mirrored those for any ROSC: shockable rhythms increased the likelihood of ROSC on admission by 3.8 times, while urban areas and residential locations reduced the chances (69.4% and 50.4% less likely). Conclusion: In conclusion, our study identified several independent predictors influencing the occurrence of shockable rhythm, any ROSC, and ROSC on admission in witnessed OHCA cases. Further research is needed to explore these interactions in diverse populations and regions, as well as to develop tailored interventions that can improve pre-hospital and in-hospital outcomes
EuReCa_Serbia 2014-2023. ANALYSIS OF THE RESUSCITATION ATTEMPS BEFORE, DURING, AND AFTER THE COVID-19 PANDEMIC
Introduction: EuReCa Serbia study collects data on out-of-hospital cardiac arrest (OHCA) from October 1, 2014, including the period during the coronavirus disease 19 (COVID-19) pandemic. The aim of this paper is to analyze the data on OHCA and its outcomes and compare them between the periods before, during and after the period of the COVID-19 pandemic. Material and Methods: The study included epidemiological data on OHCA collected through the EuReCa study questionnaire during the period 2014-2023. Data on OHCA incidence,frequency of initiation/non-initiation of cardiopulmonary resuscitation (CPR), participation of bystanders in applying CPR, as well as the incidence of shockable initial heart rhythm, return of spontaneous circulation on scene (any ROSC), admission to hospital with spontaneous circulation,were collected and their association and trend before, during and after the COVID-19 pandemic in Serbia were analyzed. Results: During the COVID-19 pandemic period, the annual incidence of recorded OHCA cases was 49.23/100,000 inhabitants compared to 114.78/100,000 before and 105.52/100,000 after the pandemic. The incidence of CPR initiation per 100,000 inhabitants in the same time periods was significantly different and amounted to 34.95 before, 48.14 during, and 75.20 after the pandemic. In percentage terms,decrease in the frequency of bystander CPR was observed during the pandemic period (10.03%), compared to the period preceding it (13.13%), while an significant increase was observed after the pandemic period (19.56%),but a trend of increasing incidence of bystander CPR per 100,000 inhabitants was observed before, during and after the pandemic periodcontinuously (4.59; 4.83 and 14.71 respectively).A significantly reduced incidence of ROSC during the COVID-19 pandemic of 15.21% was observed compared to 21.55% and 31.11% before and after the pandemic, respectively. The annual incidence of survival to hospital admission per 100,000 inhabitants among the groups of OHCA cases before, during, and after the pandemic was also significantly different among these periods (6.12, 6.54, and 16.21, respectively). Conclusion: The EuReCa_Serbia registry observed a decrease in the incidence of OHCA during the COVID-19 pandemic, compared to the periods before and after the pandemic. The incidence of bystander CPR had an increasing trend looking before, during, and after the pandemic. The incidence of any ROSC, hospital admission with spontaneous circulation was unchanged before and during, while an increase was observed in the post-pandemic period.
TWO-YEAR TREND OF OUT-OF-HOSPITAL CARDIAC ARREST IN BOSNIA AND HERZEGOVINA
ABSTRACT: Introduction: Participating in research under the auspices of the International Liaison Committee on Resuscitation /ILCOR - available data on out-of-hospital cardiac arrest /OHCA- Out-of-hospital cardiac arrest/ for 2016 and 2017 from Bosnia and Herzegovina were collected. Methods : We invited the voluntary participation of all emergency medical services in the collection of OHCA data in 2015-2017 in Bosnia and Herzegovina/BiH/. We received descriptive data on the most important elements of the latest recommendations of the Utstein form for 2016 and 2017 from Sarajevo Canton and Tuzla. Results: The research in BiH in 2016 covered 417,498 or 12.0% of the total population, and in 2017 it covered 529,521 or 15.0%. The annual incidence of OHCA in Bosnia and Herzegovina treated by emergency medical services in 2016 was 75.4, in 2017 it was 65.0 per 100,000 inhabitants. Provision of cardiopulmonary resuscitation /CPR/ by eyewitnesses was 2.9% in 2016 and 4.1% in 2017. Emergency medical care witnessed OHCA in 2.2% of patients in 2016 and 7.3% in 2017. Survival of OHCA until discharge from the hospital or 30-day survival of patients who were treated by emergency medical assistance in BiH was 12.7% in 2016, 7.8% in 2017. Conclusion: We observed that there are no national or local registers of out-of-hospital cardiac arrest in accordance with the Utstein recommendations. The extremely low number of CPR initiated by eyewitnesses affects the total number of survival to discharge from the hospital and the 30-day survival of the patient.
EuReCa_Serbia 2014-2023 - Analysis of data on non-start of CPR in relation to time of day
Abstract Aim: The aim of this study was to determine a potential difference in the initiation of cardiopulmonary resuscitation (CPR) based on the period of the day. The reason for this lies in the results of a few studies which implied that there is a significant difference in survival rates after day and night out of hospital cardiac arrest (OHCA). Material and methods: This study analyzed epidemiological data on OHCA from the EuReCa study, collected via the European Resuscitation Council (ERC) EuReCa ONE protocol. The dataset, covering October 1, 2014, to December 31, 2021, was created using data from 16 municipalities in Serbia, representing 24.13% of the population. Results: During the period 2014-2023 year, 10458 cases of OHCA were identified via EuReCa Serbia programme. In 4261 out of those 10458 cases (40,7%) CPR was initiated by a witness or an ambulance, and it remained uninitiated in 6192/10458 (59,2%) cases. After splitting one day into four 6-hours periods, we have noticed a statistically significant difference in the proportion of initiated vs. uninitiated CPR according to the period of the day. The biggest proportion of uninitiated CPR cases occurred during the period of 6 to 12 o’clock 2177/3440 (63,3%), while the smallest proportion happend between 18 and 24 o’clock 1251/2332 (53,6%). When looking into the connection between days in the week and working days comparing to weekend, we haven’t established a statistically significant difference. Nevertheless, we did find one when investigating the proportion of initiated CPR cases compared to the season of the year. Conclusion: The proportion of initiated CPR cases is below the European average. We have concluded a statistically significant difference in the proportion of initiated vs. uninitiated CPR according to the period of the day. The biggest proportion of uninitiated CPR cases occurred during the period of 6 to 12 o’clock which is also the period with the highest frequency of OHCA. It is encouraging that despite many authors describing a lower survival rate after a night OHCA, we have found that the highest proportion of initiated CPR cases occurred during the night.
EuReCa_Serbia 2014-2021. Epidemiological analysis of out-of-hospital cardiac arrest - the influence of reactive time on the success of resuscitation
The aim of this study is to analyze the basic epidemiological data related to OHCA and the impact of time intervals during the care of OHCA patients on their survival. Materials and Methods: Epidemiological data, data related to time intervals during the response and care process of OHCA patients, as well as outcome data for these patients, were analyzed in seven municipalities in Serbia. Data were collected as part of the EuReCa_Srbija program during the period from October 1, 2014, to December 31, 2021. Results: The overall annual incidence of recorded OHCA in the studied area was 137.43/100,000 inhabitants, while the annual incidence of initiating CPR measures was 50.16/100,000. In the group of patients with initiated CPR measures, a bystander initiated CPR in 16.98% of cases (annual incidence 8.52/100,000). Return of spontaneous circulation (ROSC) at the scene was recorded in 18.71% of cases with an annual incidence of 9.38/100,000, while in the same group, 15.49% of patients with ROSC were admitted to the hospital (annual incidence 7.77/100,000). The median response time of emergency medical services was 9.0 (IQR 5.0-17.0) minutes, the time from achieving ROSC to hospital arrival was 17.0 (IQR 12.0-27.0) minutes, and the time from departure from the cardiac arrest scene to hospital arrival was 9.5 (IQR 5.0-17.0) minutes. The cumulative proportion of ROSC was 50% after 5.6 kilometers traveled, or 5 minutes from the emergency call. ROSC at the scene was not recorded after 20 minutes from the emergency call, or after 11.2 kilometers traveled from the call reception to the scene. Conclusion: The incidence of OHCA in Serbia is comparable to that in other countries, with room for improvement in terms of greater layperson involvement in initiating CPR measures. The time intervals during the EMS response and care process for OHCA patients are longer compared to reports from other countries, indicating the need to modify factors that directly or indirectly affect these intervals.
EuReCa_Srbija 2014-2021 - Analysis of data on non-initiation of CPR in relation to the place of cardiac arrest
Objective: The aim of this study was to analyze the distribution of initiation and non-initiation of cardiopulmonary resuscitation (CPR) measures across various location groups using a sample collected within the EuReCa_Serbia project. A particular focus was placed on determining how these distributions vary according to the patient's age and the types of locations where cardiac arrest occurred. Materials and Methods: The study included epidemiological data on out-of-hospital cardiac arrest (OHCA) collected through the EuReCa study questionnaire by the European Resuscitation Council (ERC). The inclusion criterion was OHCA cases managed by the emergency medical services (EMS). The analysis included pediatric patients as well as patients with non-cardiac causes of cardiac arrest (including traumatic cardiac arrest). The database was created from information defined by the unique protocol of the EuReCa_One study from October 1, 2014, to December 31, 2021. After each questionnaire was completed, the data were entered into a unique electronic database at each research center and then into a centralized database. Results: Between October 1, 2014, and December 31, 2021, a total of 8,349 OHCA cases were recorded, of which CPR was initiated in 2,758 cases (33.1%). The analysis revealed a statistically significant difference in the frequency of initiation or non-initiation of CPR depending on specific categories of the location of the incident (χ2(8) = 847.217; p < 0.001). Additionally, a significant difference was found in the frequency of CPR initiation between cases where the cardiac arrest occurred at the patient's residence and those outside the residence (χ2(1) = 75.319; p < 0.001). Highly statistically significant differences were also observed among different arrest locations in the group of patients older than 65 years (χ2(8) = 664.652; p < 0.001) as well as in the group of patients 65 years or younger (χ2(8) = 134.075; p < 0.001). Conclusion: The study showed that survival rates after OHCA vary depending on the location of the incident. OHCA most commonly occurs in residential settings, where outcomes are poorer due to the isolation of patients, the lack of AED devices, and a lower likelihood of a witness being present. In long-term care facilities, the high rate of non-initiation of CPR can be attributed to the age and poor health status of the patients. Conversely, public places and sports facilities offer better outcomes due to the availability of AEDs and a higher likelihood of CPR being performed. It is necessary to improve emergency response strategies in residential settings and long-term care facilities, including enhancing the availability of AEDs and training for staff.
EuReCa_Serbia Subotica 2014-2021. Epidemiology of Out-of-Hospital Cardiac Arrest
Aims and goals Continuous monitoring of epidemiology, treatment and outcome of out of hospital cardiac arrest on the territory of Subotica municipality. Methodology EuReCa Serbia is a part of international, prospective, multicentric, EuReCa_One project, which records survival of patients (epidemiology, treatment, outcome) with out of hospital cardiac arrest in Europe, who are registered on „clinicaltrials.gov (registration number: NCT02236819) by ERC. Data gathered by research center Subotica from October 1, 2014 to December 31, 2021. have been observed. Statistical software SPSS Statistics for Windows v27.0 was used for analysis. Variables are presented through incidence and percentage, and Chi-Square test was used for connection testing between categorical variables. Results During the observed time period, the incidence of EuReCa events was 171,67/100.000. Annual incidence of initiated cardiopulmonary resuscitation was 60.75/100000. Age Median for both sexes was 71 (IQR 62-81). Incidence of out of hospital cardiac arrest in patients“ residences, per year, was 157.08 /100.000. Yearly Incidence of provided basic life support was 11.07. Return of spontaneous circulation (ROSC) was achieved in 164 patients of 516 cases (31.78%), which makes the incidence of achieved ROSC, per year, 19.31/100 000. Conclusion Incidence of initiated cardiopulmonary resuscitation and achieved return of spontaneous circulation can be compared with results of european countries. Further monitoring of OHCA is necessary so that the reasons for poor laymen involvement can be determined.
EuReCa_Srbija 2014-2023 - Analysis of data on non-initiation of CPR in relation to the etiology of cardiac arrest
Introduction: Cardiac arrest is one of the five leading causes of death in Europe. Timely recognition and application of cardiopulmonary resuscitation (CPR) significantly increase the chances of survival. It is necessary to better understand the reasons for not starting CPR, with the aim that their identification leads to the improvement of guidelines and an increase in survival rates. The Aim: The aim of this study is to analyze the data on the non-initiation of CPR in the context of the etiology of cardiac arrest. Material and Methods: The study included epidemiologic data on out-of-hospital cardiac arrest (OHCA) collected through questionnaires from the EuReCa, European Resuscitation Council (ERC) studies. The criterion for inclusion in the research was a OHCA treated by the emergency medical service (EMS). Pediatric patients were also included in the analysis. The created database consisted of information defined by the unique protocol of the EuReCa ONE study, for the period of October 1, 2014 to December 31, 2023. Results: We found a statistically significant correlation between Utstein and EuReCa etiology of cardiac arrest and the proportion of non-initiation of CPR in recorded cases (p<0.001). The highest percentage of non-initiation of CPR was observed in patients after drowning, where out of 40 recorded cases of submersion, the application of CPR measures was not initiated in any of them, while the lowest percentage of non-initiation of CPR was recorded in electrocution, where out of a total of 15 recorded cases, CPR was not initiated in 5/ 15 (33.33%) cases. The ratio of starting and not starting CPR in the group of patients with cardiogenic cardiac arrest was almost identical, that is, CPR was not started in 3293/6708 (49.1%) cases. Binary logistic regression analysis indicated the female gender as a significant predictor of non-initiation of CPR (p<0.001, OR 2.037, 95% CI 1.880-2.208). Conclusion: This study provides significant data that can contribute to the improvement of strategies for recognition and intervention in out-of-hospital cardiac arrest in Serbia. Additional research and continuous monitoring are needed to determine the influence of etiology, but also of other factors, on the decision not to start CPR.
EuReCa Serbia 2014-2021 - Analysis of data on non-initiation of CPR in relation to gender of patients with OHCA
Aims: . The analysis aimed to investigate differences in the initiation of cardiopulmonary resuscitation based on gender, as well as differences between geneders considering location of the cardiac arrest, etiology, and age. Material and methods: This study analyzed epidemiological data on out-of-hospital cardiac arrest from the EuReCa study, collected via the European Resuscitation Council and EuReCa ONE protocol. The dataset, covering October 1, 2014, to December 31, 2021, was created using data from 16 municipalities in Serbia, representing 24.13% of the population. Results: Data revealed a total of 8,349 OHCA cases, with CPR initiated in 2,758 cases (33.1%). Statistically significant differences in CPR initiation were observed between genders, with a higher initiation rate for males (41.7%) compared to females (23.5%) (χ2 (1) = 307.312; p<0.001). Initiation rates were higher for males across all locations of arrest, including residence and non-residence settings, and for various etiologies, particularly cardiac causes (χ2 (1) = 186.341; p<0.001). Age-related differences were significant for those over 65, with CPR initiation less frequent in females compared to males (χ2 (1) = 244.642; p<0.001). Conclusion: The findings indicate a gender disparity in CPR initiation. These results highlight the need for tailored resuscitation guidelines to address gender disparities and improve outcomes for all patients experiencing OHCA. Further research is required to explore underlying factors contributing to these differences and to refine resuscitation protocols.
EuReCa_Srbija 2014-2021 - Analysis of data on non-initiation of CPR in relation to the age of patients with VBSZ
Objectives: Sudden out-of-hospital cardiac arrest represents a significant public health issue as the third leading cause of death worldwide. The annual incidence of OHCA in Europe ranges between 67 and 170 cases per 100,000 inhabitants, although it is believed that the actual number might be higher. Despite the measures taken and the attention drawn to the importance of this issue, both among healthcare professionals and the general population, the survival rate remains below 10%. Early recognition of cardiac arrest, initiation of CPR, and early defibrillation significantly improve survival and long-term outcomes in survivors of OHCA. Materials and Methods: The study included epidemiological data on OHCA collected through the European Resuscitation Council's EuReCa study questionnaires, covering the period from October 1, 2014, to December 31, 2021. Variables are presented as frequencies and percentages. Analytical statistical steps included the Chi-square test to examine the association between categorical variables and the Fisher exact probability test. Results: A total of 8,349 OHCA cases were recorded during the observed period. Out of that number, CPR was initiated in 2,758/8,349 cases (33.1%). A statistically significant difference was observed depending on the age group of the patients (χ2 (3) = 225.376; p<0.001). A statistically significant difference in the frequency of initiating/not initiating CPR measures between genders was also observed in the age groups of 40 to 60 years (χ2 (1) = 5.072; p=0.024) and over 60 years (χ2 (1) = 271.585; p<0.001), while no statistically significant difference was observed in other age categories. In the group of patients in whom CPR measures were initiated, a statistically significant difference in the frequency of return of spontaneous circulation (ROSC) at the scene was observed among different age groups (χ2(3)=16.764; p<0.001). However, this difference was not observed when comparing the frequency of admission to the nearest hospital with spontaneous circulation (χ2(3)=4.342; p=0.227). Conclusion: This study is the first in Serbia to address the issue of initiating or not initiating cardiopulmonary resuscitation depending on the age of patients with out-of-hospital cardiac arrest. Our data indicate a significantly higher percentage of non-initiated resuscitations compared to the European average. Notably, the highest percentage of non-initiated resuscitations is recorded among older patients. The observed differences in the frequency of initiating CPR between genders, particularly among older women, also require further research to understand and potentially reduce existing inequalities.
Guidelines 2021 Changes in Guidelines for First Aid
Guidelines for the implementation of first aid measures are part of the Guidelines 2021 of the European Resuscitation Council from 2015. In 2020, the ILCOR Committee made a scientific consensus for this area, and the European Resuscitation Council in 2021 made new recommendations based on this document and reviewed the existing ones. Recommendations for the application of first aid measures include first aid in emergencies and injuries.Recommendations that include emergencies consider the following content: recovery position, optimal positioning for shock, use of bronchodilators in patients with asthma in first aid, recognition of stroke, use of aspirin for chest pain, giving a second dose of adrenaline in anaphylaxis, first aid for hypoglycemia , oral rehydration, first aid for stress - related dehydration, heat stroke management and application of cooling measures, use of oxygen in providing first aid measures in acute stroke, and first aid for presyncope. First aid for trauma includes the following topics: control of life-threatening bleeding, first aid and treatment of open chest injuries, recognition of concussions, cooling burns, dental avulsion, and first aid for eye injuries due to exposure to chemicals.
Guidelines 2021 - Novelties in the protocol of advanced life support
Adult advanced life support guidelines 2021 provided by the European Resuscitation Council in its largest extent do not differ signifficantly from equivalent guidelines published six years ago. However, some important points were further emphasized, and some protocols show new additions and structural changes. According to the new guidelines, there is a greater recognition that patients with both in-hospital and out-of-hospital cardiac arrest have premonitory signs, and that many of these arrests may be preventable. High-quality chest compressions with minimal interruption, early defibrillation, and treatment of reversible causes remained high priority steps in resuscitation process. New guidelines also recommend that, if an advanced airway is required, rescuers with a high tracheal intubation success rate should use this technique. With regard to using diagnostic procedures, medications, and special methods of cardiopulmonary resuscitation, newest guidelines also made new suggestions. According to these guidelines, when adrenaline is used, it should be used as soon as possible when the cardiac arrest rhythm is non-shockable, and after three defibrillation attempts for a shockable cardiac arrest rhythm. The guidelines recognise the increasing role of point-of-care ultrasound in peri-arrest care for diagnosis, but emphasise that it requires a skilled operator, and the need to minimise interruptions during chest compression. Additionally, 2015 guidelines suggested use of point-of-care ultrasound in diagnosing several various conditions with potential of causing cardiac arrest. However, 2021 guidelines limited indications in diagnosing only cardiac causes, such as tamponade or pneumothorax. The guidelines also reflect the increasing evidence for extracorporeal cardiopulmonary resuscitation as a rescue therapy for selected patients with cardiac arrest when conventional advanced life support measures are failing or to facilitate specific interventions. Additionally, newest guidelines made significant changes in the order of steps used in the In/hospital resuscitation algorithm, as well as changes in several very important steps of treating tachycardias and high heart rate accosiated arrhythmias.
Copyright (c) 2021 Journal Resuscitatio Balcanica
Anaphylaxis in new European Resuscitation Council Guidelines 2021
Anaphylaxis is a potentially life-threatening allergic reaction. New guideline for treatment of anaphylaxis is presented in European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. There are no major changes. This guideline is specific for the initial treatment of adult patients with anaphylaxis or suspected anaphylaxis by clinician. Adrenaline is the most important drug for the treatment of anaphylaxis and the first line of treatment
Guidelines 2021 - The system saving lives
The European Resuscitation Council (ERC) has produced these Systems Saving Lives guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include chain of survival, measuring performance of resuscitation, social media and smartphones apps for engaging community, European Restart a Heart Day, World Restart a Heart, KIDS SAVE LIVES campaign, early warning scores, rapid response systems, and medical emergency team, cardiac arrest centres and role of dispatcher. The Systems Saving Lives chapter describes numerous and important factors that can globally improve the management of cardiac arrest patients not as a single intervention but as a system-level approach. The aim of this paper is to provide evidence-informed best practice guidance, about interventions which can be implemented by healthcare systems to improve outcomes of out-of-hospital and/or in-hospital cardiac arrest (OHCA and IHCA). The intended audience of the paper are governments, managers of health and education systems, healthcare professionals, teachers, students and laypeople.
Recommendations of the Resuscitation Council of Serbia for the implementation of resuscitation measures during the Covid 19 pandemic
The COVID 19 pandemic is caused by a virus we do not know enough about. The new situation has led to the need to enable quality resuscitation of patients with COVID 19 infection, but with quality protection of medical professionals from the risk of infection. Our efforts within our program activities are aimed at making recommendations to the Resuscitation Council of Serbia as the leading professional professional organization for the implementation of resuscitation measures in the conditions of the COVID 19 pandemic. We have made Recommendations for the implementation of resuscitation measures, Recommendations for ethical issues, the application of resuscitation measures in patients with COVID 19 infection and recommendations for training during the COVID-19 pandemic. We have made recommendations in cooperation with the European Resuscitation Council and other partner organizations, which are part of the network of national councils for resuscitation medicine in Europe. The recommendations will be modified in the coming period with the appearance of new knowledge and supplemented in relation to this basic text on the basis of new scientific evidence every 6 months until the adoption of unique recommendations of the European Resuscitation Council which are expected to be published in autumn 2021.
Copyright (c) 2020 Journal Resuscitatio Balcanica
Adverse events associated with tracheostomy cannulas in patients with COVID-19: causes and solutions
Patients with severe lung injury due to COVID-19 are often in need of mechanical ventilation. Due to the predicted length of invasive respiratory support, tracheostomy is commonly indicated to improve patient comfort, to reduce the need for sedation and to allow safer airway care. In this article we report two clinical cases of patients with COVID-19, who suffered cardiac arrest due to problems with tracheostomy canula placement. The first case report is regarding a 74-year-old patient, who was transported to CT from the ICU. Problems first occurred in the elevator, where specialist were forced to switch to bag ventilation, when the oxygen supply ran out. As a result, an episode of desaturation to 80% was registered. Upon arriving in the ICU, the patient was connected to a mechanical ventilator, however ventilation was ineffective: peak pressure was more than 40 cmH2O and the tidal volume was less than 100 ml. Debridement of the trachea was performed, the position of the cannula was secured with no effect. While preparing for oropharyngeal intubation, the patient’s saturation dropped to 70%, haemodynamics were unstable (BP 76/40), ECG showed bradycardia of 30 bpm, which quickly turned to asystole. Cardiopulmonary resuscitation was performed and the patient was intubated, mechanical ventilation was effective. The total time of cardiac arrest was around 2 minutes, when ROSC was achieved and sinus rhythm was registered on the ECG. In 6 hours after ROSC signs of acute coronary syndrome were registered, the patient received treatment accordingly. Despite the complications, the patient’s condition improved and he was transferred to the therapeutics ward and later discharged home with no signs of neurological impairment. The second case presents a similar clinical situation with an alternate outcome. A 32-year-old patient with COVID-19 was transferred to ICU due to signs of respiratory distress. His condition worsened and the patient was intubated, and soon percutaneous dilatational tracheostomy was performed. On day 9 of treatment in ICU an episode of desaturation to 75% was registered. Debridement of the trachea was not possible due to a block in the cannula. Due to rapid demise in the patient’s condition, the cannula was removed and the patient was intubated. After bronchoscopy, re-tracheostomy was performed. During the procedure, it was noted that the standard cannula was displaced at an angle to the posterior wall of the trachea. The cannula was replaced by an armored cannula. In the following hours, hypoxemia was observed, as well as subcutaneous emphysema of the patient’s face and upper body. Applying a thoracic X-ray, a left-side pneumothorax was diagnosed, which was urgently drained. In the following days of intensive care the patient’s condition gradually improved, mechanical ventilation was effective and signs of respiratory distress were fading. Neurologically the patient was responsive, able to perform simple tasks. Unfortunately, on the 15th day of ICU care the patient’s condition worsened: his fever spiked to 39-40,2C, CRP was 149, and CT showed signs of ARDS progression and vasopressors were administered due to hemodynamic instability. An episode of desaturation to 88% was noted. It was assumed that the tracheostomy cannula had been displaced, which was not proven by bronchoscopy. Later that day, while turning the patient to the side, bradycardia was noted on the monitor with progression to asystole. Cardiopulmonary resuscitation was performed for 5 minutes until ROSC. The tracheostomy cannula was then removed, due to inadequate ventilation and the patient was intubated and ventilated through an IT tube. After ROSC the patient’s neurological status was closely monitored. Without sedation the patient was unconscious (coma), non-responsive, hyporeflexive with little response to pain stimuli. In two weeks his neurological condition was regarded as a vegetative state (GCS -6).
Evaluation of Healthcare Professionals’ Knowledge on Code Blue: A Multi-Centre Survey Study
Introduction: The Blue Code practice provides increase in survival rates and decrease in the rate of permanent sequelae after cardiac arrest. There are issues that healthcare workers should pay attention to in the Code Blue practice. Aim: The primary purpose of this survey study is to determine the knowledge levels of physicians and nurses about the Code Blue and cardiopulmonary resuscitation in 6 centres. The secondary aim is to determine the solutions that can be made to eliminate these deficiencies. Methods: After the approval of the Faculty Ethics Committee, Mersin University Faculty of Medicine, Adana Baskent Turgut Noyan Training and Research Hospital, Dokuz Eylül Univ. Faculty of Medicine, Hacettepe University Faculty of Medicine, Gulhane Training and Research Hospital, Manisa Celal Bayar Univ. Faculty of Medicine, except for the doctors and technicians of the Department of Anaesthesiology and Reanimation and the healthcare professionals working in the intensive care units, the doctors and nurses working in other departments were asked to answer the questions in the questionnaire via the internet with the questionnaire form stated in Appendix 1. Results: A total of 415 participants responded the survey. Of them, 45.8% were nurses, 24.8% residents, 23.3% faculty members, 5.4% specialist doctors and 0.7% general practitioners. Totally 86.6% of the participants knew the Code Blue number. To the question "What is the Code Blue?", 92.7% of the participants gave the correct answer to his question. "Do you hesitate to intervene when you encounter a patient requiring emergency intervention?" 25.9% of the participants answered "Yes" to the question. "Is there a form about Code Blue in your clinic?" 41% answered "No" to the question. Conclusion: According to the results of the survey we conducted, we are of the opinion that healthcare workers have insufficient knowledge about the Code Blue. In order to solve these problems, it would be appropriate to direct healthcare professionals to both in-hospital and external training programs.
Introduction: Care and management of a life threatened child is a stressful event per se, further aggravated by the need for precise calculation of medication doses, the amount of fluids for volume replacement and choosing the rightsized equipment based on child’s weight and age, which is often an information unavailable at the scene of the emergency event. Objective: Our objective was to make a pediatric tape modeled by Broselow tape, but modified for medications and overall conditions present in our region. The original Broselow tape is not available in our country. Method and materials: For tailoring this pediatric tape we used the original Broselow tape.The connection between length/height of a child and its body weight was used in the same way, and then doses of medications and sizes of medical equipment were calculated for the appropriate age/body weight. Discussion: Our pediatric tape has two measuring parts: measuring tape with colored zones and cards that follow the appropriate color. Tape is divided into nine zones with calculated doses of medications, the amounts of fluids for volume replacement and sizes of equipment for each zone. Conclusion: Hoping that this pediatric tape will find its place and use in our region, we hereby open a discussion of our professional community regarding this accessory and its future potential.
PRESS RELEASE The fairness of ethical decisions related to the allocation of medical resources within the COVID-19 pandemic
The Serbian Resuscitation Council discussed, considered, and adopted based on the National Course Director opinion leaders consensus in the field of resuscitation medicine about the basic principles of resource allocations, related to the application of resuscitation procedures and care of patients during the pandemics, The COVID-19 pandemic around the world has brought a lot of changes within all segments of life, we all are faced to everyday challenges, including ethics in medicine, which is a very sensitive area due to specifics that are unique and different in each country individually, with strong cultural, economic, religious, medical, legal, and other diversities. The challenges are enormous, given by the current lack of a specific therapy, by the limited resources available for diagnosis, intervention, and preventive measures. The pandemic also brought the need to create conditions for the application of "unusual" requirements, measures, and procedures of the healthcare system and medical care, which entails a certain reorganization of medical interventions and care systems, including mandatory personal protection measures, adherence to adequate social distance, and all hygienic procedures. General ethical principles, such as maximum benefit and equality of treatment, while giving priority to those with the most severe conditions, have created the need to create ethical recommendations related to the allocation of medical resources in the COVID-19 pandemic and Eziekel et al. published six principles related to the above in terms of maximizing benefits, giving an advantage to healthcare professionals, triage outside the framework of the "first arrival" basis, responding to findings, recognizing participation in research, and applying the same principles to COVID-19 and in non-COVID-19 patients. A fair allocation of these ethical values ​​and principles requires adaptable ethical frameworks depending on the resources available and the organizational structure of the healthcare system.
BLS training: Standard vs Virtual reality BLS training
ABSTRACT Aim: European Resuscitation Council BLS Provider course has well determined aims, objectives and outcomes. New technologies offer new opportunities and new didactic equipment for providing BLS training. Serbian Resuscitation Councils BLS working group opened the question related to the methodology in conducting these courses with use of devices which provide virtual reality (VR). A pilot course program with the use of VR devices was settled and conducted during students teaching at Universities in Serbia. Methods: Prospective randomized manikin study. Students were randomly selected at registration and divided into two groups. Group I –standard ERC BLS course. Group II – BLS course with use of VR didactic device. Before and after the course all candidates were assessed with Cardiff scoring system related to CPR protocol and chest compression. Results: 250 medical students participated. Group I had 125 students in total. The Zoll AED Pro showed that the depth and frequency of compressions was good in 67, 04%. In this group candidate evaluation marks was 4, 35 at the scale 1 to 5 points. Group II – 125 students in total. The data showed 63, 16 % of compressions were satisfactory in aspects of depth and/or frequency and there evaluation marks was 4,65. Conclusion: Virtual reality contributed to the candidate’s sense of satisfaction but did not significantly change the outcome and results of the BLS training
Dispatcher-assisted resuscitation - EuReCa_Serbia 2014-2019
ABSTRACT Background: There are studies that indicate that dispatcher-guided CPR increases survival in Out-Of-Hospital cardiac arrest (OHCA). In this study, we observed the role of dispatcher lead CPR in OHCA and determined it’s influence on return of spontaneous circulation and survival. Method: Data was collected via the National OHCA Registry Serbia. Results: The collected results were obtained from 40/179 municipalities, 48.7% of the population in Serbia. In the period of 2014 – 2019. 6312 OHCA were registered. A witness was present in 3655/6312 (57,91%) patients. Witness-CPR was performed in 365/3655 (9,99%) events, dispatch CPR was applied in 197/365 (53,9%) cases. The calculated chance for the ROSC is 1,2 higher when the dispatcher was leading the CPR compared to cases where the witness-CPR was performed without dispatchers assistance (OR = 1,128; 95%CI = 0,685–1,913). Conclusion: In observed data of the National OHCA Registry Serbia, the results indicate that the outcome was insignificantly improved compared to ROSC and survival rate when dispatch-lead-CPR was performed. There is no specific dispatcher education program in Serbia and that fact should be investigate in purpose of further results and activities.
Bystander CPR – EuReCa_ Serbia 2014 -2019
ABSTRACT The aim of this study is to determinate a chance of surviving in bystander CPR in out-of-hospital cardiac arrest (OHCA) in Serbia. Methodology: The study was conducted as a prospective and observational study of the collection of data in the period 2014 -2019 via the National OHCA Registry Serbia. EuReCa program is registered Clinical Trial ID:NCT03130088. Data analysis was done by IBM SPSS Statistics 20. Results: A total of 6312 OHCA is registered. A witness was present in 3655/6312 or 57,9% OHCA, but CPR is done in 365/3655, or 10,2% witness presented OHCA. ROSC is achieved in 9,7% patients, 6,6% patients which CPR by bystander were not done and 28,1% patients in which CPR by bystander were done, which is statistically significant (χ2 = 122,792; df = 1; p = 0.000). A chance for ROSC is 5,4 higher when CPR by bystander is done before EMS arrival (OR = 5,4; 95% C.I. 3,967-7.377). ROSC has commonly occurred in older males with shorter EMS time to arrival but most important is bystander CPR. Conclusion: People who experienced out-of-hospital cardiac arrest have a 5,4 higher chance for ROSC which means, finally observing, a higher chance for survival when bystander CPR is performed.