Studienportal
Airway Management Analysis in the Rescue Environment of the Emergency Service Zug (AWARE)
1. Hypothese / Ziel
Airway management is a critical procedure in emergency medicine, especially endotracheal intubation, which can be life-saving. Various techniques, such as video laryngoscopes and conventional laryngoscopes, are used, with success depending on first-pass success. The aim of this retrospective data analysis is to determine the success rate of endotracheal intubation in the first attempt in the Zug Rescue Service between 01/20 and 01/25 with various airway management devices already used in everyday life. The individual complications should secondary with regard to frequency and category as well as possible risk factors. risk factors. The aim is to examine the data on airway management of patients who had to be intubated due to a critical illness (e.g. impaired oxygenation or ventilation, reduced vigilance, cardiovascular arrest, etc.). The data is continuously collected and evaluated by the RDZ as part of quality assurance.
2. Studiendesign / Prozesse
Retroperspective Cohort
Inclusion Criteria:
All adult patients who have had their airway secured by endotracheal intubation by RDZ staff
Exclusion Criteria:
Existence of a documented refusal.
Age < 18 years.
Study Population:
The aim is to examine the data on airway management in the Zug Rescue Service who had to be intubated due to a critical illness (e.g. oxygenation or ventilation disorder, reduced vigilance, cardiovascular arrest, etc.). The data is continuously collected and evaluated by the RDZ as part of quality assurance.
Groups/Cohorts:
videolaryngocopy with bougie (S Guide)
Device: bougie (S Guide) bougie (S Guide) Device: videolaryngoscopy: videolaryngoscopy hyperangulated or Macintosh
conventional laryngoscopy with bougie (S Guide)
Device: bougie (S Guide), bougie (S Guide)
videolaryngoscopy with introducer Device: videolaryngoscopy
videolaryngoscopy hyperangulated or Macintosh
conventional laryngoscopy with introducer: Device videolaryngoscopy hyperangulated or Macintosh
conventional laryngoscopy with introducer: Device conventional laryngoscopy
3. Ergebnis / Endpunkt
Outcome Measure:
- Success rate (first pass success) with the airway management tools already used in the Zug rescue service (Video laryngoscope with Macintosh blade "C-MAC")
- Success rate (first pass success) with the airway management tools already used in the Zug rescue service (hyperangulated video laryngoscope "D-BLADE")
- Success rate (first pass success) with the airway management tools already used in the Zug rescue service (Conventional laryngoscope)
- Success rate (first pass success) with the airway management tools already used in the Zug rescue service (Surgical airway protection)
- Success rate (first pass success) with the airway management tools already used in the Zug rescue service (Bougie/tube introducer)
- Success rate (first pass success) with the airway management tools already used in the Zug rescue service (Stylet/guide rot)
Secondary Outcome Measures:
- Incidence of complications (mechanical damage)
- Incidence of airways retrospectively assessed as definitively difficult (proportion of "definitive difficult airway" to "anticipated difficult airway" and "unanticipated difficult airway")
- Evaluation of operational and patient-related data (Medical/non-medical occupational group)
- Incidence of complications (drop in saturation SpO2 <90%)
- Evaluation of operational and patient-related data (years of clinical experience of the intubator)
- Evaluation of operational and patient-related data (Date, time, day or night shift)
- Evaluation of operational and patient-related data (Reason for initiating resuscitation/DAI)
- Evaluation of operational and patient-related data (Patient demographics (age, gender)
Studienzweck: Therapie
Klassifizierung: Kohortenstudie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Emergency Medical Service Canton Zug (CH)
Dauer: 01.12.2024 - 01.07.2025
Aktiv/Inaktiv: Aktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Scherr, Benedikt Florian MD
Bemerkungen: Investigators: Benedikt Florian Scherr, MD https://orcid.org/0000-0001-7722-0851 Gian Andrea Cajöri, MD https://orcid.org/0000-0002-1568-0251 Felix Brinkmann, MBA https://orcid.org/0009-0004-7492-3251
Kontaktperson: Felix Brinkmann
E-Mail: felix.brinkmann@zg.ch
Links: https://clinicaltrials.gov/study/NCT06653166
Dateien:
ID: 42851
Basec ID:
Validation of Utstein-Based score to predict return of spontaneous circulation (UB-ROSC) in patients with out-of-hospital cardiac arrest
Background and aims:
The Utstein Based-ROSC (UB-ROSC) score has been developed to predict ROSC in OHCA victims. Aim of the study was to validate the UB-ROSC score using two Utstein-based OHCA registries: the SWiss REgistry of Cardiac Arrest (SWISSRECA) and the Lombardia Cardiac Arrest Registry (Lombardia CARe), northern Italy.
Methods:
Consecutive patients with OHCA of any etiology occurring between January 1st, 2019 and December 31st 2021 were included in this retrospective validation study. UB-ROSC score was computed for each patient and categorized in one of three subgroups: low, medium or high likelihood of ROSC according to the UB-ROSC cut-offs (≤−19; −18 to 12; ≥13). To assess the performance of the UB-ROSC score in this new cohort, we assessed both discrimination and calibration. The score was plotted against the survival to hospital admission.
Results:
A total of 12.577 patients were included in the study. A sustained ROSC was obtained in 2.719 patients (22%). The UB-ROSC model resulted well calibrated and showed a good discrimination (AUC 0.71, 95% CI 0.70–0.72). In the low likelihood subgroup of UB-ROSC, only 10% of patients achieved ROSC, whereas the proportion raised to 36% for a score between −18 and 12 (OR 5.0, 95% CI 2.9–8.6, p < 0.001) and to 85% for a score ≥13 (OR 49.4, 95% CI 14.3–170.6, p < 0.001).
Conclusions:
UB-ROSC score represents a reliable tool to predict ROSC probability in OHCA patients. Its application may help the medical decision-making process, providing a realistic stratification of the probability for ROSC.
Studienzweck: Prognose
Klassifizierung: Kohortenstudie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Switzerland
Dauer: 01.01.2019 - 31.12.2021
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Interverband für Rettungswesen IVR-IAS
Bemerkungen: https://www.resuscitationjournal.com/article/S0300-9572(24)00006-6/fulltext
Kontaktperson: Maria Luce Caputo - Department of Cardiology, Cardiocentro Ticino Institute-EOC, Lugano, Switzerland Fondazione Ticino Cuore, Lugano, Switzerland
E-Mail: marialuce.caputo@eoc.ch
Links: https://www.resuscitationjournal.com/action/showPdf?pii=S0300-9572%2824%2900006-6
Dateien:
ID: 38580
Basec ID: -1
Reporting standard for describing first responder systems, smartphone alerting systems, and AED networks
Standardized reporting of data is crucial for out-of-hospital cardiac arrest (OHCA) research. While the implementation of first responder systems
dispatching volunteers to OHCA is encouraged, there is currently no uniform reporting standard for describing these systems.
A steering committee established a literature search to identify experts in smartphone alerting systems. These international experts were invited to a
conference held in Hinterzarten, Germany, with 40 researchers from 13 countries in attendance. Prior to the conference, participants submitted proposals for parameters to be included in the reporting standard. The conference comprised five workshops covering different aspects of smartphone
alerting systems. Proposed parameters were discussed, clarified, and consensus was achieved using the Nominal Group Technique. Participants
voted in a modified Delphi approach on including each category as a core or supplementary element in the reporting standard. Results were presented, and a writing group developed definitions for all categories and items, which were sent to participants for revision and final voting using
LimeSurvey web-based software.
The resulting reporting standard consists of 68 core items and 21 supplementary items grouped into five topics (first responder system, first responder network, technology/algorithm/strategies, reporting data, and automated external defibrillators (AED)).
This proposed reporting standard generated by an expert opinion group fills the gap in describing first responder systems. Its adoption in future
research will facilitate comparison of systems and research outcomes, enhancing the transfer of scientific findings to clinical practice.
Studienzweck: Gesundheitssystemforschung
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Europe
For Switzerland: Interverband für Rettungswesen (IVR-IAS) / Swiss Resuscitation Council (SRC)
Dauer:
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: German Resuscitation Council / European Resuscitation Council
Bemerkungen: Please cite this article as: M.P. Mu¨ller, C. Metelmann, K.C. Thies et al., Reporting standard for describing first responder systems, smartphone alerting systems, and AED networks, Resuscitation, https://doi.org/10.1016/j.resuscitation.2023.110087
Kontaktperson: Prof. Michael Müller
E-Mail: michael.mueller@grc-org.de
Links:
Dateien: Datei 1
ID: 38368
Basec ID:
The impact of COVID-19 pandemic on out-of-hospital cardiac arrest: An individual patient data meta-analysis
Aim: Prior studies have reported increased out-of-hospital cardiac arrests (OHCA) incidence and lower survival during the COVID-19 pandemic. We evaluated how the COVID-19 pandemic affected OHCA incidence, bystander CPR rate and patients’ outcomes, accounting for regional COVID-19 incidence and OHCA characteristics.
Methods: Individual patient data meta-analysis of studies which provided a comparison of OHCA incidence during the first pandemic wave (COVIDperiod) with a reference period of the previous year(s) (pre-COVID period). We computed COVID-19 incidence per 100,000 inhabitants in each of 97 regions per each week and divided it into its quartiles.
Results: We considered a total of 49,882 patients in 10 studies. OHCA incidence increased significantly compared to previous years in regions
where weekly COVID-19 incidence was in the fourth quartile (>136/100,000/week), and patients in these regions had a lower odds of bystander
CPR (OR 0.49, 95%CI 0.29–0.81, p = 0.005). Overall, the COVID-period was associated with an increase in medical etiology (89.2% vs 87.5%,
p < 0.001) and OHCAs at home (74.7% vs 67.4%, p < 0.001), and a decrease in shockable initial rhythm (16.5% vs 20.3%, p < 0.001). The
COVID-period was independently associated with pre-hospital death (OR 1.73, 95%CI 1.55–1.93, p < 0.001) and negatively associated with survival
to hospital admission (OR 0.68, 95%CI 0.64–0.72, p < 0.001) and survival to discharge (OR 0.50, 95%CI 0.46–0.54, p < 0.001).
Conclusions: During the first COVID-19 pandemic wave, there was higher OHCA incidence and lower bystander CPR rate in regions with a highburden of COVID-19. COVID-19 was also associated with a change in patient characteristics and lower survival independently of COVID-19 incidence in the region where OHCA occurred.
Keywords: Out-of-hospital cardiac arrest, COVID-19, SARS-CoV-2, Individual patient data meta-analysis
Studienzweck: Therapie
Klassifizierung: Kohortenstudie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Europe
Dauer: 2020
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Corresponding author at: Division of Cardiology Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. E-mail address: enrico.baldi@unipv.it (E. Baldi).
Bemerkungen: https://www.resuscitationjournal.com/article/S0300-9572(23)00770-0/fulltext
Kontaktperson: Dr med. Enrico Baldi - Pavia
E-Mail: enrico.baldi@unipv.it
Links:
Dateien: Datei 1
ID: 37950
Basec ID:
A roadmap to building first responder networks: Lessons learned and best practices from Belgium and Switzerland
1. Ipotesi / Obiettivo
Limited bystander assistance and delayed emergency medical service arrival reduce the chances of survival in cardiac arrest victims. Early basic life support through trained first responders (FR) and automatic external defibrillation both improve the outcome. Well-organized FR networks have shown promise, but guidance on effective implementation is lacking. This study evaluates two FR networks, in Belgium and in Switzerland, to identify main advancements in the development of such systems
2. Design dello studio / Processi
Direct comparison is made of the barriers and facilitators in the development of both FR systems from 2006 up until December 2022, and summarized within a roadmap.
3. Risultato / Endpoint+
The Roadmap comprises four integral steps: exploration, installation, initiation, and implementation. Exploration involves understanding the national legislation, engaging with advisory bodies, and establishing local steering committees. The installation phase focuses on FR recruitment, engaging specific professional groups such as firemen, registering public Automated External Defibrillators (AEDs), and requesting feedback. The initiation step includes implementing improvement cycles and fidelity measures. Finally, implementation expands the network, leading to increased survival rates and the integration of these practices into legislation. A significant focus is placed on FR's psychological wellbeing. Moreover, the roadmap highlights the use of efficient geo-mapping to simplify optimal AED placement and automatically assign FRs to tasks
Conclusion
The importance of FR networks for early resuscitation is increasingly recognized and various systems are being developed. Key developmental strategies of the EVapp and Ticino Cuore app system may serve as a roadmap for other systems and implementations within Europe and beyond.
Studienzweck: Gesundheitssystemforschung
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ghent University, Ghent, Belgium
Ghent University Hospital, Ghent, Belgium
Emergency Volunteer Application (EVapp) NGO, Belgium
Cardiocentro Ticino Institute, Lugano, Switzerland
Fondazione Ticino Cuore, Lugano, Switzerland
OLVG Hospital, Amsterdam, The Netherlands
Dauer: 29.09.2023
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Esther Moens, Eva Degraeuwe, Maria Luce Caputo, Ruggero Cresta, Robin Arys, Nina Van Moorter, Thomas Tackaert, Claudio Benvenuti, Angelo Auricchio, Steven Vercammen
Bemerkungen:
Kontaktperson: marialuce.caputo@eoc.ch
E-Mail:
Links:
Dateien:
ID: 37027
Basec ID:
Article Impact of the First Swiss Conference on Prehospital Emergency Care and Trauma Research (SPECTRe) on Paramedics‘ Intention to Engage in Research: cross-sectional study
Background:
In Switzerland, paramedics lack academic training, meaning they do not receive specialized education in the field of research. Similar to many other European countries, paramedics are seldom included in prehospital research. However, consid-ering the significant gaps in knowledge within prehospital emergency medicine, educating and involving paramedics could markedly enhance prehospital emergency medicine research and decrease knowledge gap in this area.
Objective:
This cross-sectional study aimed to evaluate the impact of the inaugural Swiss Conference on Prehospital Emergency Care and Trauma Research on paramedics’ inclination to participate in prehospital research.
Methods:
A questionnaire was administered using Likert-type scales. All participants (100) were asked to answer a web-based questionnaire after attending the conference.
Results:
Out of 80 responses (80%), 72 were filled by paramedics and therefore included in the analysis. Participants were significantly more willing to engage in prehospital research after attending the conference (40/56, 71.4%) than before (23/56, 41.1%); p<0.001. Among participants already actively involved, 46.7% (7/15) responded that the event had a positive impact on their level of involvement. The results revealed a noteworthily increase in willingness to engage in research.
Conclusions:
A one-day conference solely focused on pre-hospital scientific research serves as a motivating factor for paramedics to partake in research in this domain. Whether this will actually lead to a higher scientific output remains to be seen.
Studienzweck: Gesundheitssystemforschung
Klassifizierung: Nicht klinische Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Neuchâtel
Dauer: 01.09.2022 - 31.12.2023
Aktiv/Inaktiv: Aktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Multiples auteurs
Bemerkungen:
Kontaktperson: Samuel Zünd - SPS Neuchâtel
E-Mail: samuel.zuend@gmail.com
Links:
Dateien:
ID: 36211
Basec ID:
Out-of-hospital cardiac arrests and mortality in Swiss Cantons with high and low COVID-19 incidence: A nationwide analysis
1. Hypothese / Ziel
Many countries reported an increase of out-of-hospital cardiac arrests (OHCAs) and mortality during the COVID-19 pandemic. However, all these data refer to regional settings and national data are still missing. We aimed to assess the OHCA incidence and population mortality during COVID-19 pandemic in whole Switzerland and in the different regions (Cantons) according to the infection rate.
2. Studiendesign / Prozesse
We considered OHCAs and deaths which occurred in Switzerland after the first diagnosed case of COVID-19 (February 25th) and for the subsequent 65 days and in the same period in 2019. We also compared Cantons with high versus low COVID-19 incidence.
3. Ergebnis / Endpunkt
A 2.4% reduction in OHCA cases was observed in Switzerland. The reduction was particularly high (21.4%) in high-incidence COVID-19 cantons, whilst OHCAs increased by 7.7% in low-incidence COVID-19 cantons. Mortality increased by 8.6% in the entire nation: a 27.8% increase in high-incidence cantons and a slight decrease (0.7%) in low-incidence cantons was observed. The OHCA occurred more frequently at home, CPR and AED use by bystander were less frequent during the pandemic. Conversely, the OHCAs percentage in which a first responder was present, initiated the CPR and used an AED, increased. The outcome of patients in COVID-19 high-incidence cantons was worse compared to low-incidence cantons.
Studienzweck: Andere
Klassifizierung: Fall-Kontroll-Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: SWITZERLAND
Pavia, Italy
Dauer: 25.02.2019 - 30.04.2020
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Enrico Baldi
Bemerkungen:
Kontaktperson: Fondazione Ticino cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36719
Basec ID:
Association of Timing of Electrocardiogram Acquisition After Return of Spontaneous Circulation With Coronary Angiography Findings in Patients With Out-of-Hospital Cardiac Arrest
1. Hypothese / Ziel
To assess whether the time from ROSC to ECG acquisition is associated with the diagnostic accuracy of ECG for STEMI.
2. Studiendesign / Prozesse
DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study (the Post- ROSC Electrocardiogram After Cardiac Arrest study) analyzed consecutive patients older than 18 years who were resuscitated from OHCA between January 1, 2015, and December 31, 2018, and were admitted to 1 of the 3 participating centers in Europe (Pavia, Italy; Lugano, Switzerland; and
Vienna, Austria).
EXPOSURE Only patients who underwent coronary angiography during hospitalization and who acquired a post-ROSC ECG before the angiography were enrolled. Patients with a nonmedical cause of OHCAs were excluded.
MAIN OUTCOMES AND MEASURES The primary end point wasf alse-positive ECG findings, defined as the percentage of patients with post-ROSC ECG findings that met STEMI criteria but who did not show obstructive coronary artery disease on angiography that was worthy of percutaneous coronary angioplasty.
3. Ergebnis / Endpunkt
Of586consecutivepatientswhowereadmittedtothe3participatingcenters,370were included in the analysis (287 men [77.6%]; median age, 62 years [interquartile range, 53-70 years]); 121 (32.7%) were enrolled in the participating center in Pavia, Italy; 38 (10.3%) in Lugano, Switzerland; and 211 (57.0%) in Vienna, Austria. The percentage of false-positive ECG findings in the first tertile of ROSC to ECG time (7 minutes) was significantly higher than that in the second (8-33 minutes) and third (>33 minutes) tertiles: 18.5% in the first tertile vs 7.2% in the second (odds ratio [OR], 0.34; 95% CI, 0.13-0.87; P = .02) and 5.8% in the third (OR, 0.27; 95% CI, 0.15-0.47; P 33 minutes: OR, 0.26; 95% CI, 0.14-0.47; P 33 minutes: OR, 0.27; 95% CI, 0.15-0.46; P 33 minutes: OR, 0.28; 95% CI, 0.15-0.52; P 33
minutes: OR, 0.27; 95% CI, 0.15-0.48; P 33 minutes: OR, 0.29; 95% CI, 0.15-0.55; P < .001), epinephrine administered (7 minutes: reference; 8-33 minutes: OR, 0.35; 95% CI, 0.13-0.98;
P = .045; >33 minutes: OR, 0.27; 95% CI, 0.16-0.48; P 33 minutes: OR, 0.26; 95% CI, 0.15- 0.46; P 33 minutes: OR, 0.27; 95% CI, 0.16-0.48; P < .001) in bivariable analyses.
Studienzweck: Diagnose
Klassifizierung: Kohortenstudie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Pavia, Italy
Lugano, Switzerland
Vienna, Austria
Dauer: 01.01.2015 - 31.12.2018
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Enrico Baldi
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36713
Basec ID:
A Multicenter International Randomized Controlled Manikin Study on Different Protocols of Cardiopulmonary Resuscitation for Laypeople
1. Hypothese / Ziel
Compression-only cardiopulmonary resuscitation (CPR) is a suggested tech- nique for laypeople facing out-of-hospital cardiac arrest (OHCA). However, it is difficult perform- ing high-quality CPR until emergency medical services arrival with this technique. We aimed to verify whether incorporating intentional interruptions of different frequency and duration increases laypeople's CPR quality during an 8-minute scenario compared with compression-only CPR.
2. Studiendesign / Prozesse
We performed a multicenter randomized manikin study selecting participants from 2154 consecutive laypeople who followed a basic life support/automatic external defibrillation course. People who achieved high-quality CPR in 1-minute test on a computer- ized manikin were asked to participate. Five hundred seventy-six were enrolled, and 59 were later excluded for technical reasons or incorrect test recording. Participants were randomized in an 8-minute OHCA scenario using 3 CPR protocols (30 compressions and 2-second pause, 30c2s; 50 compressions and 5-second pause, 50c5s; 100 compressions and 10-second pause, 100c10s) or compression-only technique. The main outcome was the percentage of chest compressions with adequate depth.
3. Ergebnis / Endpunkt
Results: Five hundred seventeen participants were evaluated. There was a statistically sig- nificant difference regarding the percentage of compressions with correct depth among the groups (30c2s, 96%; 50c5s, 96%; 100c10s, 92%; compression only, 79%; P = 0.006). Post hoc comparison showed a significant difference for 30c2s (P = 0.023) and for 50c5s (P = 0.003) versus compression only. Regarding secondary outcome, there were a higher chest compression fraction in the compression-only group and a higher rate of pauses lon- ger than 10 seconds in the 100c10s.
Conclusions: In a simulated OHCA, 30c2s and 50c5s protocols were characterized by a higher rate of chest compressions with correct depth than compression only. This could have practical consequences in laypeople CPR training and recommendations.
Studienzweck: Andere
Klassifizierung: Randomisierte kontrollierte Studie RCT
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Pavia, Italy
Palermo, Italy
Robbio, Italy
Pordenone, Italy
Lugano, Switzerland
Lausanne, Switzerland
Cortaillod, Switzerland
Cugy, Switzerland
Dauer: 16.04.2016 - 26.04.2019
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Enrico Baldi
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36731
Basec ID:
Leitstellendisposition und deren Qualitätsbewertung
Sanitätsnotrufzentralen (Leitstellen) haben als Teil der Rettungskette eine hohe Verantwortung bezüglich der Aktivierung geeigneter Rettungsmittel. Sie übernehmen eine rechtliche Garantenstellung. Auf der Suche nach Best-Practice-Modellen werden die gesetzlichen Grundlagen, die organisationsinternen Vorgehensweisen der Qualitätsbewertungen und die Auswertungen von Kennzahlen zwischen einer Schweizer und zwei österreichischen Leitstellen verglichen.
Studienzweck: Qualitaetsmanagement
Klassifizierung: Nicht klinische Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: St.Gallen, Landessicherheitszentrale Burgenland, Leitstelle Notruf Niederösterreich
Dauer:
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Günter Bildstein
Bemerkungen:
Kontaktperson: Günter Bildstein
E-Mail: guenter.bildstein@rettung-sg.ch
Links:
Dateien:
ID: 36203
Basec ID:
An Utstein-based model score to predict survival to hospital admission: The UB-ROSC score
1. Hypothese / Ziel
To develop and validate a multi-parametric practical score to predict the probability of survival to hospital admission of an out-of-hospital cardiac arrest (OHCA) victim by using Utstein Style-based variables.
2. Studiendesign / Prozesse
All consecutive OHCA cases occurring from 2015 to 2017 in two regions, Pavia Province (Italy) and Canton Ticino (Switzerland) were included. We used random effect logistic regression to model survival to hospital admission after an OHCA. We computed the model area under the ROC curve (AUC ROC) for discrimination and we performed both internal and external validation by considering all OHCAs occurring in the aforementioned regions in 2018. The Utstein-Based ROSC (UB-ROSC) score was derived by using the coefficients estimated in the regression model. The score value was obtained adding the pertinent score components calculated for each variable. The score was then plotted against the probability of survival to hospital admission.
3. Ergebnis / Endpunkt
1962 OHCAs were included (62% male, mean age 73 ± 16 years). Age, aetiology, location, witnessed OHCA, bystander CPR, EMS arrival time and shockable rhythm were independently associated with survival to hospital admission. The model showed excellent discrimination (AUC 0.83, 95%CI 0.81-0.85) for predicting survival to hospital admission, also at internal cross-validation (AUC 0.82, 95%CI 0.80-0.84). The model maintained good discrimination after external validation by using the 2018 OHCA cohort (AUC 0.77, 95%CI 0.74-0.80).
Studienzweck: Prognose
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Pavia, Italy
Ticino, Switzeland
Dauer: 01.01.2015 - 31.12.2018
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.sciencedirect.com/science/article/pii/S016752731936379X
Dateien: Datei 1
ID: 36701
Basec ID:
Real-life time and distance covered by lay first responders alerted by means of smartphone-application: Implications for early initiation of cardiopulmonary resuscitation and access to automatic external defibrillators
1. Hypothese / Ziel
To investigate the distance covered by lay first responders (LFR) alerted for an out-of- hospital cardiac arrest (OHCA), evaluate the time elapsed between mission acceptance and arrival at the OHCA site, as well as the distance between the LFRs to the closest automatic external defibrillator (AED).
2. Studiendesign / Prozesse
The LFR route, thus time, distance information, and the average speed of each responder were estimated. The same methodology was used to calculate the distance between the closest AED and the LFRs, as well as the distance between the AED and OHCA site.
3. Ergebnis / Endpunkt
Between June 1st, 2014 and December 31st, 2017, the LFR network was activated in occasion of 484 suspected OHCAs. 710 LFRs were automatically selected by the application and accepted the mission. On average 1.5 LFRs arrived at the OHCA site. LFRs covered a distance of 1196 m (IQR 596–2314) at a median speed of 6.9 m/s (IQR 4.5–9.8) or 24.8 Km/h. In 4.4% of the cases the speed of the LFRs was compatible with a brisk walk activity (<1.5 m/sec). The total intervention time of an LFR, who first retrieved an AED and then went to the OHCA site, was longer (275 s, IQR: 184 s–414 s) compared to the total intervention time of a LFR (197 s, IQR: 120 s–306 s; p < 0.001), who went to the OHCA site directly without retrieving an AED.
Studienzweck: Qualitaetsmanagement
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Pavia, Italy
Dauer: 01.06.2014 - 31.12.2017
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Angelo Auricchio
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36711
Basec ID:
Gender differences in presentation and outcome of out-of-hospital cardiac arrest
1. Hypothese / Ziel
We aimed to analyse the outcome of OHCAs occurred in Swiss Canton Ticino according to the victim’s gender.
2. Studiendesign / Prozesse
We performed a retrospective analysis of prospectively collected data of OHCAs since 1st of January 2005 to 31st of December 2017 in Swiss Canton Ticino. When a cardiac arrest is suspected, assisted triage and life support are dispatched and medical assistance is initiated until an ambulance arrives. The Emergency Medical Service (EMS) dispatcher send the ambulance and, in parallel, notifies the alert to the traditional first-responders (police officers and fire brigade), trained in Basic Life Support-Defibrillation (BLS-D) and equipped with an automatic external defibrillator (AED). If conditions are regarded as safe, the first responeders (FR) are notified as well. The latter are mostly lay persons, but even off-duty healthcare providers.
3. Ergebnis / Endpunkt
A total of 3623 patients, 1140 women (31 %) and 2493 men (69%), were included. OHCA in women occurred more often at home (72% versus 63%, respectively, p<0.001) and less frequently it was witnessed (56% versus 63%, respectively, p <0.001). Women were more likely to be older than men (median age 76 versus 69 years old, respectively, p < 0.001).
Conclusions: In our experience, OHCA presentation and outcome significantly differs according to sex. Women presenting with a shockable rhythm had a lower survival compared to male patients due to different clinical presentation (more often occurring at home and unwitnessed) and to delayed time of defibrillation.
Studienzweck: Andere
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2005 - 31.12.2017
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Caputo ML
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36735
Basec ID:
Spatial-temporal heterogeneity of out-of-hospital cardiac arrest incidence in Swiss Canton Ticino
1. Hypothese / Ziel
We aimed to determine whether OHCA incidence was homogeneously distributed at municipality level in Swiss Canton Ticino, a large territory including rural and urban areas; to assess areas of increased risk of OHCAs over time, according to demographic characteristics of the resident population and to predict OHCA events at municipality level.
2. Studiendesign / Prozesse
All data regarding OHCAs which occurred in Canton Ticino (Switzerland) from January 1, 2005, through to December 31, 2017 were entered into a prospectively designed registry and geolocated. Demographic characteristics (sex composition and age distribution) at the level of single municipality were collected from the Federal Office of Statistics. Counting and incidences were calculated at level of each municipality, by taking into account gender and age distribution.
The Integrated Nested Laplace Approximation (INLA) was used for estimate OHCA incidences with related uncertainty in a training sample (OHCAs occurred between 2005 and 2015), and to predict OHCA incidences in a validation cohort (OHCAs occurred in 2016-2017).
3. Ergebnis / Endpunkt
A total of 2129 OHCAs of presumed cardiac origin occurred in the 117 municipalities of Canton Ticino. Of those, 564 (27%) had a VT or VF as presenting rhythm. There was a negligible annual fluctuation in the absolute number of OHCA without significant change over time of the overall OHCA incidence. OHCAs occurred prevalently at home (70%), in men (68%) of a median age of 71 years. We observed a concentration of cardiac events in the Southern part of Ticino, with a spatial distribution that followed the geographical configuration of valleys. As expected, the absolute numbers of OHCAs were higher in more populated areas, but some less populated municipalities showed relevant OHCAs incidence, that could be explained with a higher prevalence of male people with an age ≥ 80 years old.
Conclusions: Significant differences in OHCA prevalence and incidence among municipalities were observed. A predictive model taking into account territorial gender and age distribution is able to predict up to 90% of events variability. This approach provides a great opportunity for preventive measures and reduction in access time to OHCA.
Studienzweck: Andere
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2005 - 31.12.2017
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Caputo ML
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36733
Basec ID:
Comparative performance assessment of commercially available automatic external defibrillators: A simulation and real-life measurement study of hands-off time
1. Hypothese / Ziel
Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients’ survival. However, AED peri- and post- shock/analysis pauses may reduce CPR effectiveness.
2. Studiendesign / Prozesse
The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time.
3. Ergebnis / Endpunkt
None of the AEDs was able to complete the analysis and to charge the capacitors in less than 10 s and the mean post-shock pause was 6.7 ± 2.4 s. For non-shockable rhythms, the mean analysis time was 10.3 ± 2 s and the mean post-analysis time was 6.2 ± 2.2 s. We analyzed 154 AED records [104 by Emergency Medical Service (EMS) rescuers; 50 by lay rescuers]. EMS rescuers were faster in resuming CPR than lay rescuers [5.3 s (95%CI 5–5.7) vs 8.6 s (95%CI 7.3–10).
Studienzweck: Qualitaetsmanagement
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Pavia, Italy
Dauer: 01.01.2016 - 05.07.2016
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
Bemerkungen: the duration of the study is estimated. It took place indicatively in early 2016.
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36709
Basec ID:
Gender-specific differences in return-to-spontaneous circulation and outcome after out-of-hospital cardiac arrest: Results of sixteen-year-state-wide initiatives
1. Hypothese / Ziel
Several studies reported a lower proportion of laypeople cardio-pulmonary resuscitation (CPR) in female victims of out-of-hospital cardiac arrest (OHCA). We aimed to verify how sixteen-years of state-wide initiatives impacted on gender-differences in OHCA treatment and survival.
2. Studiendesign / Prozesse
All the 2481 consecutive OHCAs of presumed cardiac origin occurred between 2002 and 2018 in the Swiss Ticino Canton and in which a resuscitation was attempted, were included. Emergency medical system (EMS)-witnessed OHCAs were excluded.
3. Ergebnis / Endpunkt
Results: Time from call to CPR decreased from 9-min in 20022006 to 5-min in 20152018 (p < 0.01) and until 2014, it was longer in women. Survival to discharge increased overall from 11% in 20022006 to 23% in 20152018 (p<0.001) related to telephone-assisted CPR development (period 2011 2014) and first responder and layperson recruitment via a mobile application (period 20152018). In males, survival increased from 12% to 25% (p = 0.001) with a statistically significant increase in odds of survival in 20072010 (OR 1.6 95%CI 1.12.3; p = 0.001), in 20112014 (OR 2 95%CI 1.4 2.8; p = 0.001), and in 20152018 (2.4 95%CI 1.73.3; p = 0.001) compared to 20022006. On the other hand, in females, survival increased from 7% to 18% (p < 0.001), with a corresponding increase in the odds of survival of almost 3 times from 20022006 to 20152018 time period (OR 2.9 95%CI 1.55.8, p=0.001). No difference in survival probability was observed according to gender when adjusted for age, presenting rhythm, year-groups, OHCA location, EMS arrival time, witnessed status and laypeople-CPR.
Conclusions: State-wide initiatives can significantly increase the chances of survival in both male and female victims of OHCAs, by increasing the probability to receive CPR in a shorter time span.
Studienzweck: Andere
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2002 - 31.12.2018
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Angelo Auricchio
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36729
Basec ID:
Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification
1. Hypothese / Ziel
We compared the time to initiation of cardiopulmonary resuscitation (CPR) by lay responders and/or first responders alerted either via Short Message Service (SMS) or by using a mobile application-based alert system (APP).
2. Studiendesign / Prozesse
The Ticino Registry of Cardiac Arrest collects all data about out-of-hospital cardiac arrests (OHCAs) occurring in the Canton of Ticino. At the time of a bystander’s call, the EMS dispatcher sends one ambulance and alerts the first-respon- ders network made up of police officers or fire brigade equipped with an automatic external defibrillator, the so called “traditional” first responders, and – if the scene was considered safe – lay responders as well. We evaluated the time from call to arrival of traditional first responders and/or lay responders when alerted either via SMS or the new developed mo- bile APP.
3. Ergebnis / Endpunkt
Over the study period 593 OHCAs have occurred. Notification to the first responders network was sent via SMS in 198 cases and via mobile APP in 134 cases. Median time to first responder/lay responder arrival on scene was sig- nificantly reduced by the APP-based system (3.5 [2.8–5.2]) compared to the SMS-based system (5.6 [4.2–8.5] min, p 0.0001). The proportion of lay responders arriving first on the scene significantly increased (70% vs. 15%, p < 0.01) with the APP. Earlier arrival of a first responder or of a lay responder determined a higher survival rate.
Studienzweck: Qualitaetsmanagement
Klassifizierung: Randomisierte kontrollierte Studie RCT
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2012 -31.12.2015
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links:
Dateien: Datei 1
ID: 36707
Basec ID:
Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories
1. Hypothese / Ziel
To test the ability of the RACA score to predict the probability of ROSC in two different regions with different local resuscitation networks: the Swiss Canton Ticino and the Italian Province of Pavia.
2. Studiendesign / Prozesse
All OHCAs occurred between January 1st 2015 and December 31st 2017 were included. The original regression coefficients for all RACA score variables were applied. The probability to obtain the ROSC as measured with the RACA score was divided in tertiles. Overall, 2041 OHCAs were included in the analysis. The RACA score showed good discrimination for ROSC (AUC 0.76) and calibration, without interaction (p 0.28) between the region and the probability of ROSC. The probability of ROSC was 15% for RACA scores 0.42.
3. Ergebnis / Endpunkt
The application of the RACA score reliably assess the probability to obtain the ROSC, with equal effectiveness in the two regions, despite different organization of the resuscitation network. Patients with a RACA score >0.42 had more than 50% probability to obtain ROSC.
Studienzweck: Prognose
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Pavia, Italy
Ticino, Switzerland
Dauer: 01.01.2015 - 31.12.2017
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Maria Luce Caputo
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36745
Basec ID:
Patient voluntarily delays call to emergency medical system for ST-elevation myocardial infarction during COVID-19 pandemic
1. Hypothese / Ziel
An increase in the time from the symptoms onset to first medical contact and to primary percutaneous coronary intervention (pPCI) has been observed in countries with high-incidence of COVID-19 cases. We aimed to verify if there was any change in the patient delay and in the EMS response times up to the pPCI for STEMI patients in Swiss Ticino Canton.
2. Studiendesign / Prozesse
We assessed STEMI management including time from symptoms onset to EMS call, time of EMS response, time to pPCI in Swiss Canton Ticino. Data were retrieved from the Acute-Coronary-Syndrome- Ticino-Registry. We considered the patients included in the registry from March to May 2020 (pandemic period) and then from June to August 2020 (post-pandemic period) in whom a pPCI was performed. We compared these patients to those undergoing a pPCI in the same months in the year 2016–2019.
3. Ergebnis / Endpunkt
During the pandemic period, the time from symptoms onset to pPCI significantly increased com- pared to non-pandemic periods. This was due to a significant prolongation of the time from symptoms onset to EMS call, that nearly tripled. In contrast, after the pandemic period, there was a significantly shorter time from symptom onset to EMS call compared to non-pandemic years, whereas all other times remained unchanged.
Studienzweck: Andere
Klassifizierung: Fall-Kontroll-Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Pavia, Italy
Dauer: 01.03.2020 - 31.08.2020
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Enrico Baldi
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36715
Basec ID:
A quantitative assessment of the contribution of “citizen First Responder” in the adult out-of- hospital chain of survival during COVID-19 pandemic
1. Hypothese / Ziel
Assessing and estimating the influence of "citizen first responders" in the adult out-of-hospital survival chain.
2. Studiendesign / Prozesse
During pandemic, scientific societies stressed the importance of donning personal pro- tective equipment (PPE) before intervening3; furthermore some FRs system were temporarily suspended or limited to “professional FRs”.2 Also in Swiss Canton Ticino only the activation “professional FRs” activity was maintained. This situation provides the unique opportunity to quantitatively assess the contribution of “citizen FRs” in OHCA resuscitation including AED use before EMS arrival.
Using data from a prospective Utstein-based registry,4,5 we com- pared the clinical characteristics and key resuscitation parameters of OHCAs occurred when the “citizen FRs” activation was halted (03/ 03/2020–26/06/2020; COVID-period) to those OHCAs occurring dur- ing the three months immediately after (27/06/2020–30/09/2020; Post-COVID period), and finally to those occurring in an historical period before COVID-19 pandemic (03/03–26/06 of years 2016– 2019; Historical periods).
3. Ergebnis / Endpunkt
Summarizing, “citizen FRs” represent an important element in OHCA management accounting for about 15% of CPR initiated before EMS arrival.
Studienzweck: Andere
Klassifizierung: Fall-Kontroll-Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Pavia, Italy
Dauer: 03.03.2020 - 30.09.2020
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Enrico Baldi
Bemerkungen: This is a published letter to the editor
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36717
Basec ID:
Better management of out-of-hospital cardiac arrest increases survival rate and improves neurological outcome in the Swiss Canton Ticino
1. Hypothese / Ziel
To determine the incidence of out-of-hospital cardiac arrest (OHCA) fulfilling Utstein criteria in the Canton Ticino,
Switzerland, the survival rate of OHCA patients and their neurological outcome.
2. Studiendesign / Prozesse
All OHCAs treated in Canton Ticino between 1 January 2005 and 31 December 2014 were followed until either death
or hospital discharge. The survival and neurological outcome of those OHCA fulfilling Utstein criteria are reported.
3. Ergebnis / Endpunkt
A total of 3367 OHCAs occurred in the Canton Ticino over a 10-year period. Resuscitation was attempted in 2298 patients; of those 1492 (65%) were of presumed cardiac origin, 454 fulfilling the Utstein comparator criteria. About 69% [95% confidence interval (CI), 66.6–71.4%] of the patients had a bystander-witnessed arrest; a dispatched cardiopulmonary resuscitation (CPR) steadily and significantly increased from 2005 to 2014. Out-of-hospital cardiac arrest occurred prevalently home (67%), in men (71%) of a mean age of 71 + 13 years. There were no statistically significant differences either in demographic characteristics of OHCA victims over these years or in presenting rhythm. There was a progressive increase in the survival at discharge from 15% in 2005 to 55% in 2014; overall 96% (95% CI, 93.3 – 99.9%) of the survivors had a good neurological outcome.
Studienzweck: Andere
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Pavia, Italy
Dauer: 01.01.2005 - 31.12.2014
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Romano Mauri
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36721
Basec ID:
NON-PROFESSIONAL FIRST RESPONDERS: ORGANIZATIONAL EFFICIENCY CRITERIA IN TICINO (SOUTHERN SWITZERLAND)
1. Hypothese / Ziel
Assess efficiency of the organizational model which has been developed in Ticino as of 2006 and is characterized by an alarm system and non professional "First Responder" (FR) (police, fire brigade, border patrol, citizens, etc.) interventions which are complementary to professional emergency services whose intervention time in average is of about 9 minutes. The service is managed and coordinated by "Ticino Soccorso 144", counts approx. 2'500 members and is activated through short text message (SMS) in case of a suspected heart attack. The FR's response is thus based on principles of randomness and voluntariness.
2. Studiendesign / Prozesse
Measurements of the hereafter listed indicators through the analysis of 816 questionnaires filled in on-line by the FR following their interventions during the period 1.1.2006-31.12.2012:
-Roll time (SMS Alert - FR starts to move)
-Response time (FR starts to move - Arrival on scene)
-Decreased therapeutic interval (at-patient time without EMS).
3. Ergebnis / Endpunkt
The results show the roll and response time are optimal, although the number of cases in which the FR can perform cardiopulmonary resuscitation before the ambulance's arrival might be improved. The effectiveness of the FR alarm system should be assessed and measured in the future.
Studienzweck: Qualitaetsmanagement
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2006 - 31.12.2012
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Claudio Benvenuti
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36739
Basec ID:
EFFECTIVENESS AND COST-EFFECTIVENESS OF OHCA-EARLY DEFIBRILLATION PROGRAM (EDP) IN SOUTHERN SWITZERLAND
1. Hypothese / Ziel
In 2006 Ticino Cuore Foundation started an early defibrillation program in southern Switzerland including com- munity BLSD training, PAED and first responder network. Aim of the present work was to evaluate effectiveness and cost-effectiveness of the OHCA early defibrillation program.
2. Studiendesign / Prozesse
The study compared clinical data (Utstein style) and economic outcomes before and after EDP implementa- tion. We used 2002-2005 as control and 2008-2012 as the intervention period. Primary clinical outcomes were: ROSC at ED admission, survival to hospital discharge and good cerebral performance (CPC 1 or 2). We applied logistic regression to compare outcomes, estimating adjusted OR using sex, age, etiology, lay wit- ness, bystander BLS and location as covariates. For economic evaluation we used a cost effectiveness analy- sis, comparing cost difference to clinical difference. We considered direct cost of implementation, as person- nel, AEDs, BLSD training, marketing and other costs.
3. Ergebnis / Endpunkt
The analysis considered 1,104 OHCA before (mean age 66,3) and 1,307 (67,9) after implementation. ROSC showed an increasing trend (19.30% before and 22.50% after; adjusted OR = 1.226 p = 0.086), while sur- vival to hospital discharge showed a significant increase (7.00% before vs 9.80% after, adjusted OR = 1.476 p = 0.028). In particular, survival to hospital discharge with CPC 1-2 increases (5.80% before vs 9.30% af- ter, adjusted OR = 1.712 p =0.004). We calculated that the program saved 9 more lives per year with good cerebral performance (16 before vs 25 after). In the same period we measured that the total cost of the program was 3.417.856 CHF Considering a conservative mean survival of 5 years for each patients, cost effectiveness results were 15,190 CHF per life year saved (16,601 $), less than 50,000 $, the US standard generally accepted per life year saved (1).
Studienzweck: Gesundheitsoekonomie
Klassifizierung: Fall-Kontroll-Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2008 - 31.12.2012
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36705
Basec ID:
PUBLIC DEFIBRILLATORS AND VANDALISM: MYTH OR REALITY?
1. Hypothese / Ziel
Our presentation shall both quali- fy and quantify the vandalism suffered during the cantonal programme of placing defibrillators in public locations in the period 2008 - 2012.
2. Studiendesign / Prozesse
Data involving vandalism on the 142 public defibrillators placed within the cantonal territory were collected from 1.1.2008 to 31.12.2012. We then classified these data ac- cording to type, seriousness and risk for the patient’s health.
3. Ergebnis / Endpunkt
The study performed shows that during the period taken into consideration, the number of acts of vandalism, on defibrillators placed in public locations was extremely reduced and there were certainly no events which could have jeopardized the patient’s security and/or health. It must also be highlighted that this might be the result of the awareness campaign and training cours- es offered to the volunteers performed during the whole early defibrillation programme. Thus the worry that there might be acts of vandalism, even if legitimate, cannot become an obstacle for the diffusion of defibrillators in public locations.
Studienzweck: Gesundheitsoekonomie
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2008 - 31.12.2012
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36703
Basec ID:
A Bayesian spatiotemporal statistical analysis of out-of-hospital cardiac arrests
1. Hypothese / Ziel
We propose a Bayesian spatiotemporal statistical model for predicting out-of-hospital cardiac arrests (OHCAs).
2. Studiendesign / Prozesse
Risk maps for Ticino, adjusted for demographic covariates, are built for explaining and forecasting the spatial distribution of OHCAs and their temporal dynamics. The occurrence intensity of the OHCA event in each area of inter- est, and the cardiac risk-based clustering of municipalities are efficiently estimated, through a statistical model that decomposes OHCA intensity into overall intensity, demographic fixed effects, spatially structured and unstructured random effects, time polynomial dependence, and spatiotemporal random effect.
3. Ergebnis / Endpunkt
In the studied geography, time evolution and dependence on demographic features are robust over different cat- egories of OHCAs, but with variability in their spatial and spatiotemporal structure. Two main OHCA incidence-based clusters of municipalities are identified.
Studienzweck: Andere
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Milan, Italy
Pavia, Italy
Dauer: 01.01.2019 - 30.05.2019
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Stefano Peluso
Bemerkungen: The duration of this study is estimated. it took place indicatively between the end of 2018 and the beginning of 2019.
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: ifo@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36723
Basec ID:
Association Between Postresuscitation 12-Lead ECG Features and Early Mortality After Out-of-Hospital Cardiac Arrest: A Post Hoc Subanalysis of the PEACE Study
1. Hypothese / Ziel
Once the return of spontaneous circulation after out-of-hospital cardiac arrest is achieved, a 12-lead ECG is strongly recommended to identify candidates for urgent coronary angiography. ECG has no apparent role in mortality risk stratification. We aimed to assess whether ECG features could be associated with 30-day survival in patients with out-of- hospital cardiac arrest.
2. Studiendesign / Prozesse
All the post-return of spontaneous circulation ECGs from January 2015 to December 2018 in 3 European centers (Pavia, Lugano, and Vienna) were collected. Prehospital data were collected according to the Utstein style. A total of 370 ECGs were collected: 287 men (77.6%) with a median age of 62years (interquartile range, 53–70years). After correction for the return of spontaneous circulation-to-ECG time, age >62years (hazard ratio [HR], 1.78 [95% CI, 1.21–2.61]; P=0.003), female sex (HR, 1.5 [95% CI, 1.05–2.13]; P=0.025), QRS wider than 120ms (HR, 1.64 [95% CI, 1.43–1.87]; P<0.001), the presence of a Brugada pattern (HR, 1.49 [95% CI, 1.39–1.59]; P1 segment (HR, 1.75 [95% CI, 1.59–1.93]; P<0.001) were independently associated with 30-day mortality. A score ranging from 0 to 26 was created, and by dividing the population into 3 tertiles, 3 classes of risk were found with significantly different survival rate at 30days (score 0–4, 73%; score 5–7, 66%; score 8–26, 45%).
3. Ergebnis / Endpunkt
The post-return of spontaneous circulation ECG can identify patients who are at high risk of mortality after out-of- hospital cardiac arrest earlier than other forms of prognostication. This provides important risk stratification possibilities in post- cardiac arrest care that could help to direct treatments and improve outcomes in patients with out-of-hospital cardiac arrest.
Studienzweck: Diagnose
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Pavia, Italy
Lugano, Switzerland
Vienna, Austria
Dauer: 01.01.2015 - 31.12.2018
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Francesca Romana Gentile, MD
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36725
Basec ID:
End-tidal carbon dioxide (ETCO2) at intubation and its increase after 10 minutes resuscitation predicts survival with good neurological outcome in out-of-hospital cardiac arrest patients
1. Hypothese / Ziel
To evaluate whether end-tidal carbon dioxide (ETCO2) value at intubation and its early increase (10 min) after intubation predict both the sur- vival to hospital admission and the survival at hospital discharge, including good neurological outcome (CPC 1–2), in patients with out-of-hospital cardiac arrest (OHCA).
2. Studiendesign / Prozesse
All consecutive OHCA patients of any etiology between 2015 and 2018 in Pavia Province (Italy) and Ticino Region (Switzerland) were considered. Patients died before ambulance arrival, with a “do-not-resuscitate” order, without ETCO2 value or with incomplete data were excluded.
3. Ergebnis / Endpunkt
Results: The study population consisted of 668 patients. An ETCO2 value at intubation > 20 mmHg and its increase 10 min after intubation were independent predictors (after correction for known predictors of OHCA outcome) of survival to hospital admission and survival at hospital discharge. Relative to hospital discharge with good neurological outcome, ETCO2 at intubation and its 10-min change were confirmed predictors both individ- ually and in a bivariable analysis (OR 1.83, 95 %CI 1.02–3.3; p = 0.04 and OR 3.9, 95 %CI 1.97–7.74; p < 0.001, respectively). This was confirmed also when accounting for gender, age, etiology and location. After further adjustment for bystander and CPR status, presenting rhythm and EMS arrival time, the ETCO2 change remained an independent predictor.
Conclusions: ETCO2 value > 20 mmHg at intubation and its increase during resuscitation improve the prediction of survival at hospital discharge with good neurological outcome of OHCA patients. ETCO2 increase during resuscitation is a more powerful predictor than ETCO2 at intubation. A larger prospective study to confirm this finding appears warranted.
Studienzweck: Prognose
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Pavia, Italy
Lugano, Ticino, Switzerland
Dauer: 01.01.2015 - 31.12.2018
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Enrico Baldi
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien:
ID: 36727
Basec ID:
Spatio-temporal prediction model of out-of- hospital cardiac arrest: Designation of medical priorities and estimation of human resources requirement
1. Hypothese / Ziel
To determine the out-of-hospital cardiac arrest (OHCA) rates and occurrences at municipality level through a novel statistical model accounting for temporal and spatial heterogeneity, space-time interactions and demographic features. We also aimed to predict OHCAs rates and number at municipality level for the upcoming years estimating the related resources requirement.
2. Studiendesign / Prozesse
All the consecutive OHCAs of presumed cardiac origin occurred from 2005 until 2018 in Canton Ticino region were included. We implemented an Integrated Nested Laplace Approximation statistical method for estimation and prediction of municipality OHCA rates, number of events and related uncertainties, using age and sex municipality compositions. Comparisons between predicted and real OHCA maps validated our model, whilst compari- sons between estimated OHCA rates in different yeas and municipalities identified significantly different OHCA rates over space and time. Longer-time predicted OHCA maps provided Bayesian predictions of OHCA coverages in varying stressful conditions.
3. Ergebnis / Endpunkt
2344 OHCAs were analyzed. OHCA incidence either progressively reduced or continuously increased over time in 6.8% of municipalities despite an overall stable spatio-temporal distribution of OHCAs. The predicted number of OHCAs accounts for 89% (2017) and 90% (2018) of the yearly variability of observed OHCAs with prediction error ≤ 1OHCA for each year in most municipalities. An increase in OHCAs number with a decline in the Automatic External Defibrillator availability per OHCA at region was estimated.
Conclusions: Our method enables prediction of OHCA risk at municipality level with high accuracy, providing a novel approach to estimate resource allocation and anticipate gaps in demand in upcoming years.
Studienzweck: Andere
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Pavia, Italy
Dauer: 01.01.2005 - 31.12.2018
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Angelo Auricchio
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: Info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36747
Basec ID:
Fifty percent survival of cardiac arrest in Switzerland: an utopian goal?
1. Hypothese / Ziel
In June 2006 we implemented in Southern Switzerland (2811 km2/320.00 inhabitants) an Early Resuscitation and Defibrillation Program creating a network of "first responders" coordinated by the regional dispatch centre. This is the first program of this kind in Switzerland. We tested the possibility of reaching a survival rate of 50% of witnessed VF/VT within the next years.
2. Studiendesign / Prozesse
We collected data according to the Utstein style and tested our hypothesis using a linear regression equation.
3. Ergebnis / Endpunkt
The predicted percentage of patients leaving Hospital increases by 5,1% per year.
Conclusions: The data suggest that it would be statistically possible to attain our survival goal also considering the regression line with the smaller slope. To stabilise the trend for better survival rate the number of bystander CPR must be improved.
To reach this goal, a cultural change in our population is necessary and for this reason we have already implemented an educational program to teach the resuscitation manoeuvres to all teenagers in the last year of compulsory school (fourteen-year-old).
Studienzweck: Andere
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2005 - 31.12.2009
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: R.Mauri
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36737
Basec ID:
Bystander CPR beats AED improving the survival rate of out-of-hospital cardiac arrest
1. Hypothese / Ziel
We studied the relative importance of bystander CPR and the number of AED in our region in term of survival of VF/VT cardiac arrest.
2. Studiendesign / Prozesse
In June 2006 we implemented in Southern Switzerland an “Early Resuscitation and Defibrillation Program”, creating a network of “first responders” coordinated by the regional dispatch center.
Our population of 320.000 inhabitants is distributed over an area of 2812 square kilometers with, urban, rural and mountainous regions.
We collected data according to the Utstein style and inserted them in a multiple regression formula.
3. Ergebnis / Endpunkt
The survival is strictly related to the number of bystand- ers CPR and AED. Currently, to raise the survival rate the increase of bystander CPR is more effective than in- creasing AED units. The "a value" (2.3720) is based on the quality of EMS and other not related factors.
At present, to get the same survival rate we would need 9 to 10 more AED for each bystander CPR.
Studienzweck: Qualitaetsmanagement
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2005 - 31.12.2009
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: R. Mauri
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36741
Basec ID:
Out-of-hospital management and outcome of ST-elevation acute coronary syndromes in Swiss Canton Ticino: 10 years of the preH-ACS registry
1. Hypothese / Ziel
Acute coronary syndrome (ACS) with ST elevation (STE) is one of the most frequent causes of emergency medical services (EMS) activation. Moreover, about 10% of ACS are complicated by out-of-hospital cardiac arrest (OHCA).
Pre-hospital management of these patients have to be provided by a fast and well- organized network in order to improve chance of survival with a good outcome. Aim of this study was to evaluate STE-ACS incidence, management and outcome in Swiss Canton Ticino and to assess prevalence and clinical characteristics of patients presenting with an OHCA during STE-ACS. Finally we investigated clinical predictors which may help to identify patients with a higher risk of OHCA during STE-ACS.
2. Studiendesign / Prozesse
We performed a retrospective analysis of prospectively collected data of STE-ACS Registry since 1st of January 2010 to 31st of December 2020 in Swiss Canton Ticino.
Since 2010, the preH-ACS registry enrolled all patients with a confirmed Hospital diagnosis of STE-ACS.
All data including hemodynamics, arrhythmias occurrence, pre-hospital clinical management and timing of intervention were collected.
3. Ergebnis / Endpunkt
A total of 2015 STE-ACS occurred in Canton Ticino (male gender 72%). Of them, 902 were fully managed in the out-of-hospital setting (45%) and 1113 (55%) self-presented at the Hospital Emergency Room. Prevalence on the territory significantly varied, with a higher proportion of events in the biggest urban agglomerates. Yearly incidence ranged from 51 per 100’000 inhabitants/year in 2010, to 42 per 100’000 inhabitants/year in 2020. Times of intervention were largely within those recommended in International Guidelines (see figure below).
A total of 88 patients (10%) had an OHCA during STE-ACS, 46 (52%) before EMS arrival and 42 (48%) after first medical contact (FMC). Yearly proportion of OHCA ranged from 4% to 15% over years without a statistically significant trend. Overall, 67% of patients who suffered from an OHCA during STE-ACS showed a shockable first rhythm. This proportion raised to 90% in the EMS witnessed group. Clinical characteristics and outcome in OHCA group respect to STE-ACS were reported in the table. Patients who had an OHCA were significantly younger and more often males.
OHCA patients were more often transported to the hospital with a combination of ambulance and helicopter, as compared with STE-ACS patients without OHCA (26% versus 13%, p 0.03). Median time of ambulance arrival did not significantly differ between the two groups as well as the median time to reperfusion.
Mortality was 4 times-higher in OHCA patients (17% versus 4%, p 0.002).
At multivariable regression analysis, a low systolic blood pressure (<90 mmHg) and the younger age were associated with a higher probability to have an OHCA.
Conclusions: Yearly incidence of ST elevation Acute Coronary syndromes in Swiss Canton Ticino was almost stable over years, with a territorial prevalence of events largely related to urban areas distribution. In line with international data, in our region out-of-hospital cardiac arrest complicates up to 15% of STE-acute coronary syndromes. A high percentage of hospital self-presented patients with STE-ACS (55%) was observed. This observation requires further interventions to raise awareness about importance of early activation of the EMS network in case of chest pain.
Studienzweck: Praevention
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Ticino, Switzerland
Dauer: 01.01.2010 - 31.12.2020
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Caputo ML
Bemerkungen:
Kontaktperson: Fondazione Ticino Cuore, Via alla Campagna 4, 6900 Lugano, CH
E-Mail: info@ticinocuore.ch
Links: https://www.ticinocuore.ch/it
Dateien: Datei 1
ID: 36743
Basec ID:
Swiss Registry of Cardiac Arrest (SWISSRECA)
Registrierung aller ausserklinischen plötzlichen Herzstillstände (OHCA) in der Schweiz, bei denen das Rettungssystem aktiviert wurde (Rettungskette).
Enregistrement de tous les arrêts cardiaques soudains (OHCA) extrahospitaliers en Suisse pour lesquels le système de sauvetage a été activé (chaîne de sauvetage).
Registrazione di tutti gli arresti cardiaci improvvisi extraospedalieri (OHCA) in Svizzera per i quali è stato attivato il sistema di soccorso (catena di soccorso).
Studienzweck: Gesundheitssystemforschung
Klassifizierung: Kohortenstudie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: DE: https://www.144.ch/qualitaetssicherung/swissreca/
FR: https://www.144.ch/fr/assurance-qualite/swissreca/
IT: https://www.144.ch/it/controllo-qualita/swissreca/
Dauer: 01.01.2018 -
Aktiv/Inaktiv: Aktiv
Rekrutierung: Weitere Studienzenter gesucht
Besitzer: Interverband für Rettungswesen
Bemerkungen: DE: Wir rekrutieren Spitäler, die Patienten nach einer Reanimation aufnehmen FR: Nous recrutons des hôpitaux qui accueillent des patients en post-réanimation. IT: Stiamo reclutando ospedali che accolgono pazienti post rianimazione
Kontaktperson: André Wilmes
E-Mail: andre.wilmes@ivr-ias.ch
Links: DE: https://www.144.ch/qualitaetssicherung/swissreca/ FR: https://www.144.ch/fr/assurance-qualite/swissreca/ IT: https://www.144.ch/it/controllo-qualita/swissreca/
Dateien:
ID: 36161
Basec ID:
Analisi del rischio delle divise per soccorritori dei servizi ambulanza affiliati alla FCTSA
1. Ipotesi / Obiettivo
2. Design dello studio / Process
3. Risultato / Endpoint
Studienzweck: Qualitaetsmanagement
Klassifizierung: Nicht klinische Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Canton Ticino e Moesano
Dauer: GG.MM.AAAA - GG.MM.AAAA
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: FCTSA
Bemerkungen: In seguito alle direttive dell’Interassociazione di Salvataggio [IAS] emanate nel 2017 che hanno definito precisi standard prestazionali per l’equipaggiamento dei soccorritori del servizio ambulanza, i servizi del Canton Ticino e del Moesano, attraverso il loro organo rappresentativo, la Federazione Cantonale Ticinese Servizi Autoambulanze [FCTSA], hanno richiesto allo studio Widmer CEC SA l’allestimento della analisi di rischio relativa alle divise dei soccorritori del servizio ambulanza e dei Dispositivi di Protezione Individuale [DPI] in dotazione con l’obiettivo di individuare la soluzione più confacente dal punto di vista della sicurezza, dell’ergonomia, della vestibilità e, conseguentemente, economico.
Kontaktperson: Daniel Pasquali
E-Mail: dan.pasquali@fctsa.ch
Links:
Dateien:
ID: 36460
Basec ID:
Valutazione soddisfazione pazienti soccorsi dai servizi ambulanza del Canton Ticino e Moesano 2015-2016
1. Ipotesi / Obiettivo
Valutare il grado di soddisfazione degli utenti rispetto alle prestazioni fornite dai servizi di soccorso affiliati alla FCTSA ed evidenziare eventuali differenze tra i risultati delle due indagini in esame. In entrambe le indagini è stato valutato il livello globale di soddisfazione nei confronti dell’intervento con una domanda specifica, così come il grado di soddisfazione per “Relazione e comunicazione”, “Cura” (“Cura e trattamento del dolore” nell’indagine 2004-2005) e “Comfort dei mezzi di soccorso” tramite tre batterie di domande.
2. Design dello studio / Processi
I dati sono stati raccolti utilizzando due formulari distinti per soccorso e trasporto. Le domande e i formulari sono stati validati in una fase precedente nel 2004.
I dati sono stati raccolti durante il periodo giugno 2015-agosto 2016 dalla FCTSA, che li ha organizzati in una banca dati in formato ACCESS. Questa banca dati e quella relativa all’indagine 2004-2005 sono state poi fornite alla SUPSI che le ha analizzate utilizzando il programma Excel 2016 e il programma statistico Stata vs 14.1.
Per la rappresentare la performance dei singoli servizi, le risposte (originariamente codificate sulla base di una scala Likert a 5 posizioni) sono state ricodificate. Le aree di analisi sono messe in relazione a fattori sociodemografici, informazione e comunicazione, comfort dei mezzi, numero di soccorritori intervenuti e i tempi di attesa.
3. Risultato / Endpoint+
In generale, in entrambe le indagini si riscontra una correlazione elevata e positiva tra i valori medi di soddisfazione e importanza (r=0.80 per l’indagine 2015-2016; r=0.70 per l’indagine 2004-2005); ciò significa che all’aumentare dell’importanza attribuita ai vari aspetti aumenta anche il grado di soddisfazione.
Il grado di soddisfazione espresso dai pazienti è sempre molto elevato.
Studienzweck: Qualitaetsmanagement
Klassifizierung: Nicht klinische Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Canton Ticino e Moesano
Dauer: 01.06.2015 - 31.08.2016
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: FCTSA
Bemerkungen: Interessante anche condividere alcuni elementi di struttura del formulario. Lo strumento di rilevazione dovrà essere modificato: - snellire il questionario rilevando soltanto la soddisfazione? Questo potrebbe risultare utile per aumentare il tasso di risposta. - l’ambito professionale è un dato utile? - è necessario che il livello formativo del paziente sia rilevato in modo così dettagliato? - ev. rivedere le categorie di risposta di alcune domande per evitare formulazioni poco chiare (es.: tempo di attesa dell’ambulanza). Il formulario é stato somministrato a pazienti che erano in grado di valutare la prestazione.
Kontaktperson: Daniel Pasquali
E-Mail: dan.pasquali@fctsa.ch
Links:
Dateien: Datei 1
ID: 36462
Basec ID:
Registri First Hour Quintet
1. Ipotesi / Obiettivo
Monitoraggio delle prestazioni offerte nelle 5 sindromi considerate dal FHQ
2. Design dello studio / Processi
Attraverso algoritmi/atti medico delegati e strumenti di rilevamento dei dati, si é automatizzato il processo di raccolta del dato, del controllo della qualità del dato e della reportisitica.
3. Risultato / Endpoint+
I servizi affiliati alla FCTSA dispongono di un cruscotto digitale che in tempo reale permette di evidenziare i KPI previsti per le patologie tempo dipendenti. Questo oltre ai dati necessari per l'accerditamento IAS.
Studienzweck: Qualitaetsmanagement
Klassifizierung: Andere
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: FCTSA e Moesano
Dauer: GG.MM.AAAA - GG.MM.AAAA
Aktiv/Inaktiv: Aktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: FCTSA
Bemerkungen: Fino al 2022 i dati specifici dei registri venivano raccolti in una seconda fase, dopo l'intervento. Venivano inseriti in un database web e i risultati venivano inseriti in un portale intranet. Con il nuovo progetto della cartella clinica informatizzata 2.0 (I servizi della FCTSA già dal 1997 utilizzavano una cartella informatizzata ma veniva informatizzata in un secondo tempo. Dal 2022 la cartella clinica informatizzata é uno strumento che permette la raccolta dati in tempo reale e funge anche da check-list secondo ABCDE, da strumento di comunicazione con gli ospedali. In questo nuovo strumento, che raccoglie in automatico anche i dati biometrici del paziente dai dispositivi medici in dotazione, sono stati aggiunti tutti i dati necessari per la valutazione dei pazienti FHQ che erano invece presenti in un portale separato. I servizi della FCTSA dispongono oggi di uno strumento di analisi degli interventi che permette di evidenziare i risultati (Criteri 8 accreditamento IAS: operativi clinici) per le situazioni di ACR, STROKE, Sindrome coronarica acuta, Insufficienza respiratoria acuta, Politrauma. Queste informazioni sono disponibili direttamente via web in tempo reale dagli operatori e dal personale che interviene e possono essere messe in relazione a trend storici oppure filtrati per area geografica. Il processo di gestione del dato viene applicato utilizzando strumenti informatici che permettono un alto livello di dataquality e data "cleaning".
Kontaktperson: Daniel Pasquali
E-Mail: dan.pasquali@fctsa.ch
Links:
Dateien: Datei 1
ID: 36464
Basec ID:
ITED project – Introduzione della trasmissione ECG a dodici derivate come attività di processo per il trattamento dello STEMI nel Canton Ticino e Moesano
1. Ipotesi / Obiettivo
Verificare apparecchiature e procedura di comunicazione con l'unità di cardiologia invasiva per garantire il gold standard di trattamento del paziente con STEMI secondo le linee guida internazionali (versione 2005-2010)
2. Design dello studio / Processi
Processo di analisi degli strumenti e validazione della qualità dell'immagine trasmessa. Valutare la procedura di contattao e trasporto diretto alla cardiologia invasiva da tutto il territorio cantonale.
3. Risultato / Endpoint+
alla fine del 2011 tutti i servizi della FCTSA trasmettevano secondo procedure i pazienti con STEMI e é stato realizzato uno strumento di analisi delle performance (Registro prev-SCA)
Studienzweck: Therapie
Klassifizierung: Nicht klinische Studie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Canton Ticino - sopraceneri
Dauer: 2008 - 2011
Aktiv/Inaktiv: Aktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: FCTSA
Bemerkungen: Il progetto ha definito una procedura che é diventata un atto medico delegato ed é stata integrata nei processi di cura del preospedaliero. Viene costantemente monitorizzata attraverso un apposito registro e dai risultati emersi il 90% dei pazienti con STEMI viene ricoverato direttamente in cardiologia invasiva e i tempi di arrivo sul posto arrivo in H sono mediamente di 70 minuti (fonte registri FCTSA).
Kontaktperson: Daniel Pasquali
E-Mail: dan.pasquali@fctsa.ch
Links:
Dateien: Datei 1 Datei 1 Datei 1
ID: 36466
Basec ID:
Out-of-hospital cardiac arrests and mortality in Swiss Cantons with high and low COVID-19 incidence: A nationwide analysis
Aims: Many countries reported an increase of out-of-hospital cardiac arrests (OHCAs) and mortality during the COVID-19 pandemic. However, all these data refer to regional settings and national data are still missing. We aimed to assess the OHCA incidence and population mortality during COVID-19 pandemic in whole Switzerland and in the different regions (Cantons) according to the infection rate.
Methods: We considered OHCAs and deaths which occurred in Switzerland after the first diagnosed case of COVID-19 (February 25th) and for the subsequent 65 days and in the same period in 2019. We also compared Cantons with high versus low COVID-19 incidence
Conclusions: During the COVID-19 pandemic in Switzerland mortality increased in Cantons with high-incidence of infection, whilst not in the lowincidence ones. OHCA occurrence followed an opposite trend showing how variables related to the health-system and EMS organization deeply influence OHCA occurrence during a pandemic.
Studienzweck: Gesundheitssystemforschung
Klassifizierung: Kohortenstudie
Multi-/Monozentrisch: Multizentrisch
Studiendurchführungsort: Switzerland
Dauer: 01.01.2019 - 31.12.2020
Aktiv/Inaktiv: Inaktiv
Rekrutierung: Keine weitere Studienorte gesucht
Besitzer: Interverband für Rettungswesen IVR-IAS
Bemerkungen:
Kontaktperson: Roman Burkart
E-Mail: roman.burkart@ivr-ias.ch
Links: https://www.sciencedirect.com/science/article/pii/S2666520421000308
Dateien:
ID: 36195
Basec ID:
