Emergency system prospective performance evaluation for cardiac arrest in Lombardia, an Italian region

Background: The aim of this research is to evaluate quality of out-of-hospital medical services in our country, using performance indicators and a new computerised database. Methods (a) Experimental design: Data were collected prospectively in three emergency dispatch centres for 90 days. Follow-up was evaluated at 1 day and 1 month after the event. This paper presents data on the cardiac arrest cohort only. (b) Setting: Three emergency dispatch centres in Lombardia. (c) Patients: One hundred and seventy-eight patients in non-traumatic cardiac arrest were enrolled. (d) Interventions: None. The study was observational only. Results: Mean interval between phone call and arrival on scene was 8.5 +/- 3.5 min. BLS manoeuvres were carried out from bystanders only in 15% of the cohort; this was associated with significant mortality reduction (85.7 versus 95.8%, chi(2) p < 0.05). One hundred and thirty-three patients (75%) received assistance from BLS crews while Drily 45 patients (25%) were assisted by ALS medical personel, with a significant mortality reduction (ALS deaths 86.7%, BLS deaths 97%). Total 24 h survival was 9% and survival at 1 month declined to 6.17%. Conclusions: Quality monitoring produces objective information on interventions and outcomes. Only with this information, is it possible to implement improvement programmes that are planned according to the data presented. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.