2016-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/649455摘要：心臟疾病是國人的第二大死因，而造成心臟病死亡重要原因的院外心跳 停止（Out-of-hospital Cardiac Arrest, OHCA)也成為重要的公共衛生與醫療 課題。由於擔任民眾緊急傷病第一道防線的緊急救護系統(Emergency Medical Services)到達病患旁的反應時間多在6-10分鐘，要大幅提升存活， 就必須優化現有的生命之鏈(chain of survival)，向社區推進，一方面提高民 眾意願並執行有效的心肺復甦術，並且在公共場所策略部署自動電擊器，在 最早期間進行電擊去顫。本研究將以三年時間，透過全國跨區域心跳停止登錄系統的建立，對於目 前我國將緊急救護系統向社區推進，優化生命之鏈的兩大措施：[社區民眾心肺 復甦]與[公共場所早期電擊]，進行整體的評估。包括：1)結合國内各重要緊急醫 療系統，建立全國共通的心跳停止登錄系統;2)進行我國社區心跳停止的流行病 學，中長期功能追蹤與重要預後分析；3)進行民眾心肺復甦的流行病學分析，探 討造成旁觀者CPR障礙的社區因素，以及不同形式旁觀者CPR(傳統vs.只壓胸) 對於預後的影響；最後4)針對公共場所早期電擊案例進行流行病學與預後分 析。本計晝建立的跨區域心跳停止登錄體系，將可涵蓋台灣68.6%的人口，是 緊急醫療救護與心跳停止研究最重要基礎工作。針對社區民眾心肺復甦與公共 場所早期電擊兩大主軸，一方面回答重要的流行病學與臨床問題，也將提供衛 生政策與教育規劃的本土實證基礎。<br> Abstract: Cardiac diseases are the second leading cause of death in Taiwan. As many cardiac deaths present as out-of-hospital cardiac arrests (OHCA), OHCAs carry significant medical and public health priority in the community. Outcomes of patients deteriorated rapidly if resuscitation not started before traditional fire-based Emergency Medical Services (EMS) can respond to the arrest, usually after 4-10 mintus. To improve patient survival, it becomes imperative to advance current chain-of-survival further into the community by promoting community bystander cardiopulmonary resuscitation (CPR) and public access defibrillation.In this three-year project, via implementing a national OHCA registry consortium, we aim to conduct a comprehensive assessment of the two optimization strategies in advancing community chain-of-survival, community bystander CPR and public access defibrillation. First we will implement a national registry for OHCA through collaboration among major EMS systems; Second, we will examine the epidemiology of cardiac arrests at a national level, including long-term functional outcomes, and factors associated with outcomes; Thirdly, we will explore the society barriers to community bystander CPR and study effects of different types of bystander CPR (traditional vs. compression-only); and finally we will carefully analyze cardiac arrests cases for which public access defibrillation was deployed before EMS arrivalThe OHCA registry developed by this study will cover 68.6% of Taiwan’s population and will serve as a major backbone for studying EMS and OHCA in Taiwan. The study not only answer key epidemiological and clinical questions to community CPR and public access defibrillation, but also provide solid evidence for public health and education policies.到院前心跳停止緊急救護系統旁觀者心肺復甦術只壓胸心肺復 甦術公共場所早期電擊自動電擊器心跳停止登錄流行病學生活品質 指標Out-of-hospital cardiac arrestsemergency medical services (EMS)bystander cardiopulmonary resuscitation (CPR)compression-only CPRautomatic external defibrillator (AED)public