COVID-19 clinic as a basis of quality primary health care in the light of the pandemic – an observational study

Aim The COVID-19 pandemic has had a major impact on societies and has required adjustments of health systems and changes in work processes, especially in the light of an aging population with increased morbidity and mortality. The primary health care level has a key role in maintaining access to healthcare and in addressing the largest proportion of patients with COVID - 19 and should therefore take steps to manage the condition. The aim is to determine the adequacy of COVID-19 clinic model for patients, who are suspected or have a confirmed infection with COVID-19. Methods In Health Centre Sevnica we have formed a model of the COVID Outpatient Clinic with unlimited access to safe and efficient health care. The introduction of COVID-19 disease diagnostic protocols, regular monitoring of patients, early detection of severe course of the disease and complications have made it possible to treat most patients at the primary health care level without the need for hospitalization. Results In our COVID clinic in the period 12 March 2020 - 31 January 2021 a total of 22,259 examinations were performed, of which only 284 patients were referred to the hospital level. As expected, the largest share of referrals was in the age group of 65 and over. Conclusion We believe that the established organization of work represents an optimal solution for managing the COVID-19 pandemic and is also a model with which we can manage future threats

To ventilate or not to ventilate during bystander CPR — A EuReCa TWO analysis

Background: Survival after out-of-hospital cardiac arrest (OHCA) is still low. For every minute without resuscitation the likelihood of survival decreases. One critical step is initiation of immediate, high quality cardiopulmonary resuscitation (CPR). The aim of this subgroup analysis of data collected for the European Registry of Cardiac Arrest Study number 2 (EuReCa TWO) was to investigate the association between OHCA survival and two types of bystander CPR namely: chest compression only CPR (CConly) and CPR with chest compressions and ventilations (FullCPR). Method: In this subgroup analysis of EuReCa TWO, all patients who received bystander CPR were included. Outcomes were return of spontaneous circulation and survival to 30-days or hospital discharge. A multilevel binary logistic regression analysis with survival as the dependent variable was performed. Results: A total of 5884 patients were included in the analysis, varying between countries from 21 to 1444. Survival was 320 (8%) in the CConly group and 174 (13%) in the FullCPR group. After adjustment for age, sex, location, rhythm, cause, time to scene, witnessed collapse and country, patients who received FullCPR had a significantly higher survival rate when compared to those who received CConly (adjusted odds ration 1.46, 95% confidence interval 1.17–1.83). Conclusion: In this analysis, FullCPR was associated with higher survival compared to CConly. Guidelines should continue to emphasise the importance of compressions and ventilations during resuscitation for patients who suffer OHCA and CPR courses should continue to teach both