Experience of Belgrade’s Emergency Medical Service in the implementation of cardiopulmonary resuscitation guidelines issued in 2010

Introduction. Implementation of cardiopulmonary resuscitation (CPR) is defined by the unified 2010 Guidelines for CPR. Objective. This paper presents the experience of Belgrade’s Emergency Medical Services (EMS) in the implementation of out-of-hospital (OH) CPR according to the new, 2010 Guidelines. Methods. A retrospective study design was used. We recorded OH CPR and analyzed four variables: patient gender and age, arrest location, bystander witnessed arrest, and arrest rhythm (shockable – group I, non-shockable – group II). The study also looked at implementation and follow-up of CPR, therapy, CPR duration, EMS reaction time, and patient outcome (Return of Spontaneous Circulation [ROSC] or death). Results. Of 794 OH CPR attempts, 136 (17%) patients with field ROSC were transported to hospital admission (HA) (22% group I, 78% group II). ROSC at HA was sustained in 64 (47%), and unsustained in 72 (53%) patients. Among the patients with ROSC on HA, 47% had spontaneous breathing and 5% fully regained consciousness. The ROSC rate was higher after arrest occurring at home (P<0.001). No statistical significance between the groups regarding the following analyzed variables was found: patient gender, age, onset time (day or night shift), bystander witnessed arrest, ROSC, breathing and consciousness at HA. In all patients, intravenous (IV) access was established. Atropine was administered in 28 (21%) group II patients. Adrenaline was administered in 71% of patients and withheld in 29% of patients due to hospital closeness or sustained ROSC. By HA, 46% were successfully intubated. The average response time in group I was 8.1±4.0 minutes, in group II 6.8 ± 4.4 minutes. A highly significant association (p<0.01) was found between CPR duration and ROSC at HA (26.23 min – ROSC vs. 14.46 min – no ROSC). Conclusion. Study results indicate the significance of the new Guidelines for CPR in the everyday practice of Belgrade’s EMS teams. Continual training increases the quality of administered CPR measures and the rate of patients with ROSC at HA. New studies would contribute to the disclosure of weak links in the survival chain after OH CPR in Belgrade

Студија - Београд_Корак ка политици здравог града [IX Међународни салон пејзажне архитектуре]

Studija "BEOGRAD KORAK KA POLITICI ZDRAVOG GRADA" je rezultat rada studenata Arhitektonskog fakulteta Univerziteta u Beogradu na predmetu Politike urbanog razvoja, školske 2020/ 2021. godine. Rad je usmeren ka boljem razumevanju politika urbanog razvoja kao dela savremenih napora na polju povezivanja, planiranja izgradnje sa realnim izvorima finansiranja, koji su utvrđeni merama, kako UN i EU politika, tako i Strategijom održivog urbanog razvoja Republike Srbije do 2030. godine i lokalnim politikama urbanog razvoja. Studija je namenjena transparentnom predstavljanju projekata urbanog razvoja, koje grad Beograd realizuje u sa radnji sa međunarodnim programima i bankama, uz podršku nacionalnih institucija, gradske uprave, organizacija i ustanova, nevladinih organizacija. U okviru studije, dat je mogući model za prikazivanje, praćenje realizacije i evaluacije projekata od značaja za urbani razvoj Beograda i/ili urbanih naselja u Srbiji. Ovaj model predstavlja i nov način sticanja znanja, uvođenja inovacija i podsticanje razvoja platforme za eksperiment u okviru visokog obrazovanja arhitekata i urbanista, uz podršku stručnjaka iz prakse