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.