Cardiopulmonary resuscitation in an outpatient emergency medical service in a COVID-19 pandemic

Kardiopulmonalna reanimacija je skup, kombinacija i organizirani sustav medicinsko-tehničkih postupaka oživljavanja i terapijskih mjera koje se primjenjuju kod osobe koja je doživjela kardijalni arest. Prije nego što nastupi biološka smrt cilj izvođenja postupka reanimacije jest ponovno uspostavljanje funkcije srčanog mišića i disanja. Medicinskim profesionalcima u izvanbolničkoj hitnoj medicinskoj službi reanimacija predstavlja još teži izazov od reanimacije u bolničkim uvjetima. Razlog tome jesu otežani terenski uvjeti rada i vanbolnička okolina, a sada još k tome treba dodati i uvjete pandemije. Godine 2019. u Kini, gradu Wuhanu, pojavio se novi soj respiratornog virusa. Svjetska zdrastvena organizacija ga je nazvala SARS-CoV-2, a bolest koju uzrokuje COVID-19. U 2020. godini, virus SARS-CoV-2 zahvatio je cjeli svijet te je epidemija COVID-19 virusa postala pandemija. Pandemija je tako opteretila zdrastvene sustave u gotovo svim državama diljem svijeta te je zbog raznih epidemioloških kriterija i mjera dodatno otežala obavljanje medicinsko-tehničkih postupaka zdrastvenim djelatnicima, sada je i postupak kardiopulmonalne reanimacije još teži i zahtjevniji no inače. Osnovna i napredna zaštitna oprema jest najbolji štit svim medicinskim radnicima tijekom obavljanja svih medicinsko-tehničkih postupaka u ovoj pandemiji, što uključuje i kardiopulmonalnu reanimaciju. Da bi se osobna i napredna zaštitna oprema mogla iskoristiti u svom punom potencijalu i da bi zaista pružila adekvatnu zaštitu medicinskim djelatnicima koji je koriste, potrebno je pridržavati se uputa i pravila struke kako ispravno koristiti osobnu zaštitnu opremu. Na medicinskim radnicima velika je odgovornost jer sada tijekom početnog kontakta s pacijentom treba uzeti i posebnu COVID-19 anamnezu. Nakon uzimanja COVID-19 anamneze medicinski radnik mora znati procjeniti koji stupanj OZO će koristiti, sukladno tome liječenje i zdrastvena skrb pacijenta moraju se uskladiti sa aktualnim propisanim epidemiološkim mjerama. U IHMS-u kvaliteta rada medicinskog tima ovisi o svakom pojedinom članu tima. Kompetencije, znanje, iskustvo, vještine, individualne posebne kvalitete koje posjeduje svaki pojedinac uvelike utječu na rad i funkcionalnost tima IHMS. Svaki individualac u timu (liječnik, medicinski tehničar/sestra, vozač) mora profesionalno, stručno, odgovorno, savjesno raditi svoj dio posla. To je jedina uspješna formula da bi tim kao cjelina bio kvalitetan i uspješan u zbrinjavanju pacijenta.Cardiopulmonary resuscitation is a set, combination and organized system of medical-technical resuscitation procedures and therapeutic measures applied to a person who has experienced cardiac arrest. Before biological death occurs, the goal of performing the resuscitation procedure is to restore the function of the heart muscle and respiration. To medical professionals in the outpatient emergency medical service, resuscitation presents an even more difficult challenge than resuscitation in a hospital setting. The reason for this is the difficult field working conditions and the outpatient environment, and now the pandemic conditions should be added to that. In 2019, a new strain of respiratory virus appeared in Wuhan, China. The World Health Organization called it SARS-CoV-2, and the disease caused by COVID-19. In 2020, the SARS-CoV-2 virus spread worldwide and the COVID-19 virus epidemic became a pandemic. The pandemic has burdened health systems in almost all countries around the world and due to various epidemiological criteria and measures has made it even more difficult to perform medical and technical procedures for health professionals, now the procedure of cardiopulmonary resuscitation is even more difficult and demanding than usual. Basic and advanced protective equipment is the best shield to all medical workers during the performance of all medical-technical procedures in this pandemic, which includes cardiopulmonary resuscitation. In order for personal and advanced protective equipment to be used to its full potential and to truly provide adequate protection to medical professionals who use it, it is necessary to follow the instructions and rules of the profession on how to properly use personal protective equipment. There is a great responsibility on medical workers because now during the initial contact with the patient, a special COVID-19 history should be taken. After taking a history of COVID-19, the healthcare professional must be able to assess the degree of PPE they will use, and accordingly, the patient's treatment and health care must be in line with current prescribed epidemiological measures. In OEMS, the quality of work of a medical team depends on each individual team member. Competencies, knowledge, experience, skills, individual special qualities possessed by each individual greatly affect the work and functionality of the OEMS team. Each individual in the team (doctor, medical technician / nurse, driver) must do his part professionally, responsibly, conscientiously. This is the only successful formula for the team as a whole to be of high quality and successful in caring for the patient