• G Citerio, D Galli, G C Cesana, M Bosio, M Landriscina, M Raimondi, G P Rossi, and A Pesenti.
• Dipartimento di Anestesia e Rianimazione, Azienda Ospedale San Gerardo di monza, Nuovo Ospedale San Gerardo, Via Donizetti, 106, 20052 Monza (MI), Italy. g.citerio@hsgerardo.org
• Resuscitation. 2002 Dec 1; 55 (3): 247-54.

BackgroundThe 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 DesignData 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)SettingThree emergency dispatch centres in Lombardia. (c)PatientsOne hundred and seventy-eight patients in non-traumatic cardiac arrest were enrolled. (d)InterventionsNone. The study was observational only.ResultsMean 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 only 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%.ConclusionsQuality 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.

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