Outcomes after out-of-hospital cardiac arrest (OHCA) remain poor in the UK. In order to increase the chances of successful resuscitation, international society guidelines on cardiopulmonary resuscitation quality have recommended titration of chest compression parameters and vasopressor administration to arterial diastolic blood pressure if invasive catheters are in situ at the time of cardiac arrest. However, prehospital initiation of arterial and central venous catheterisation is seldom undertaken due to the risks and significant technical challenges in the context of ongoing resuscitation in this environment. In 2019, a dedicated programme was started at East Anglian Air Ambulance (EAAA) to enable the safe introduction of contemporary emergency vascular access devices, in order to improve physiological monitoring intra-arrest and deliver nuanced, goal-directed resuscitation in OHCA patients. This programme was entitled Specialist Percutaneous Emergency Aortic Resuscitation (SPEAR). This article details the EAAA SPEAR technique; and the development, implementation and governance of this novel endovascular strategy in our UK physician-paramedic staffed helicopter emergency medical service.

中文翻译：

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在直升机紧急医疗服务中实施 OHCA 期间先进的血管通路、生理监测和目标导向复苏

英国院外心脏骤停（OHCA）后的结果仍然很差。为了增加成功复苏的机会，国际心肺复苏质量指南建议，如果心脏骤停时有创导管就位，则应调整胸外按压参数并使用血管加压药至动脉舒张压。然而，由于在这种环境下持续复苏的风险和重大技术挑战，很少进行院前动脉和中心静脉导管插入术。 2019 年，东安格利亚空中救护公司 (EAAA) 启动了一项专门计划，以安全引入现代紧急血管通路设备，以改善逮捕期间的生理监测，并为 OHCA 患者提供细致入微、有目标的复苏。该计划的名称为专家经皮紧急主动脉复苏 (SPEAR)。本文详细介绍了 EAAA SPEAR 技术；以及我们英国医生-护理人员直升机紧急医疗服务中这种新型血管内策略的开发、实施和治理。