Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1993 Dec;70(6):568–573. doi: 10.1136/hrt.70.6.568

Out-of-hospital resuscitation in East Sussex: 1981 to 1989.

S J Lewis 1, S Holmberg 1, E Quinn 1, K Baker 1, R Grainger 1, R Vincent 1, D A Chamberlain 1
PMCID: PMC1025395  PMID: 8280528

Abstract

OBJECTIVE--To assess the impact of extended training in advanced life support on the outcome of resuscitation. DESIGN--Analysis of the successful resuscitations from 1981 to 1989. SETTING--Brighton and East Sussex. RESULTS--248 patients were resuscitated from cardiac or respiratory arrest in the community and subsequently survived to leave hospital. Their mean age was 64 years and one year survival was 77%. In most cases the cause of collapse was cardiac but 38 (15%) suffered a respiratory arrest. In 140 of the successful resuscitations (56%) collapse occurred before the arrival of the ambulance. Basic life support, with ventilation and chest compression where necessary, was sufficient to revive 35 (14%) of the patients. Defibrillation was also required in 107 patients (43%), and in a further 106 patients (43%) who had prolonged cardiorespiratory arrest requiring endotracheal intubation and the use of several drugs. Review of ambulance forms and case notes showed that in 87 cases (35%) the abilities of the paramedical ambulance staff in advanced resuscitation techniques contributed decisively to the success of resuscitation. These skills are illustrated by eight case reports. CONCLUSIONS--Extended training for ambulance staff increases the likelihood of successful resuscitation from out-of-hospital cardiopulmonary arrest. Though instruction in defibrillation must have the highest priority, full paramedical training can bring appreciable additional benefits.

Full text

PDF
568

Images in this article

573Image
on p.573

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson I. W., Black R. J., Ledingham I. M., Little K., Robertson C. E., Urquhart J. D. Early emergency care study: the potential and benefits of advanced prehospital care. Br Med J (Clin Res Ed) 1987 Jan 24;294(6566):228–231. doi: 10.1136/bmj.294.6566.228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bayés de Luna A., Coumel P., Leclercq J. F. Ambulatory sudden cardiac death: mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J. 1989 Jan;117(1):151–159. doi: 10.1016/0002-8703(89)90670-4. [DOI] [PubMed] [Google Scholar]
  3. Cobbe S. M., Redmond M. J., Watson J. M., Hollingworth J., Carrington D. J. "Heartstart Scotland"--initial experience of a national scheme for out of hospital defibrillation. BMJ. 1991 Jun 22;302(6791):1517–1520. doi: 10.1136/bmj.302.6791.1517. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Colquhoun M. C. Use of defibrillators by general practitioners. BMJ. 1988 Jul 30;297(6644):336–336. doi: 10.1136/bmj.297.6644.336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cummins R. O. From concept to standard-of-care? Review of the clinical experience with automated external defibrillators. Ann Emerg Med. 1989 Dec;18(12):1269–1275. doi: 10.1016/s0196-0644(89)80257-4. [DOI] [PubMed] [Google Scholar]
  6. Cummins R. O., Ornato J. P., Thies W. H., Pepe P. E. Improving survival from sudden cardiac arrest: the "chain of survival" concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation. 1991 May;83(5):1832–1847. doi: 10.1161/01.cir.83.5.1832. [DOI] [PubMed] [Google Scholar]
  7. Dickey W., MacKenzie G., Adgey A. A. Long-term survival after resuscitation from ventricular fibrillation occurring before hospital admission. Q J Med. 1991 Sep;80(293):729–737. [PubMed] [Google Scholar]
  8. Eisenberg M. S., Hallstrom A., Bergner L. Long-term survival after out-of-hospital cardiac arrest. N Engl J Med. 1982 Jun 3;306(22):1340–1343. doi: 10.1056/NEJM198206033062206. [DOI] [PubMed] [Google Scholar]
  9. Hampton J. R., Dowling M., Nicholas C. Comparison of results from a cardiac ambulance manned by medical or non-medical personnel. Lancet. 1977 Mar 5;1(8010):526–529. doi: 10.1016/s0140-6736(77)91384-8. [DOI] [PubMed] [Google Scholar]
  10. Jaggarao N. S., Heber M., Grainger R., Vincent R., Chamberlain D. A., Aronson A. L. Use of an automated external defibrillator-pacemaker by ambulance staff. Lancet. 1982 Jul 10;2(8289):73–75. doi: 10.1016/s0140-6736(82)91692-0. [DOI] [PubMed] [Google Scholar]
  11. Jaggarao N. S., Sless H., Grainger R., Vincent R., Chamberlain D. A. Defibrillation at a football stadium: an experiment with Brighton and Hove Albion. Br Med J (Clin Res Ed) 1982 May 15;284(6327):1451–1453. doi: 10.1136/bmj.284.6327.1451. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Jakobsson J., Rehnqvist N., Nyquist O. One year's experience of early defibrillation in Stockholm. J Intern Med. 1989 May;225(5):297–301. doi: 10.1111/j.1365-2796.1989.tb00085.x. [DOI] [PubMed] [Google Scholar]
  13. Pantridge J. F., Geddes J. S. A mobile intensive-care unit in the management of myocardial infarction. Lancet. 1967 Aug 5;2(7510):271–273. doi: 10.1016/s0140-6736(67)90110-9. [DOI] [PubMed] [Google Scholar]
  14. Ritter G., Wolfe R. A., Goldstein S., Landis J. R., Vasu C. M., Acheson A., Leighton R., Medendrop S. V. The effect of bystander CPR on survival of out-of-hospital cardiac arrest victims. Am Heart J. 1985 Nov;110(5):932–937. doi: 10.1016/0002-8703(85)90187-5. [DOI] [PubMed] [Google Scholar]
  15. Rowley J. M., Garner C., Hampton J. R. The limited potential of special ambulance services in the management of cardiac arrest. Br Heart J. 1990 Nov;64(5):309–312. doi: 10.1136/hrt.64.5.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Rowley J. M., Mounser P., Garner C., Hampton J. R. Advanced training for ambulance crews: implications from 403 consecutive patients with cardiac arrest managed by crews with simple training. Br Med J (Clin Res Ed) 1987 Nov 28;295(6610):1387–1389. doi: 10.1136/bmj.295.6610.1387. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Sims D. G., Downham M. A., Gardner P. S., Webb J. K., Weightman D. Study of 8-year-old children with a history of respiratory syncytial virus bronchiolitis in infancy. Br Med J. 1978 Jan 7;1(6104):11–14. doi: 10.1136/bmj.1.6104.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Stults K. R., Brown D. D., Schug V. L., Bean J. A. Prehospital defibrillation performed by emergency medical technicians in rural communities. N Engl J Med. 1984 Jan 26;310(4):219–223. doi: 10.1056/NEJM198401263100403. [DOI] [PubMed] [Google Scholar]
  19. Thompson R. G., Hallstrom A. P., Cobb L. A. Bystander-initiated cardiopulmonary resuscitation in the management of ventricular fibrillation. Ann Intern Med. 1979 May;90(5):737–740. doi: 10.7326/0003-4819-90-5-737. [DOI] [PubMed] [Google Scholar]
  20. Vincent R., Martin B., Williams G., Quinn E., Robertson G., Chamberlain D. A. A community training scheme in cardiopulmonary resuscitation. Br Med J (Clin Res Ed) 1984 Feb 25;288(6417):617–620. doi: 10.1136/bmj.288.6417.617. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Weaver W. D., Cobb L. A., Hallstrom A. P., Fahrenbruch C., Copass M. K., Ray R. Factors influencing survival after out-of-hospital cardiac arrest. J Am Coll Cardiol. 1986 Apr;7(4):752–757. doi: 10.1016/s0735-1097(86)80332-1. [DOI] [PubMed] [Google Scholar]
  22. White N. M., Parker W. S., Binning R. A., Kimber E. R., Ead H. W., Chamberlain D. A. Mobile coronary care provided by ambulance personnel. Br Med J. 1973 Sep 22;3(5881):618–622. doi: 10.1136/bmj.3.5881.618. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Wright D., Bannister J., Ryder M., Mackintosh A. F. Resuscitation of patients with cardiac arrest by ambulance staff with extended training in West Yorkshire. BMJ. 1990 Sep 22;301(6752):600–602. doi: 10.1136/bmj.301.6752.600. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES