Abstract
OBJECTIVE--To investigate the results of resuscitation of patients with cardiac arrest by ambulance staff with extended training in West Yorkshire. DESIGN--Study of all such attempts at resuscitation over 32 months, based on the standard report form for each call made by the ambulance staff and the electrocardiogram that showed the initial rhythm in each patient. SETTING--Area covered by West Yorkshire ambulance service. SUBJECTS--1196 Patients with cardiac arrests attended by 29 ambulance staff with extended training. MAIN OUTCOME MEASURE--Result of resuscitation. RESULTS--The initial rhythm was asystole or electromechanical dissociation in 740 patients and ventricular fibrillation in 456 patients; overall 65 patients survived to be discharged from hospital. Sixty four of the 456 patients in whom ventricular fibrillation was the initial rhythm recorded, and 46 in whom ventricular fibrillation persisted after the ambulance staff arrived, survived. Only one of the 740 patients who initially had asystole or electromechanical dissociation survived. Factors associated with a greater chance of ventricular fibrillation occurring were: age less than 71, the arrest being witnessed by a bystander, resuscitation by a bystander, the arrest occurring in a public place, and a response time by the ambulance staff of less than six minutes. For patients found in ventricular fibrillation a shorter response time was associated with improved survival but resuscitation by a bystander was not. Additional skills learnt during extended training were used for 51 of the 65 patients who survived. CONCLUSIONS--Ambulance staff with extended training can save the lives of patients with cardiac arrest due to fibrillation, though asystole and electromechanical dissociation have a poor prognosis and should perhaps receive little attention during extended training.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Eisenberg M. S., Bergner L., Hallstrom A. Cardiac resuscitation in the community. Importance of rapid provision and implications for program planning. JAMA. 1979 May 4;241(18):1905–1907. doi: 10.1001/jama.241.18.1905. [DOI] [PubMed] [Google Scholar]
- 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]
- Iseri L. T., Humphrey S. B., Siner E. J. Prehospital brady-asystolic cardiac arrest. Ann Intern Med. 1978 Jun;88(6):741–745. doi: 10.7326/0003-4819-88-6-741. [DOI] [PubMed] [Google Scholar]
- Jakobsson J., Nyquist O., Rehnqvist N. Effects of early defibrillation of out-of-hospital cardiac arrest patients by ambulance personnel. Eur Heart J. 1987 Nov;8(11):1189–1194. doi: 10.1093/oxfordjournals.eurheartj.a062191. [DOI] [PubMed] [Google Scholar]
- Myerburg R. J., Estes D., Zaman L., Luceri R. M., Kessler K. M., Trohman R. G., Castellanos A. Outcome of resuscitation from bradyarrhythmic or asystolic prehospital cardiac arrest. J Am Coll Cardiol. 1984 Dec;4(6):1118–1122. doi: 10.1016/s0735-1097(84)80130-8. [DOI] [PubMed] [Google Scholar]
- 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]
- Shingles: a belt of roses from Hell. Br Med J. 1979 Jan 6;1(6155):5–5. [PMC free article] [PubMed] [Google Scholar]
- 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]
- Tresch D. D., Thakur R., Hoffmann R. G., Brooks H. L. Comparison of outcome of resuscitation of out-of-hospital cardiac arrest in persons younger and older than 70 years of age. Am J Cardiol. 1988 May 1;61(13):1120–1122. doi: 10.1016/0002-9149(88)90141-5. [DOI] [PubMed] [Google Scholar]
- 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]
- Wright D., James C., Marsden A. K., Mackintosh A. F. Defibrillation by ambulance staff who have had extended training. BMJ. 1989 Jul 8;299(6691):96–97. doi: 10.1136/bmj.299.6691.96. [DOI] [PMC free article] [PubMed] [Google Scholar]