Abstract
The survival rate for patients with out-of-hospital cardiac arrest is low in communities where emergency service is provided solely by emergency medical technicians. We trained such technicians in a suburban community of 79,000 to recognize and treat out-of-hospital ventricular fibrillation with up to three defibrillatory shocks without the use of medications or special airway protection. Outcomes from cardiac arrest due to underlying heart disease were determined during two periods: two years with standard care by emergency medical technicians and one year with defibrillator-trained technicians. During the period with standard care, four of 100 patients with cardiac arrest were resuscitated and discharged alive from the hospital, as compared with 10 of 54 patients during the period with defibrillator-trained technicians (P<0.01). In 12 of 38 patients with ventricular fibrillation, a stable perfusing cardiac rhythm followed defibrillatory shocks given by defibrillator technicians. The enhanced survival after cardiac arrest is encouraging, and further trials of defibrillation by emergency medical technicians are warranted. (N Engl J Med. 1980; 302:1379–83.)
Supported in part by a grant (HS 03215) from the National Center for Health Services Research and a grant (HL 18805) from the National Heart, Lung, and Blood Institute.
We are indebted to the emergency medical technicians who volunteered to receive the special training and who cooperated so fully with study, and to the fire departments and districts, ambulance companies, paramedic programs, and hospitals for their cooperation. Tom Torell, Sue Edwards, and the Seattle Medic I Training Program provided assistance in training. Dr. Robert Leahy reviewed the study design. Linda Becker, Tom Hearne, and Anne Wilson assisted in the collection and analysis of data. Drs. Noel Weiss and Douglas Weaver reviewed the manuscript. Specially designed equipment was provided by Physio-Control Corporation, Redmond, Washington.
Source Information
From the departments of Medicine and Biostatistics, University of Washington, the King County Health Department, and the King County Emergency Medical Services Division, King County, Wash, (address reprint requests to Dr. Eisenberg at Room 508, Smith Tower, 506 Second Ave., Seattle, WA 98104).
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