Enhancing survival after cardiac arrest — The effect of initial rhythm and a new strategy in emergency care

✍ Scribed by WD Weaver; LA Cobb; MK Copass; AP Hallstrom; M Emery

• Publisher: Elsevier Science
• Year: 1985
• Tongue: English
• Weight: 150 KB
• Volume: 14
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(85)80402-9

✦ Synopsis

Recent studies suggest that medical professionals may perform better external CPR than do nonprofessional citizens. Professional bystander CPR performed by two distinct groups was studied retrospectively, first with fire department first-responder basic EMTs and then with physicians, nurses, and other EMTs. These groups were compared independently to groups of patients receiving either citizen bystander CPR or no bystander CPR. Four hundred twenty-one consecutive witnessed cardiopulmonary arrests presenting with the initial rhythm of coarse ventricular fibrillation treated by a regional paramedic system from January 1980 to June 1982 were analyzed. Pediatric, trauma, and poisoning patients and those receiving IV or endotracheal medications prior to initial defibrillations were excluded (58). A successful defibrillation occurred if defibrillation prior to administration of medications produced an effective cardiac rhythm with pulses. Response time is defined as the difference between the time of call to arrival of the paramedic unit. There was no significant difference in response time, successful defibrillation rate, successful resuscitation rate {transport to the hospital with a pulsatile rhythm), and save rate (discharge alive from the hospital) when comparing bystander CPR done by physician, nurse, and other EMT to citizen bystander CPR and no bystander CPR. There was also no significant difference between fire department first-responder bystander CPR and citizen bystander CPR. Patients receiving fire department first-responder bystander CPR had a significantly faster response time (5.0 min vs 6.3 min, P < .025) and a significantly better successful defibrillation rate (38% [12/32] vs 22% [47/219], P < .025) than did patients receiving no bystander CPR. Patients receiving bystander CPR performed by physicians, nurses, and other EMTs do not have better clinical results than do patients receiving citizen bystander CPR or no bystander CPR. Patients receiving bystander CPR performed by fire department first responders were more likely to have a pulse after initial defibrillations when compared to patients receiving no bystander CPR, but a faster response time may be a factor in the better clinical results.