Sodium bicarbonate therapy in severe diabetic ketoacidosis: Lever E, Jaspan JB Am J Med 75:263–268 Aug 1983
✍ Scribed by Gary Halvorson
- Book ID
- 104312802
- Publisher
- Elsevier Science
- Year
- 1984
- Tongue
- English
- Weight
- 229 KB
- Volume
- 13
- Category
- Article
- ISSN
- 1097-6760
No coin nor oath required. For personal study only.
✦ Synopsis
The authors attempted to determine whether EMTs trained in defibrillation could improve survival from cardiac arrest in a tiered-response system. During the three-year study period, 406 EMTs received a 10-hour course in recognition of ventricular fibrillation (VF) and defibrillation. For part of the study period, defibrillators were made available to trained EMTs in a random fashion. For the remainder of the study, defibrillators were made available to those departments that chose to so participate. Standing orders allowed delivery of up to three 320-joule shocks for VE Intubations or medications were not part of the EMT-delivered care. ACLS care by paramedics followed that by EMTs. Outcomes were determined for 540 cases of witnessed out-ofhospital cardiac arrest due to VF. Overall, 366 patients received basic EMT and paramedic care, while 174 received EMT defibrillation and paramedic care. When the time interval between EMT and paramedic arrival was 4 minutes or less, there was no statistically significant difference in survival between the two groups. In contrast, for the randomized cases, when the interval between EMT and paramedic arrival was greater than 4 minutes, there was significantly improved survival with EMT defibrillation and paramedic care (42%) compared with basic EMT and paramedic care (19%). Similar results occurred when all 540 cases were considered (38% vs 18% ). The authors conclude that the addition of defibrillation capabilities to EMT care can enhance survival from ventricular defibrillation when the time interval between EMT and paramedic arrival is greater than 4 minutes.