Effects of adding links to "the chain of survival" for prehospital cardiac arrest: a contrast in outcomes in 1975 and 1995 at a single institution
Abstract
The concept of a "chain of survival" to improve outcome from prehospital cardiac arrest has been defined and promulgated over the last two decades. The purpose of this study was to compare outcomes of prehospital cardiac arrest in 1975 and 1995 at a single institution. This longitudinal, before-after study compares published data collected at our municipal, tertiary care in 1974-1975 with data collected prospectively in 1995. The 1975 study group served as control subjects (n = 120). We enrolled an equal number of consecutive patients who met inclusion criteria in the 1995 cohort (consecutive patients who experienced prehospital arrest and who received prehospital Advanced Cardiac Life Support (ACLS) measures during the two study periods). Patients younger than 18 years or with posttraumatic arrest were excluded. Between 1975 and 1995 the following "links" in the "chain of survival" were added to the prehospital care system: (1) 911 access and dispatch, (2) paramedic endotracheal intubation, (3) EMT automated defibrillation, (4) standing out-of-hospital orders before hospital radiotelemetry contact, and (5) introduction of American Heart Association ACLS algorithms. The following significant differences (chi 2) were observed be...Continue Reading
References
A community program for emergency cardiac care. A three-year coronary ambulance-paramedic evaluation
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