Apr 13, 1999

Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation

JAMA : the Journal of the American Medical Association
L A CobbA P Hallstrom

Abstract

Use of automated external defibrillators (AEDs) by first arriving emergency medical technicians (EMTs) is advocated to improve the outcome for out-of-hospital ventricular fibrillation (VF). However, adding AEDs to the emergency medical system in Seattle, Wash, did not improve survival. Studies in animals have shown improved outcomes when cardiopulmonary resuscitation (CPR) was administered prior to an initial shock for VF of several minutes' duration. To evaluate the effects of providing 90 seconds of CPR to persons with out-of-hospital VF prior to delivery of a shock by first-arriving EMTs. Observational, prospectively defined, population-based study with 42 months of preintervention analysis (July 1, 1990-December 31, 1993) and 36 months of post-intervention analysis (January 1, 1994-December 31, 1996). Seattle fire department-based, 2-tiered emergency medical system. A total of 639 patients treated for out-of-hospital VF before the intervention and 478 after the intervention. Modification of the protocol for use of AEDs, emphasizing approximately 90 seconds of CPR prior to delivery of a shock. Survival and neurologic status at hospital discharge determined by retrospective chart review as a function of early (<4 minutes) and...Continue Reading

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Mentioned in this Paper

Ophthalmoplegia
Ventricular Fibrillation
Emergency Care
Survival Analysis
Logistic Regression
Basic Cardiac Life Support
Observation - Diagnostic Procedure
Logistic Models
Cardiopulmonary
Electroversion Therapy

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