EFFECT OF FIRE DEPARTMENT FIRST-RESPONDER AUTOMATED DEFIBRILLATION

被引：46

作者：

SHUSTER, M

KELLER, JL

机构：

[1] Department of Emergency Medicine, Chedoke-McMaster Hospitals, Hamilton, Ont.

[2] Hamilton Paramedic Program, Chedoke-McMaster Hospitals, Hamilton, Ont.

[3] Division of Emergency Medicine, McMaster University, Hamilton, Ont.

来源：

ANNALS OF EMERGENCY MEDICINE | 1993年 / 22卷 / 04期

关键词：

cardiac arrest; emergency medical services; first-responder; out-of-hospital defibrillation;

D O I：

10.1016/S0196-0644(05)81856-6

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To examine the effect of fire department first-responder defibrillation on time to defibrillation in a mid-sized community with two tiers of emergency medical services (EMS) ambulance response. Design: Retrospective cohort. Setting: The study area was the region of Hamilton-Wentworth, which has more than 445,000 inhabitants and covers 1,136 km2 (438 square miles). Type of participants: We studied 297 victims of out-of-hospital cardiac arrest presenting to the EMS system between May 1, 1990, and April 30, 1991. Measurements and main results: The mean defibrillation interval was decreased from 11.96 minutes to 8.50 minutes (P< .001) by the introduction of fire first-responder defibrillation. Survival was significantly greater with bystander-witnessed arrest, initial rhythm of ventricular fibrillation, and presence of a pulse on arrival in the emergency department. Conclusion: In our EMS system, fire first-responders were able to provide defibrillation in significantly shorter times than ambulance attendants. Other EMS systems should review their response times and consider instituting first-responder defibrillation as one means of reducing defibrillation intervals.

引用

页码：721 / 727

页数：7

共 32 条

[1]

Becker, Ostrander, Barrett, Et al., Outcome of CPR in a large metropolitan area—Where are the survivors?, Ann Emerg Med, 20, pp. 355-361, (1991)

[2]

Hargarten, Stueven, Waite, Et al., Prehospital experience with defibrillation of coarse ventricular fibrillation: A ten-year review, Ann Emerg Med, 19, pp. 157-162, (1990)

[3]

Olson, LaRochelle, Fark, Et al., EMT-defibrillation: The Wisconsin experience, Ann Emerg Med, 18, pp. 806-811, (1989)

[4]

Weaver, Copass, Bufi, Et al., Improved neurologic recovery and survival after early defibrillation, Circulation, 69, pp. 943-948, (1984)

[5]

Vukov, White, Bachman, Et al., New prespectives on EMT defibrillation, Ann Emerg Med, 17, pp. 318-321, (1988)

[6]

Stults, Brown, Special considerations for defibrillation performed by emergency medical technicians in small communities, Circulation, 74, pp. 13-17, (1986)

[7]

Cummins, Eisenberg, Hallstrom, Et al., What is a “save”? Outcome measures in clinical evaluations of automatic external defibrillators, Am Heart J, 110, pp. 1133-1138, (1985)

[8]

Eisenberg, Copass, Hallstrom, Et al., Treatment of out of hospital cardiac arrest with rapid defibrillation by emergency medical technicians, N Engl J Med, 302, pp. 1379-1383, (1980)

[9]

Pinkowski, Thompson, Gruchow, Et al., Resuscitation time in ventricular fibrillation—A prognostic indicator, Annals of Emergency Medicine, 12, pp. 733-738, (1983)

[10]

Jakobsson, Nyguist, Rehnqvist, Effects of early defibrillation of out-of-hospital cardiac arrest patients by ambulance personnel, Eur Heart J, 8, pp. 1189-1194, (1987)

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