Faculty Collaboration Database

EMT-defibrillation: the Wisconsin experience. Ann Emerg Med 1989 Aug;18(8):806-11

Date

08/01/1989

Pubmed ID

2667406

DOI

10.1016/s0196-0644(89)80200-8

Scopus ID

2-s2.0-0024391150 (requires institutional sign-in at Scopus site)   81 Citations

Abstract

The survival rate for patients with prehospital cardiac arrest has improved in some communities with early defibrillation by emergency medical technician-defibrillators (EMT-Ds). In rural areas, previous studies on survival with defibrillation by EMT-Ds have been variable. We conducted an EMT-D study to determine effectiveness in various prehospital settings. Sixty-four ambulance services from communities ranging in size from rural areas to city suburbs participated in our prospective study. EMTs were trained in rhythm recognition and the use of a manual defibrillator during a standardized 20-hour course. Over 18 months, data were collected locally for central analysis. Five hundred sixty-six patients with primary cardiac arrest were included in our study: 36 (6.4%) survived. Retrospective review revealed survival before EMT-D implementation to be 3.6% (P less than .02). Three hundred four patients (54%) had an initial rhythm of ventricular fibrillation, with 33 (11%) surviving. The survival rate for EMT-D-witnessed arrest with an initial rhythm of ventricular fibrillation was 42%. Patients with asystole were countershocked in our study; however, there were no survivors from this group. The neurologic status of survivors at time of hospital discharge was normal in 72%. The average response time, defined as time of emergency medical services activation to the time of EMT-D arrival, was 7.3 +/- 5.8 and 3.7 +/- 2.0 minutes for nonsurvivors and survivors, respectively (P less than .002). There were no survivors when the response time was more than eight minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Author List

Olson DW, LaRochelle J, Fark D, Aprahamian C, Aufderheide TP, Mateer JR, Hargarten KM, Stueven HA

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Electric Countershock
Emergency Medical Services
Emergency Medical Technicians
Female
Heart Arrest
Hospitalization
Humans
Male
Prospective Studies
Resuscitation
Rural Population
Time Factors
Ventricular Fibrillation
Wisconsin