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16. First Responder Defibrillation Does Not Increase Survival from Sudden Cardiac Death in a Two-Tiered Urban-Suburban EMS System

Published online by Cambridge University Press:  28 June 2012

Thomas A. Sweeney ,
Jeffrey W. Runge ,
Michael A. Gibbs ,
Janet M. Carter ,
Robert W. Schafermeyer  and
James A. Norton
Thomas A. Sweeney
Affiliation:
Medical Center of Delaware, Wilmington, Delaware USA and the Carolinas Medical Center
Jeffrey W. Runge
Affiliation:
Medical Center of Delaware, Wilmington, Delaware USA and the Carolinas Medical Center
Michael A. Gibbs
Affiliation:
Medical Center of Delaware, Wilmington, Delaware USA and the Carolinas Medical Center
Janet M. Carter
Affiliation:
Medical Center of Delaware, Wilmington, Delaware USA and the Carolinas Medical Center
Robert W. Schafermeyer
Affiliation:
Medical Center of Delaware, Wilmington, Delaware USA and the Carolinas Medical Center
James A. Norton
Affiliation:
Medical Center of Delaware, Wilmington, Delaware USA and the Carolinas Medical Center
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Purpose: The use of automatic external defibrillators (AED) by emergency medical service (EMS) first responders (FR) is widely advocated based largely on reports from one metropolitan area, but widespread impact on survival remains unproven. We hypothesized that the addition of AEDs to an EMS system with short FR and prolonged paramedic response times (4 vs. 10 minutes) would improve survival from sudden cardiac death.

Methods: Prospective, controlled, crossover study (AED vs. no AED) of consecutive cardiac arrests managed by 24 FR fire companies from 1992–1995 in a city of 440,000. Patients were stratified by the Utstein criteria. Primary end-point was survival to hospital discharge among patients with bystander witnessed arrests of cardiac etiology. Power was set at 0.8 to detect a 10% difference in survival.

Results: A total of 627 patients were studied. Groups were comparable for age, gender, history of myocardial infarction, congestive heart failure or diabetes, arrest at home, bystander CPR, and ventricular fibrillation (VF) as initial rhythm.

Type
Oral Presentations
Information
Prehospital and Disaster Medicine , Volume 11 , supplement S2: Abstracts of Scientific Papers. The Twelth Annual Conference and Scientific Assembly of the National Association of EMS Physicians, 13-15 July 1996, Loews Coronado Bay Resort, San Diego, California, USA , September 1996 , pp. S28
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996