Improved Out-of-Hospital Cardiac Arrest Survival Through the Inexpensive Optimization of an Existing Defibrillation Program
JAMAPublished 7 April 1999
Ian G. Stiell, George A. Wells, Brian Field, Daniel W. Spaite, Valerie J. De Maio, Roxanne Ward
Citations392
SJR quartileQ1
SJR score5.35
SNIP10.71
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TL;DR
An inexpensive, multifaceted system optimization approach to rapid defibrillation can lead to significant improvements in survival after cardiac arrest in a large BLS-D EMS system.
Abstract
An inexpensive, multifaceted system optimization approach to rapid defibrillation can lead to significant improvements in survival after cardiac arrest in a large BLS-D EMS system.
Keywords
Medicine
Annals of Emergency MedicinePredicting survival from out-of-hospital cardiac arrest: A graphic model
1,233 Citations1993Mary Pat Larsen, Mickey S. Eisenberg +2 more
A graphic model that describes survival from sudden out-of-hospital cardiac arrest as a function of time intervals to critical prehospital interventions is developed and is useful in planning community EMS programs, comparing EMS systems, and showing how different arrival times within a system affect survival rate.
The LancetA MOBILE INTENSIVE-CARE UNIT IN THE MANAGEMENT OF MYOCARDIAL INFARCTION
635 Citations1967J.F. Pantridge, J S Geddes
It has been shown perhaps for the first time that the correction of cardiac arrest outside hospital is a practicable proposition and no death has occurred in transit in a fifteen-month period.
New England Journal of MedicineUse of the Automatic External Defibrillator in the Management of Out-of-Hospital Cardiac Arrest
479 Citations1988Will Weaver, Deborah L. Hill +5 more
The widespread use of the automatic external defibrillator as an important part of the treatment of out-of-hospital cardiac arrest is supported, although the overall impact of the use of this device on community survival rates is still uncertain.
New England Journal of MedicineTreatment of Out-of-Hospital Cardiac Arrests with Rapid Defibrillation by Emergency Medical Technicians
469 Citations1980Mickey S. Eisenberg, Michael K. Copass +5 more
The enhanced survival after cardiac arrest is encouraging, and further trials of defibrillation by emergency medical technicians are warranted.
The American Journal of Emergency MedicineSurvival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation
438 Citations1985Richard O. Cummins, Mickey S. Eisenberg +2 more
It is concluded that early initiation of CPR by bystanders significantly improves survival from out-of-hospital cardiac arrest, and it is suggested that it may do so by prolonging the duration of VF after collapse and by increasing cardiac susceptibility to defibrillation.
JAMACardiac resuscitation in the community. Importance of rapid provision and implications for program planning
402 Citations1979Mickey S. Eisenberg
New England Journal of MedicinePrehospital Defibrillation Performed by Emergency Medical Technicians in Rural Communities
306 Citations1984Kenneth R. Stults, Donald D. Brown +2 more
Early defibrillation by minimally trained ambulance technicians is an effective approach to emergency cardiac care in rural communities.
JAMAImpact of First-Responder Defibrillation in an Urban Emergency Medical Services System
164 Citations1993Arthur L. Kellermann
Although the authors' automated external defibrillators proved to be reliable and efficacious for terminating ventricular fibrillation and pulseless ventricular tachycardia, patients treated by an automated externaldefibrillator-equipped engine company were no more likely than CPR-treated controls to be resuscitated, to survive to hospital admission, or to survived to hospital discharge.
Annals of Emergency MedicineEffectiveness of Emergency Medical Services for Victims of Out-of-Hospital Cardiac Arrest: A Metaanalysis
156 Citations1996Graham Nichol, Allan S. Detsky +4 more
Increased survival to hospital discharge may be associated with decreased response time interval and with the use of a two-tier EMS system as opposed to a one-tier system.
Annals of Emergency MedicineEffect of Out-of-Hospital Defibrillation by Basic Life Support Providers on Cardiac Arrest Mortality: A Metaanalysis
150 Citations1995Thomas E. Auble, James J. Menegazzi +1 more
BLS defibrillation can reduce the relative risk of death for out-of-hospital cardiac arrest victims in ventricular fibrillation, and weaknesses in individual study designs and regional clustering limit the strength of this metaanalysis.
JAMAA Study of Out-of-Hospital Cardiac Arrests in Northeastern Minnesota
147 Citations1986John W. Bachman
Training in advanced cardiac life support and defibrillation and community programs in cardiopulmonary resuscitation had limited success in resuscitating patients with cardiac arrest in the Arrowhead region of Minnesota, and overall survival was low.
ResuscitationPerformance of an established system of first responder out-of-hospital defibrillation. The results of the second year of the Heartstart Scotland Project in the ‘Utstein Style’
143 Citations1993Martin L. Sedgwick, Kirsty Dalziel +3 more
The Heartstart Scotland project for out-of-hospital defibrillation covers the whole of Scotland, a population of approximately 5,102,400, and patients who were defibrillated within 4 min of arrest had a 43% survival rate to hospital discharge.
Annals of Emergency MedicineNew perspectives on rural EMT defibrillation
95 Citations1988Larry F. Vukov, Roger D. White +2 more
It is suggested that certain prerequisites, especially CPR prior to ambulance arrival and collapse to defibrillation times of less than ten minutes, are clearly essential to produce significant benefits from emergency medical technicians trained in defibrillation in rural communities.
JAMAManagement of Out-of-Hospital Cardiac Arrest
95 Citations1980Mickey S. Eisenberg
The evident factor accounting for the difference in survival rates was the time from collapse to receiving definitive care (advanced cardiac life support)--26 minutes in the EMT area compared to 7.8 minutes in adjacent suburban communities with paramedic services.
Annals of Emergency MedicineThe Ontario Prehospital Advanced Life Support (OPALS) Study: Rationale and Methodology for Cardiac Arrest Patients
81 Citations1998Ian G. Stiell, George A. Wells +11 more
The OPALS study will evaluate the incremental benefit of rapid defibrillation and prehospital Advanced Cardiac Life Support measures for cardiac arrest survival and the benefit of Advanced Life Support for patients with traumatic injuries and other critically ill prehospital patients.
Annals of Emergency MedicineEMT-defibrillation: The Wisconsin experience
77 Citations1989David Olson, Jacques LaRochelle +6 more
The survival rate for patients with prehospital cardiac arrest has improved in some communities with early defibrillation by emergency medical technician-defibrillators (EMT-Ds), but in rural areas, previous studies on survival with defibrilling by EMT-Ds have been variable.
Annals of Emergency MedicineEffect of fire department first-responder automated defibrillation
76 Citations1993Michael Shüster, Jana L. Keller
In the EMS system, fire first-responders were able to provide defibrillation in significantly shorter times than ambulance attendants, and survival was significantly greater with bystander-witnessed arrest, initial rhythm of ventricular fibrillation, and presence of a pulse on arrival in the emergency department.
PubMedCardiac arrest in Ontario: circumstances, community response, role of prehospital defibrillation and predictors of survival.
73 Citations1992R J Brison, James R. Davidson +6 more
To improve survival rates after cardiac arrest ambulance response times must be reduced and the frequency of bystander-initiated CPR increased, once these changes are in place a beneficial effect from advanced manoeuvres such as prehospital defibrillation may be seen.
Annals of Emergency MedicineCost-effectiveness analysis of paramedic emergency medical services in the treatment of prehospital cardiopulmonary arrest
67 Citations1990Terence D. Valenzuela, Elizabeth A. Criss +4 more
Out-of-hospital treatment by paramedics of cardiopulmonary arrest is more cost effective than heart, liver, bone marrow transplantation, or curative chemotherapy for acute leukemia.
BMJUse of the automatic external defibrillator-pacemaker by ambulance personnel: the Stockport experience.
55 Citations1987Alasdair Gray, A D Redmond +1 more
In an attempt to reduce the number of people who die from a cardiac arrest in the Stockport area ambulances were equipped with automatic external defibrillator-pacemakers, and ambulance personnel were trained in their use.
Academic Emergency MedicinePopulation Density, Automated External Defibrillator Use, and Survival in Rural Cardiac Arrest
54 Citations1997J. Stephan Stapczynski, James E. Svenson +1 more
It is found that population density is strongly associated with survival from out-of-hospital cardiac arrest and BLS services within areas with population densities < or = 100/sq mi sustained little benefit from the addition of AEDs to their treatment of patients who had out of hospital cardiac arrests.
Medical CareSurvival From Out-of-Hospital Cardiac Arrest
53 Citations1991Virginia L. Wilcox-G k
The initial postarrest cardiac rhythm is shown to be an indicator of the heart's condition, but when other factors associated with survival are included in the analysis, it does not independently influence an individual's probability of survival.
Archives of SurgeryEmergency Medical Care System
33 Citations1974Stephen W. Carveth
The objective of the Lincoln (Neb) emergency care system was the provision of an effective method by which a collapsed person could be rapidly and efficiently placed in a modern stratified system of emergency care.
JAMAThe Impact of First-Responder Defibrillation
5 Citations1994Ian G. Stiell
Concerns are raised that the low percentage of patients in the defibrillator arm of the study actually receiving automatic defibrillation may bias the study toward finding no significant difference in survival between groups.