BMJ 1995;311:508-509 (19 August)

Letters

Benefit of paramedics in non-ventricular fibrillation arrests is transitory

EDITOR,--We agree with U M Guly and colleagues' conclusion that intervention by paramedics does not improve the outcome of cardiopulmonary arrest occurring outside hospital when compared with intervention by ambulance technicians using basic life support with early defibrillation.1 A retrospective study in Hampshire of 98 patients who had a cardiac arrest outside hospital showed that the introduction of paramedics resulted in an increase in the number who regained spontaneous cardiac output from 12 to 21 (P=0.01).2 The number who survived to discharge from hospital, however, did not increase.

In the group treated by paramedics seven of 23 patients who regained spontaneous cardiac output were in asystolic arrest or electromechanical dissociation when first monitored. In the group treated by ambulance technicians only one patient who regained spontaneous cardiac output had such an arrest. The success of initial resuscitation showed a direct but transient benefit of intervention by a paramedic since none . . . [Full text of this article]


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Relevant Article

Paramedics and technicians are equally successful at managing cardiac arrest outside hospital
U M Guly, R G Mitchell, R Cook, D J Steedman, and C E Robertson
BMJ 1995 310: 1091-1094. [Abstract] [Full Text]

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