Improved neurologic recovery and survival after early defibrillation.

TLDR

Eighty‑seven out‑of‑hospital cardiac arrest patients received early defibrillation from minimally trained first responders before paramedic arrival, and their outcomes were compared to 370 patients who received only basic life support until paramedics arrived. Early defibrillation increased survival to 62% versus 27% (p < .02) and improved neurologic recovery, with 39% of patients awake at 24 h versus 24% (p < .02), thereby reducing mortality and morbidity.

Abstract

Eighty-seven patients who had out-of-hospital cardiac arrests received defibrillating shocks delivered by minimally trained first responders before the arrival of paramedics in a city with short emergency response times. Their outcomes were compared with those of 370 other victims who received only basic life support by first responders until paramedics arrived. Survival was improved by early defibrillation in cases in which there was a delay in initiating cardiopulmonary resuscitation and in which paramedic response times exceeded 9 min; there was 62% survival after early defibrillation by first responders and 27% if first responders provided only basic life support (p less than .02). Neurologic recovery was also improved after early defibrillation. Eighteen of 46 resuscitated patients (39%) receiving early defibrillation were awake at 24 hr compared with 49 of 204 patients (24%) who received only basic life support while awaiting paramedics (p less than .02). Incorporating defibrillation as part of basic life support can reduce both mortality and morbidity from cardiac arrest, even in cities with established, rapidly responding emergency care systems.