New South Wales intensive care ambulance system: Outcome of patients with ventricular fibrillation

Sammel, Neville; Taylor, Karen; Selig, Murray; O’Rourke, Michael

doi:10.5694/j.1326-5377.1981.tb112982.x

Cited by 30 publications

(11 citation statements)

References 9 publications

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“…In Australia, the outcome from prehospital cardiac arrest has been reported for the New South Wales intensive care ambulance system and for the cities of Perth, Ipswich and Geelong 3–6 .…”

Section: Discussionmentioning

confidence: 99%

“…In 1981, Sammel et al reported the outcome of 434 patients with VF who were transported by the intensive care ambulance system in New South Wales 3 . Of these, 369 were in VF on arrival of the intensive care ambulance and 81 (22%) were eventually discharged from hospital.…”

Section: Discussionmentioning

confidence: 99%

“…Patient survival is dependent upon prompt treatment. Although outcomes have been extensively studied in North America and Europe there have been relatively tew reports from Australia 2–7 . This study was undertaken to establish the incidence and outcome of prehospital cardiac arrest in Melbourne, Australia.…”

Section: Introductionmentioning

confidence: 99%

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Outcome from prehospital cardiac arrest in Melbourne, Australia

Bernard

1998

Emergency Medicine

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Although the incidence and outcome of prehospital cardiac arrest have been reported for many cities, relatively few have originated from Australia. This study reviewed ambulance and hospital records of all patients who were in cardiac arrest when first attended by ambulance officers in metropolitan Melbourne between 1 February and 31 July 1995. Of 361 patients with a presumed primary cardiac cause of arrest, 113 (31%) were initially in ventricular fibrillation. The average ambulance response time was 9.4 minutes. Bystander cardiopulmonary resuscitation was performed on 22% of patients. Ten patients (3%) were discharged alive from hospital of whom eight (2%) were to independent living at home. All survivors were in ventricular fibrillation when first seen. It is concluded that survival from prehospital cardiac arrest in Melbourne is low. Strategies to improve outcome are suggested.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcome from prehospital cardiac arrest in Melbourne, Australia

Bernard

1998

Emergency Medicine

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“…Sammel et al (1981) reported that, of 434 patients suffering out-ofhospital VF and resuscitated by paramedic teams in the Sydney metropolitan area during 1979, 35% were immediate survivors and 21% long-term survivorsan impressive figure given a mean delay of 15.9min before the arrival of paramedics and defibrillation. However, 80% of patients received CPR from bystanders, standard ambulance teams or medical practitioners, although no information was available regarding the timing of CPR.…”

Section: Discussionmentioning

confidence: 99%

Early defibrillation in out-of-hospital sudden cardiac death: an Australian experience.

Scott

FitzGerald²

1993

Emergency Medicine Journal

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SUMMARYAll patients with primary cardiac disease presenting with out-of-hospital sudden cardiac death (OH-SCD) to a provincial hospital were reviewed retrospectively over a 5-year period from 1985 to 1989. This coincided with the introduction of out-of-hospital defibrillation (OH-DEFIB) by ambulance officers. Of 215 patients, 17 (9%) survived to leave hospital alive, 15 of whom underwent OH-DEFIB. There was an increase in survivors from 4%, prior to OH-DEFIB, to 9% of all cardiac arrests, but this was not statistically significant (P = 0.3). However, long term survival amongst immediate survivors was associated with a statistically significant improvement following the introduction of OH-DEFIB (15 of 30 (50%) vs. 2 of 19 (10.5%), P<0.01).Mean call-out, at-scene and transfer times did not significantly vary between survivors and non-survivors. A total of 155 (72%) had a known cardiac history, with the majority (74%) of arrests occurring at home. Of 134 witfessed arrests, only 46 (34%) underwent bystander-initiated cardioplumonary resuscitation (CPR).A programme in CPR aimed at relatives of known cardiac patients, and the adoption of a paramedic protocol which improves oxygenation at the time of arrest are recommended.

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“…7,10 Recognizing that only a small percentage of calls ever utilize advanced life support (ALS) skills, modern priority dispatch systems have been developed that either triage the need for a rapid, ''lights and siren'' response (which may pose some additional traffic risk) or, in other cases, simply limit paramedic deployment to those emergencies that probably will require advanced skills. 7,[10][11][12][13][14][15][16][17][18][19][20][21] By sending nonparamedic ambulances staffed by BLS-providing emergency medical technicians (EMTs) to the lower-priority calls, EMS systems can function with fewer paramedics. 1,6,7,22 With fewer paramedics, each paramedic gains more experience with those true emergency situations for which he or she needs to be focused, thereby improving his or her clinical performance in these situations.…”

mentioning

confidence: 99%

Can First Responders Be Sent to Selected 9-1-1 Emergency Medical Services Calls without an Ambulance?

Key¹

2003

Academic Emergency Medicine

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Objectives: To evaluate the feasibility and safety of initially dispatching only first responders (FRs) to selected low-risk 9-1-1 requests for emergency medical services. First responders are rapidly-responding fire crews on apparatus without transport capabilities, with firefighters trained to at least a FR level and in most cases to the basic emergency medical technician (EMT) level. Low-risk 9-1-1 requests include automatic medical alerts (ALERTs), motor vehicle incidents (MVIs) for which the caller was unable to answer any medical dispatch questions designed to prioritize the call, and 9-1-1 call disconnects (D/Cs). Methods: A beforeand-after study of patient dispositions was conducted using historical controls for comparison. During the historical control phase of six months, one year prior to the study phase, basic life support ambulances (staffed with two basic EMTs) were dispatched to selected low-risk 9-1-1 incidents. During the six-month study phase, a fire FR crew equipped with automated external defibrillators (AEDs) was sent initially without an ambulance to these incidents. Results: For ALERTs (n ¼ 290 in historical group vs. 330 in study group), there was no statistical difference in the transport rate (7% vs 10%), but there was a statistically significant increase in the follow-up use of advanced life support (ALS) (1% vs 4%, p ¼ 0.009). No patient in the ALERTs historical

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New South Wales intensive care ambulance system: Outcome of patients with ventricular fibrillation

Cited by 30 publications

References 9 publications

Outcome from prehospital cardiac arrest in Melbourne, Australia

Outcome from prehospital cardiac arrest in Melbourne, Australia

Early defibrillation in out-of-hospital sudden cardiac death: an Australian experience.

Can First Responders Be Sent to Selected 9-1-1 Emergency Medical Services Calls without an Ambulance?

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