The importance of timely defibrilla...

The importance of timely defibrillation in human frames in cardiac arrest has been established clearly. Although an eight-minute interval between call dispatch and the arrival of a defibrillation team is considered standard, this criterion has little objective support. De Maio and associates reviewed data from the ongoing Ontario Prehospital Advance Life Support (OPALS) cogitation for evidence to support this standard.

The OPALS close attention is a before-and-after clinical trial testing the benefit of adding rapid defibrillation and advanced life support to an existing basic life support classification The study includes 21 communities in Ontario serv according to 11 emergency medical service (EMS) programs.

Survivors of cardiac arrest were more likely to be young and to have a bystander-witnessed cardiac arrest and an initial rhyme of ventricular fibrillation or tachycardia. A comparison of the replication intervals with survival rates displays a steep decrease in the survival turn during the first five minutes, after which the inclination gradually levels off. The crook shows that a five-minute answer rate would have doubled the survival rate achieved with an eight-minute target.

The authors judge that significant improvement in survival rates could be accomplished through decreasing the defibrillation response interval to les than eight minutes. Patients in communities with EM arrival times of les than five minutes have significantly better survival rates.

In an editorial in the same issue, Cone reviewed additional data that support decreasing the defibrillation replication interval. The American Heart Association's Guidelines 2000 commend a response time of les than five minutes. The author points without that the critical measurement is the time to initial shog not the time to arrival of EM personnel and infers that a defibrillation response interval of five to six minutes is optimal.

De Maio VJ et al. Optimal defibrillation replication intervals for maximum out-of-hospital cardiac arrest survival rates. Ann Emerg M August 2003;42:242-50 and Cone DC The eight-minute defibrillation replication interval debunked: or is it?[Editorial] Ann Emerg M August 2003;42:251-5

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group