Heart 1997;78:399-402 ( October )
Heartstart Scotland: the use of paramedic skills in out of hospital resuscitation
a Department of Medical Cardiology, Royal Infirmary,
Glasgow, UK, b Scottish Ambulance Service, Edinburgh, UK
Correspondence to: Dr Adams, Department of Medical Cardiology, Fourth Floor, Western Infirmary, Dumbarton Road, Glasgow G11 6NT, UK.
Accepted for publication 19 June 1997
Objective
To assess the frequency with which
paramedic skills were used in out of hospital cardiac arrest and the
effect of tracheal intubation on outcome.
DesignRetrospective analysis of ambulance service
reports and hospital records.
SettingScottish Ambulance Service and
hospitals admitting acute patients throughout Scotland.
ResultsA total of 8651 out of hospital
resuscitation attempts were recorded and tracheal intubation was
attempted in 3427 (39.6%) arrests. One hundred and thirty six patients
(3.7%) were intubated and 476 (9.1%) of the patients who were not
intubated survived to hospital discharge (p < 0.001). Among the
patients who were defibrillated the proportion intubated was highest in
the patients who received the greatest number of shocks (p < 0.01).
Among subjects receiving similar numbers of shocks survival rates were
lower for intubated patients (p < 0.01). Patients with unwitnessed
arrests were most frequently intubated and survival rates were lowest in this group.
ConclusionsPatients who are intubated seem to
have lower survival rates. This may however reflect the difficulty of
the resuscitation attempt rather than the effects of intubation. The
use of basic life support skills rapidly after cardiac arrest is
associated with the best survival rates.
© 1997 by Heart
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