Objective: To compare the deployment of paramedics in a separate rapid response unit with their deployment in a standard emergency ambulance.
Design: A one year period of each deployment.
Setting: Throughout the community in some parts of West Yorkshire.
Participants: All patients receiving resuscitation for cardiac arrest by paramedics.
Interventions: Using the same group of paramedics and central control, 12 months with the paramedics deployed in separate cars in addition to the standard ambulances (period 1) were followed by another 12 months when they were deployed as one crew member of a standard emergency ambulance (period 2).
Main outcome measures: Number of arrests attended, number of patients in ventricular fibrillation at paramedic arrival, response times, survival to leave hospital.
Results: In period 1, 580 arrests were attended with 31 survivors. In period 2, 462 arrests resulted in 25 survivors. The mean response time was shorter in period 1 (6.24 versus 6.60 min, Cl--0.01-0.73 min). In period 1, 217 patients were found in ventricular fibrillation (23 survivors): In period 2, 141 patients were found in ventricular fibrillation (11 survivors).
Conclusion: Separating paramedics from the standard emergency ambulances increases the number of survivors of cardiac arrest but the difference may not be sufficiently large to justify the additional expenditure.