Analysis of different emergency medical service systems
| Study | Emergency medical service system | Mean response interval (min)2-151 call to BLS (ALS) | Incidence of out-of-hospital CPR (per 100000 inhabitants per year) | Discharge rate after bystander witnessed cardiac arrest of cardiac aetiology with initial rhythm VF n (%) | Discharge rate after cardiac arrest of cardiac aetiology n (%) |
|---|---|---|---|---|---|
| EMT-BLS and physician staffed ALS services | |||||
| Heidelberg 1999 | BLS + ALS-P | (8.0)2-152 | 34.24 | 26/69 (38) | 48/338 (14) |
| Bonn 199713 | BLS + ALS-P | 5.0 (8.2) | 48.33 | 41/118 (35) NS | 74/464 (16) NS |
| Helsinki 199614 | BLS + ALS + ALS-P | 7.0 (10.3) | 53.07 | 41/126 (33) NS | 44/255 (17) NS |
| Mainz 199415 | BLS + ALS-P | 6.0 (10.0) | 78.14 | 13/54 (24) NS | 19/211 (9) NS |
| Helsinki 199016 | BLS + ALS-P | 5.5 (10.7)2-152 | 48.20 | 39/144 (27) NS | ND |
| EMT-BLS and/or ALS services without physicians | |||||
| Auckland 199519 | ALS | (7.0) | 38.11 | 89/545 (16)** | 135/1069 (13) NS |
| Oakland County 199525 | BLS + ALS | 3.6 (6.5) | 53.80 | 72/476 (15)** | ND |
| York-Adams 199421 | BLS + ALS | ND | 73.05 | 22/260 (8)** | 36/599 (6)** |
| New York City 19945 | BLS + ALS | 9.4 (13.0) | 63.52 | 22/415 (5)** | 33/2329 (1)** |
| Scotland 199322 | BLS | 9.0 | 32.85 | 71/643 (11)** | 174/1676 (10)2-150 |
| Tucson 199226 | BLS + ALS | 4.1 (5.1) | 50.50 | 18/118 (15)** | 22/372 (6)** |
| Chicago 199118 | ALS | (13.0) | 107.37 | 15/371 (4)** | 55/3221 (2)** |
| Tucson 199023 | BLS + ALS | 3.0 (5.0) | 62.08 | 21/96 (22)2-150 | 25/298 (8)2-150 |
| York-Adams 198820 | BLS + ALS | ND | 47.11 | 47/382 (12)** | 68/1066 (6)** |
| Milwaukee 198624 | BLS + ALS | 2.0 (5.0) | ND | 183/779 (23)2-150 | ND |
| King County 198517 | BLS + ALS | 4.4 (9.2) | 38.91 | 314/951 (33) NS | ND |
Register of studies in patients suffering from out-of-hospital cardiac arrest of cardiac aetiology and reporting their data according to the Utstein recommendations. Statistical analysis (χ2test) revealed that outcome in the present study is comparable to that of all other two13 ,15 ,16 and three14 tier EMT-BLS and physician staffed ALS systems and to one ALS system with paramedics,17 all located in midsized urban/suburban areas.13-16
↵2-150 p < 0.05, **p < 0.001;
↵2-151 Time between emergency call and arrival BLS/ALS on the scene;
↵2-152 data reflect time interval between alarm of ALS unit and arrival on the scene.
ALS, advanced cardiac life support by paramedics; ALS-P, advanced cardiac life support by physicians; BLS, basic life support; EMT-BLS, emergency medical technician service providing basic cardiac life support; ND, not determined; NS, not significant.