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March 9, 1994

Out-of-Hospital CPR

Author Affiliations

Highland Park, Ill

JAMA. 1994;271(10):748. doi:10.1001/jama.1994.03510340037026

To the Editor.  —The recent article entitled "Predicting the Outcome of Unsuccessful Prehospital Advanced Cardiac Life Support" by Kellermann et al1 prompted this letter. I am a physician who happened to be in my parents' Memphis, Tenn, home the night of my father's cardiac arrest, April 9, 1993.Kellermann et al state that "on-line emergency medical service physicians should authorize paramedics to cease efforts in the field" (referring to patients who fail to respond to prehospital advanced cardiac life support [ACLS]).1 The night my father became ill, I called 911 and requested help for my very dyspneic father who had a history of heart disease. He subsequently arrested, and I began cardiopulmonary resuscitation (CPR) prior to the paramedics' arrival. However, because the paramedics were unavailable (they were out on another call), firefighters arrived. They checked his vital signs (he regained a pulse) and administered oxygen. Unfortunately, he soon

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