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April 6, 1984

Treatment of Ventricular Fibrillation: Emergency Medical Technician Defibrillation and Paramedic Services

Author Affiliations

From the Departments of Medicine (Drs Eisenberg, Copass, and Short), Biostatistics (Dr Hallstrom), and Health Services (Dr Bergner), University of Washington; and the King County Medical Services Division, King County Health Department (Ms Pierce), Seattle.

JAMA. 1984;251(13):1723-1726. doi:10.1001/jama.1984.03340370055030

We compared the effect of rapid defibrillation by emergency medical technicians (EMTs) combined with paramedic care with that of standard EMT and paramedic care on survival from 540 witnessed episodes of out-of-hospital cardiac arrest caused by ventricular fibrillation. More than 400 EMTs were trained in the recognition of ventricular fibrillation and operation of a defibrillator. For a portion of the three-year study, emergency care for 179 cases was randomized between the two types of services. For randomized cases, when the time interval between EMT and paramedic arrival was greater than four minutes there was significantly improved survival with EMT defibrillation and paramedic care (42%) compared with basic EMT and paramedic care (19%). Similar findings occurred when all cases were considered (38% v 18%). Defibrillation by EMTs combined with paramedic services can enhance survival from ventricular fibrillation, compared with basic EMT and paramedic care.

(JAMA 1984;251:1723-1726)