Prehospital cardiac arrest in a paramedic first-responder system using the Utstein style

To describe the characteristics of patients found to have cardiac arrest and to evaluate the characteristics predictive of survival after cardiac arrest in a paramedic first-responder model.

All patients who suffered out-of-hospital cardiac arrest in the city of Reading, Ohio, from January 1998 to December 2003 were recorded in the Utstein style. The number and incidence rate of witnessed arrests, initial rhythms, rate of bystander cardiopulmonary resuscitation (CPR), and 30-day mortality rate were retrospectively collected. Demographics, time to hospital, and response times were evaluated as predictors of survival.

Of those patients initially found to be in cardiac arrest, 14.3% were discharged alive. Witnessed arrests were more likely to result in live discharge of the patient. Whether bystander CPR was performed was not found to affect survival, nor was initial rhythm, although no patients initially found in asystole were discharged alive. No demographic characteristics or response times were predictive of survival.

The rates of survival in this paramedic first-response system are favorable compared with basic emergency medical technician first-response systems. Further study using direct comparison methodology is warranted to confirm these findings.