[Advanced cardiac life support outside the hospital in Reykjavik and the surrounding area 1987-1990]

The purpose of this study was to evaluate the results of advanced cardiac life support (ACLS) performed by the crew of the emergency ambulance in Reykjavik and surrounding area from 1987 to 1990 and compare these with results of previous studies. During these four years the crew of the emergency ambulance attempted resuscitation in 195 patients with cardiac arrest. Sixty-four (33%) patients were admitted to the CCU and ICU and 31 (16%) survived to be discharged from the hospital. Asystole was the most common initial arrhythmia, seen in 92 (47%) patients, ventricular fibrillation in 77 (40%) and ventricular tachycardia in four (2%). Other arrhythmias, such as electromechanical dissociation and agonal rhythm were seen in 22 cases (11%). Of those 31, who survived the attack, ventricular fibrillation was by far the most common arrhythmia seen in 23 patients, two had ventricular tachycardia and six asystole on the first rhythm strip. The mean response time of the emergency ambulance was 4.6 minutes, but 4.1 minute when the patient survived the attack. In this study there were relatively more patients with asystole and more cases happened at home than was the case in 1982 to 1986 when the emergency ambulance was not operated during nights or on Sundays and holidays. Witnesses to cardiac arrest are not present nearly as often at home and the results of ACLS at home are also not as good as of ACLS elsewhere. No significant difference is between the main results of this study and the first study of ACLS in the prehospital setting in Reykjavik (1).