Evaluation of resuscitation from cardiopulmonary arrest by paramedics

A series of 100 consecutive victims of cardiopulmonary arrest were evaluated for treatment in the field by paramedic teams and for the patients' subsequent course. Analysis of the data correlated success rates with specific factors, including response, treatment and transportation times, proximity to the emergency center, establishment of an intravenous line and administration of drugs, pulmonary aspiration of gastric contents, cardiopulmonary resuscitation by a bystander, cardiopulmonary arrest in the presence of the team, and other factors. Successful resuscitation was accomplished in 24% of cases, and 7% of the victims ultimately returned to their previous lifestyles. Therapeutic maneuvers which prolonged time at the scene worsened prognosis. These results were compared to recent reports from other institutions with specific reference to differences in technique regarding success rates. Although the basic policy of "rush the patient to the hospital" of past years has shifted to one of evaluation, emergency treatment and stabilization at the scene before transportation, the data suggest that specific guidelines consistent with the urgency of the situation are necessary to maximize the patient salvage rate.