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Effect of out-of-hospital defibrillation by basic life support providers on cardiac arrest mortality: a metaanalysis
T E Auble1, J J Menegazzi, P M Paris
1Division of Emergency Medicine, University of Pittsburgh School of Medicine, PA, USA.
Study Objective:
Although some studies demonstrate otherwise, we hypothesized that metaanalysis would demonstrate a reduction in the relative risk of mortality when basic life support (BLS) providers can defibrillate out-of-hospital cardiac arrest patients.
Design:
Metaanalysis of studies meeting the following criteria: single-tier or two-tier emergency medical service (EMS) system, survival to hospital discharge for patients in ventricular fibrillation, and manual and/or automatic external defibrillators. The alpha error rate was .05.
Results:
Seven trials qualified for metaanalysis. Across all trials, the risk of mortality for BLS care with defibrillation versus that without was .915 (P = .0003). Separate subset analyses of single-tier and two-tier EMS systems demonstrated similar results.
Conclusion:
BLS defibrillation can reduce the relative risk of death for out-of-hospital cardiac arrest victims in ventricular fibrillation. Weaknesses in individual study designs and regional clustering limit the strength of this metaanalysis and conclusion.