[Semiautomatic defibrillation in out-of-hospital cardiac arrest]

In a Danish suburban community the following attempts were made aimed at increasing survival of out-of-hospital cardiac arrest (CA): the citizens were offered training in diagnosis and treatment of CA and the ambulances serving the community were provided with a semiautomatic defibrillator. The results of these effects were evaluated over a two-year period. One hundred and seventy persons out of a population of 85,824 received training in CPR. The study included 113 cases of CA due to ischaemic heart disease. CA was witnessed in 84 cases (74%). Bystander CPR was attempted in 21 cases out of whom three survived (14%), compared to seven survivors among the remaining 92 patients (8%). If CPR was initiated within five minutes of CA, eight of 57 patients survived (15%), compared to one in 31 cases if resuscitation was attempted later. If ventricular fibrillation was present seven of 51 patients survived (14%); none of the 24 patients who initially had asystole, survived. In 336 situations tape recordings of the ECG at CA were available for analysis. Ventricular fibrillation was present in all of the 129 cases where DC-conversion was advised by the apparatus. There were two additional cases, one of ventricular fibrillation of low frequency and one of ventricular tachycardia where DC-conversion was not advised, but might have been beneficial.