Comparison of two methods of transporting paramedics to cardiac arrests outside hospital.
OBJECTIVE
To compare the deployment of paramedics in a separate rapid response unit with their deployment in a standard emergency ambulance.


METHODS
A one year period of each deployment.


METHODS
Throughout the community in some parts of West Yorkshire.


METHODS
All patients receiving resuscitation for cardiac arrest by paramedics.


METHODS
Using the same group of paramedics and central control, 12 months with the paramedics deployed in separate cars in addition to the standard ambulances (period 1) were followed by another 12 months when they were deployed as one crew member of a standard emergency ambulance (period 2).


METHODS
Number of arrests attended, number of patients in ventricular fibrillation at paramedic arrival, response times, survival to leave hospital.


RESULTS
In period 1, 580 arrests were attended with 31 survivors. In period 2, 462 arrests resulted in 25 survivors. The mean response time was shorter in period 1 (6.24 versus 6.60 min, Cl--0.01-0.73 min). In period 1, 217 patients were found in ventricular fibrillation (23 survivors): In period 2, 141 patients were found in ventricular fibrillation (11 survivors).


CONCLUSIONS
Separating paramedics from the standard emergency ambulances increases the number of survivors of cardiac arrest but the difference may not be sufficiently large to justify the additional expenditure.
Wright
D
D
St James's University Hospital, Leeds, UK.
Bannister
J
J
Ryder
M
M
Mackintosh
A F
AF
D000552:Ambulances / Q000706:statistics & numerical data*; D001336:Automobiles; D004632:Emergency Medical Services / Q000379:methods; D004634:Emergency Medical Technicians / Q000600:supply & distribution*; D004739:England / Q000453:epidemiology; D006323:Heart Arrest / Q000401:mortality; D006801:Humans; D013997:Time Factors; D014186:Transportation / Q000379:methods