title: [Standards for preclinical resuscitation--requirements for efficient therapy and scientific analysis. A prospective study using as an example the combined emergency medical service of the Munich administrative district and capital].
abstract: A standardized treatment protocol is essential for scientific evaluation of parameters influencing the outcome and survival of patients who have suffered cardiac arrest in a non-hospital situation. In addition, a standardized therapy algorithm permits effective, time-saving interaction of all members of the emergency team who work together to perform cardiopulmonary resuscitation (CPR) in any emergency outside the hospital. This paper gives the results obtained in 50 patients in whom on-the-spot resuscitation was performed by a specially trained team [emergency medical team (EMT) + on-scene physician] using an ACLS (advanced cardiac life support) protocol modified from the AHA (American Heart Association) standard. Two different algorithms were used one for ventricular fibrillation (VF) and pulseless ventricular tachycardia and one for asystole and pulseless bradycardia. When indicated, countershocks were first administered at a continuous energy level of 360 J, up to three times one after the other. All patients then received epinephrine intratracheally, 2 mg, immediately after intubation. In the case or persisting asystole a further 2-mg dose of epinephrine and then one 5-mg dose were given i.v. in keeping with the ACLS protocol. In the case of persisting VF or pulseless tachycardia we gave one 100-mg dose of lidocaine i.v. and then performed the next countershock at the same energy level. The time the team members actually needed for the single steps of the ACLS protocol was meticulously documented with the aid of a stop watch.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Chirurgische Klinik und Poliklinik Innenstadt der Ludwig-Maximilians-Universität München.
authors.forename: A
authors.initials: A
authors.lastname: Neumann
authors.forename: C
authors.initials: C
authors.lastname: Waydhas
authors.forename: K
authors.initials: K
authors.lastname: Schneider
authors.forename: M
authors.initials: M
authors.lastname: Haider
authors.forename: K
authors.initials: K
authors.lastname: Theissen
authors.forename: S
authors.initials: S
authors.lastname: Schmidbauer
authors.forename: L
authors.initials: L
authors.lastname: Schweiberer
mesh_terms: D000465:Algorithms; D004526:Efficiency; D004632:Emergency Medical Services / Q000592:standards*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D011446:Prospective Studies; D012151:Resuscitation / Q000379:methods* / Q000592:standards
vernacular_title: Standard in der präklinischen Reanimation--Voraussetzung für effiziente Therapie und wissenschaftliche Analyse. Prospektive Untersuchung am Beispiel des gemeinsamen Notarztdienstes des Landkreises und der Landeshauptstadt München.