Survival after cardiac arrest outside hospital over a 12-year period in Gothenburg.
BACKGROUND
A two-tiered ambulance system with a mobile coronary care unit and standard ambulance has operated in Gothenburg (population 434,000) since 1980. Mass education in cardiopulmonary resuscitation (CPR) commenced in 1985 and in 1988 semiautomatic defibrillators were introduced.


OBJECTIVE
To describe early and late survival after cardiac arrest outside hospital over a 12-year period.


METHODS
All patients with prehospital cardiac arrest in Gothenburg reached by mobile coronary care unit or standard ambulance between 1980 and 1992.


RESULTS
The number of patients with cardiac arrest remained fairly steady over time. Among patients with witnessed ventricular fibrillation, the time to defibrillation decreased over time. The proportion of patients in whom bystander initiated CPR was increased only moderately over time. The proportion of patients given medication such as lignocaine and adrenaline successively increased. The number of patients with cardiac arrest who were discharged from hospital per year remained steady between 1981 and 1990 (20 per year), but increased during 1991 and 1992 to 41 and 31 respectively.


CONCLUSIONS
Improvements in the emergency medical service in Gothenburg over a 12-year period have lead to: (1) a shortened delay time between cardiac arrest and first defibrillation and (2) an improved survival of patients with cardiac arrest outside hospital probably explained by this shortened delay time.
Ekström
L
L
Division of Cardiology, Sahlgrenska, Hospital, Gothenburg, Sweden.
Herlitz
J
J
Wennerblom
B
B
Axelsson
A
A
Bång
A
A
Holmberg
S
S
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000552:Ambulances; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000706:statistics & numerical data; D004554:Electric Countershock / Q000706:statistics & numerical data; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000401:mortality* / Q000628:therapy
D008012:Lidocaine; D004837:Epinephrine