title: Effect of fire department first-responder automated defibrillation.
abstract: OBJECTIVE
  To examine the effect of fire department first-responder defibrillation on time to defibrillation in a mid-sized community with two tiers of emergency medical services (EMS) ambulance response.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  The study area was the region of Hamilton-Wentworth, which has more than 445,000 inhabitants and covers 1,136 km2 (438 square miles).
  
  
  METHODS
  We studied 297 victims of out-of-hospital cardiac arrest presenting to the EMS system between May 1, 1990, and April 30, 1991.
  
  
  RESULTS
  The mean defibrillation interval was decreased from 11.96 minutes to 8.50 minutes (P < .001) by the introduction of fire first-responder defibrillation. Survival was significantly greater with bystander-witnessed arrest, initial rhythm of ventricular fibrillation, and presence of a pulse on arrival in the emergency department.
  
  
  CONCLUSIONS
  In our EMS system, fire first-responders were able to provide defibrillation in significantly shorter times than ambulance attendants. Other EMS systems should review their response times and consider instituting first-responder defibrillation as one means of reducing defibrillation intervals.
authors.affiliation: Department of Emergency Medicine, Chedoke-McMaster Hospitals, Hamilton, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Shuster
authors.forename: J L
authors.initials: JL
authors.lastname: Keller
mesh_terms: D000368:Aged; D000552:Ambulances; D004554:Electric Countershock; D004632:Emergency Medical Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D013997:Time Factors