Literature DB >> 11397740

Effect of reducing ambulance response times on deaths from out of hospital cardiac arrest: cohort study.

J P Pell1, J M Sirel, A K Marsden, I Ford, S M Cobbe.   

Abstract

OBJECTIVES: To determine the association between ambulance response time and survival from out of hospital cardiopulmonary arrest and to estimate the effect of reducing response times.
DESIGN: Cohort study.
SETTING: Scottish Ambulance Service.
SUBJECTS: All out of hospital cardiopulmonary arrests due to cardiac disease attended by the Scottish Ambulance Service during May 1991 to March 1998. MAIN OUTCOME MEASURES: Survival rate to hospital discharge and potential improvement from reducing response times.
RESULTS: Of 13 822 arrests not witnessed by ambulance crews but attended by them within 15 minutes, complete data were available for 10 554 (76%). Of these patients, 653 (6%) survived to hospital discharge. After other significant covariates were adjusted for, shorter response time was significantly associated with increased probability of receiving defibrillation and survival to discharge among those defibrillated. Reducing the 90th centile for response time to 8 minutes increased the predicted survival to 8%, and reducing it to 5 minutes increased survival to 10-11% (depending on the model used).
CONCLUSIONS: Reducing ambulance response times to 5 minutes could almost double the survival rate for cardiac arrests not witnessed by ambulance crews.

Entities:  

Mesh:

Year:  2001        PMID: 11397740      PMCID: PMC32251          DOI: 10.1136/bmj.322.7299.1385

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  17 in total

Review 1.  Improving survival from sudden cardiac arrest: the "chain of survival" concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association.

Authors:  R O Cummins; J P Ornato; W H Thies; P E Pepe
Journal:  Circulation       Date:  1991-05       Impact factor: 29.690

2.  "Heartstart Scotland"--initial experience of a national scheme for out of hospital defibrillation.

Authors:  S M Cobbe; M J Redmond; J M Watson; J Hollingworth; D J Carrington
Journal:  BMJ       Date:  1991-06-22

Review 3.  Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council.

Authors:  R O Cummins; D A Chamberlain; N S Abramson; M Allen; P J Baskett; L Becker; L Bossaert; H H Delooz; W F Dick; M S Eisenberg
Journal:  Circulation       Date:  1991-08       Impact factor: 29.690

4.  Cost-effectiveness analysis of potential improvements to emergency medical services for victims of out-of-hospital cardiac arrest.

Authors:  G Nichol; A Laupacis; I G Stiell; K O'Rourke; A Anis; H Bolley; A S Detsky
Journal:  Ann Emerg Med       Date:  1996-06       Impact factor: 5.721

5.  Community-based interventions for sudden cardiac death. Impact, limitations, and changes.

Authors:  L A Cobb; W D Weaver; C E Fahrenbruch; A P Hallstrom; M K Copass
Journal:  Circulation       Date:  1992-01       Impact factor: 29.690

6.  Use of the automatic external defibrillator in the management of out-of-hospital cardiac arrest.

Authors:  W D Weaver; D Hill; C E Fahrenbruch; M K Copass; J S Martin; L A Cobb; A P Hallstrom
Journal:  N Engl J Med       Date:  1988-09-15       Impact factor: 91.245

7.  Efficacy of out of hospital defibrillation by ambulance technicians using automated external defibrillators. The Heartstart Scotland Project.

Authors:  M L Sedgwick; J Watson; K Dalziel; D J Carrington; S M Cobbe
Journal:  Resuscitation       Date:  1992 Aug-Sep       Impact factor: 5.262

8.  Automatic external defibrillators used by emergency medical technicians. A controlled clinical trial.

Authors:  R O Cummins; M S Eisenberg; P E Litwin; J R Graves; T R Hearne; A P Hallstrom
Journal:  JAMA       Date:  1987-03-27       Impact factor: 56.272

9.  Cardiac arrest treated with a new automatic external defibrillator by out-of-hospital first responders.

Authors:  W D Weaver; M K Copass; D L Hill; C Fahrenbruch; A P Hallstrom; L A Cobb
Journal:  Am J Cardiol       Date:  1986-05-01       Impact factor: 2.778

Review 10.  From concept to standard-of-care? Review of the clinical experience with automated external defibrillators.

Authors:  R O Cummins
Journal:  Ann Emerg Med       Date:  1989-12       Impact factor: 5.721

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  47 in total

1.  Doctor's positioning of defibrillation paddles. Level of evidence should have been assessed.

Authors:  J Calinas-Correia
Journal:  BMJ       Date:  2001-11-03

2.  Public access defibrillators. Potential efficacy of public access defibrillation may be underestimated.

Authors:  Malcolm F Woollard
Journal:  BMJ       Date:  2003-01-18

3.  Surviving out of hospital cardiac arrest at home: a postcode lottery?

Authors:  R M Lyon; S M Cobbe; J M Bradley; N R Grubb
Journal:  Emerg Med J       Date:  2004-09       Impact factor: 2.740

4.  The debate on public place defibrillators: charged but shockingly ill informed.

Authors:  J P Pell
Journal:  Heart       Date:  2003-12       Impact factor: 5.994

5.  An emergency system to improve ambulance dispatching, ambulance diversion and clinical handover communication-a proposed model.

Authors:  Samir El-Masri; Basema Saddik
Journal:  J Med Syst       Date:  2012-06-07       Impact factor: 4.460

6.  Ambulance services at hospital universiti sains malaysia and hospital kota bharu: a retrospective study of calls.

Authors:  Mohd Shaharudin Shah Che Hamzah; Rashidi Ahmad; Nik Hisamuddin Nik Abdul Rahman; Kasmah Wati Pardi; Naimah Jaafar; Wan Aasim Wan Adnan; Kamaruddin Jaalam; Syed Mohsin Sahil Jamalullail
Journal:  Malays J Med Sci       Date:  2005-07

7.  [Identification of common locations of out-of-hospital cardiac arrests in a German metropolis].

Authors:  C Hanefeld; F Rosbund; A Kloppe; C Kloppe
Journal:  Med Klin Intensivmed Notfmed       Date:  2017-06-14       Impact factor: 0.840

8.  Treating the clock and not the patient: ambulance response times and risk.

Authors:  L Price
Journal:  Qual Saf Health Care       Date:  2006-04

9.  Cost effectiveness and cost utility model of public place defibrillators in improving survival after prehospital cardiopulmonary arrest.

Authors:  Andrew Walker; Jane M Sirel; Andrew K Marsden; Stuart M Cobbe; Jill P Pell
Journal:  BMJ       Date:  2003-12-06

10.  Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK.

Authors:  Gwyn Bevan; Richard Hamblin
Journal:  J R Stat Soc Ser A Stat Soc       Date:  2009-01       Impact factor: 2.483

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