Factors in successful resuscitation by paramedics.

The out-of-hospital reports of 2152 consecutive paramedic fire rescue responses were reviewed. Examination of emergency department records and outcome was conducted in all cardiopulmonary arrests (120), major trauma (59) or nontraumatic hemorrhage (9) and one half (95 of 199 patients) with chest pain or possible myocardial infarction. Predominant age was 50 to 70 (66%) and men outnumbered women by four to one. At the scene arrival was under five minutes in over 70% of the cases. Thirty of the 120 patients with cardiopulmonary arrest (12 occurred after paramedic arrival) responded to initial cardiopulmonary resuscitation, 24 patients entered the coronary care unit, and 16 were discharged alive. Ventricular fibrillation (50) and asystole (40) were the documented rhythms. All survivors had ventricular fibrillation. Evaluation of the trauma and nontraumatic blood loss victims indicated that, after the paramedic places an intravenous line, the paramedic role is less well defined. Mean transportation time was 36 (trauma) and 38 (hemorrhage) minutes to the hospital.