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Defibrillation by general practitioners.

M C Colquhoun
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Abstract

OBJECTIVE: To investigate the mode of cardiac arrest in patients with acute myocardial infarction attended by general practitioners, and the effectiveness of early defibrillation. DESIGN: Retrospective observational study. SETTING: British general practice. PARTICIPANTS: General practitioners equipped with defibrillators by the British Heart Foundation. MAIN OUTCOME MEASURES: Cardiac rhythm when first monitored, response to defibrillation assessed by survival to reach hospital alive and survival to hospital discharge. INTERVENTIONS: Defibrillation and standard cardiopulmonary resuscitation in patients with cardiac arrest complicating acute myocardial infarction attended by British general practitioners. RESULTS: When a doctor equipped with a defibrillator witnessed an arrest or was able to initiate resuscitation within 4 min of the patient collapsing, 90% of patients were found to have developed a rhythm likely to respond to a defibrillatory shock. Defibrillation under these circumstances was very successful with more than 70% of patients subsequently admitted to hospital alive and approximately 60% surviving to be discharged alive. When the doctor commenced resuscitation later, fewer patients were found to have rhythms likely to be responsive to a DC shock. A greater proportion was in asystole and resuscitation was less frequently successful under these circumstances. When the arrest occurred in the doctor's surgery, 85% of patients were admitted to hospital alive and three quarters survived to hospital discharge. CONCLUSIONS: All those who provide the initial care for this vulnerable group of patients should be equipped with defibrillators. The more widespread deployment of defibrillators in the community may be a successful strategy for reducing unnecessary deaths from coronary heart disease.

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AgedCardiopulmonary ResuscitationElectric CountershockFamily PracticeFemaleHeart ArrestHumansMaleMyocardial InfarctionState MedicineTime FactorsUnited KingdomJournal Article

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M C Colquhoun. 2002. Defibrillation by general practitioners.. https://doi.org/10.1016/s0300-9572(01)00450-6

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