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Establishment and results of an EMT-D program in a two-tiered physician-escorted rescue system. The experience in Berlin, Germany.

Abstract
Early defibrillation by emergency medical technicians or even less qualified personnel has been shown to improve survival rates for out-of-hospital cardiac arrest caused by ventricular fibrillation. It has been questioned whether these favourable results can be applied within the context of physician-attended emergency medical systems. Taking into consideration the results of a pilot study and after a careful analysis of the logistic and epidemiological background, the first German EMT-D program was introduced in the former West Berlin in December 1988. The first 2 years of experience with 499 technician-initiated resuscitation attempts in which the mobile intensive care unit of Klinikum Steglitz was involved, confirmed the results of the pilot study with an improved long-term survival rate (18%) for patients with ventricular fibrillation. We conclude that EMT defibrillation should be introduced in emergency physician-attended two-tiered emergency medical systems, whenever a thorough analysis of the existing rescue systems exhibits a 'relevant frequency' of resuscitation and response interval of 15 min or less.
AuthorsH R Arntz, M Oeff, S N Willich, W H Storch, R Schröder
JournalResuscitation (Resuscitation) Vol. 26 Issue 1 Pg. 39-46 (Aug 1993) ISSN: 0300-9572 [Print] Ireland
PMID8210730 (Publication Type: Journal Article)
Topics
  • Ambulances
  • Berlin (epidemiology)
  • Cardiopulmonary Resuscitation (statistics & numerical data)
  • Electric Countershock
  • Emergency Medical Services (organization & administration)
  • Emergency Medical Technicians
  • Heart Arrest (mortality, therapy)
  • Humans

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