Paramedics and technicians are equally successful at managing cardiac arrest outside hospital

Abstract

Objective: To examine the effect on survival of treatment by ambulance paramedics and ambulance technicians after cardiac arrest outside hospital. Design: Prospective study over two years from 1 April 1992 to 31 March 1994. Setting: Accident and emergency department of university teaching hospital. Subjects: 502 consecutive adult patients with out of hospital cardiopulmonary arrest of cardiac origin. Interventions: Treatment by ambulance technicians or paramedics both equipped with semi-automatic defibrillators. Main outcome measures: Rate of return of spontaneous circulation, hospital admission, and survival to hospital discharge. Results: Rates of return of spontaneous circulation, hospital admission, and survival to hospital discharge were not significantly different for patients treated by paramedics as opposed to ambulance technicians. Paramedics spent significantly longer at the scene of the arrest than technicians (PConclusions: The response of ambulance paramedics to patients with cardiopulmonary arrest outside hospital does not provide improved outcome when compared with ambulance technicians using basic techniques and equipped with semi-automatic defibrillators. Key messages Ambulance paramedics undergo extensive further training in resuscitation techniques No improvement in overall outcome was seen when paramedics attended the patients The government plans to have at least one paramedic in every front line ambulance by the end of 1995 The outcome of patients treated by technicians v paramedics does not justify the government's plans