ESTABLISHMENT AND RESULTS OF AN EMT-D PROGRAM IN A 2-TIERED PHYSICIAN-ESCORTED RESCUE SYSTEM - THE EXPERIENCE IN BERLIN, GERMANY

Early defibrillation by emergency medical technicians or even less qua lified personnel has been shown to improve survival rates for out-of-h ospital 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 analysi s 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 resuscit ation attempts in which the mobile intensive care unit of Klinikum Ste glitz was involved, confirmed the results of the pilot study with an i mproved long-term survival rate (18%) for patients with ventricular fi brillation. We conclude that EMT defibrillation should be introduced i n emergency physician-attended two-tiered emergency medical systems, w henever a thorough analysis of the existing rescue systems exhibits a 'relevant frequency' of resuscitation and response interval of 15 min or less.