Paramedic activities, drug administration and survival from out of hospital cardiac arrest

Objective: To examine the impact of administration of cardioactive drugs on the outcome from out of hospital cardiac arrest. Design: Longitudinal obse rvational cohort study with historical controls before and after the introd uction of drug use in cardiac arrest by paramedics. Subjects: Adult patient s who had sustained an out of hospital cardiac arrest of cardiac aetiology and were treated by paramedics. Setting: Edinburgh, Scotland. Outcome measu res: Return of spontaneous circulation, admission to and discharge from hos pital. Results: There was no significant difference in the demographics bet ween Period I (prior to drug administration) and Period 2 (after). There wa s no difference in outcome between Period 1 and Period 2 for all three para meters, return of spontaneous output 30.1 versus 35%, admission to hospital 18.9 versus 24.5% and discharge 5.8 versus 6.5%. If the presenting rhythm of VP/pulseless VT alone was considered survival to hospital discharge was 12.1% in Period 1 and 10.3% in Period 2. Conclusion: The addition of cardio active drug administration to the treatment of out of hospital cardiac arre st does not improve survival. (C) 2000 Elsevier Science Ireland Ltd. All ri ghts reserved.