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

Abstract

Objective: To examine the impact of administration of cardioactive drugs on the outcome from out of hospital cardiac arrest. Design: Longitudinal observational cohort study with historical controls before and after the introduction of drug use in cardiac arrest by paramedics. Subjects: Adult patients who had sustained an out of hospital cardiac arrest of cardiac aetiology and were treated by paramedics. Setting: Edinburgh, Scotland. Outcome measures: Return of spontaneous circulation, admission to and discharge from hospital. Results: There was no significant difference in the demographics between Period 1 (prior to drug administration) and Period 2 (after). There was no difference in outcome between Period 1 and Period 2 for all three parameters, 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 VF/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 cardioactive drug administration to the treatment of out of hospital cardiac arrest does not improve survival.