• Kenji Ohshige, Shuji Shimazaki, Hiroyuki Hirasawa, Masataka Nakamura, Hiroshi Kin, Chiiho Fujii, Kazuo Okuchi, Yasuhiro Yamamoto, Katsuya Akashi, Junzo Takeda, Takashi Hanyuda, and Osamu Tochikubo.
• Department of Public Health, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. kenoh@med.yokohama-cu.ac.jp
• Resuscitation. 2005 Jul 1;66(1):53-61.

ObjectiveThis study aimed at evaluating two emergency medical service systems, one in which emergency life-saving technicians (ELSTs) are allowed to administer epinephrine (adrenaline) to patients with out-of-hospital cardiac arrest and one in which ELSTs are allowed to administer epinephrine, lidocaine, and atropine.MethodsA modified, prospective community health trial was conducted from April 1 to October 31, 2003. Areas served by physician-manned ambulances, where out-of-hospital cardiopulmonary resuscitation (CPR) was performed with resuscitative drugs (experimental areas), were compared to areas served by ELST-manned ambulances, where resuscitative drugs were not administered outside the hospital (reference areas). The sequence of emergency procedures performed in the experimental areas was divided into three phases. Phase I included administration of epinephrine, which simulated administration of epinephrine by ELSTs. Phase II started with the use of lidocaine or atropine. Phases I and II simulated administration of epinephrine, lidocaine, and atropine by ELSTs. Phase III began with administration of another drug. Outcomes, resuscitation rates and 1-month survival rates were determined, and differences between the two types of areas were analyzed.ResultsFor non-traumatic cardiac arrest, outcomes through phase II in the experimental areas were significantly better than those in the reference areas. Phase I-only outcomes in the experimental areas were better, but not significantly better, than those in the reference areas.ConclusionUse of resuscitative drugs for non-traumatic prehospital CPR appears to be effective in terms of resuscitation rates and 1-month survival rates.

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