• C J Mann and H Guly.
• Department of Accident and Emergency Medicine, Derriford Hospital, Plymouth.
• J Accid Emerg Med. 1997 May 1;14(3):149-50.

ObjectiveTo determine whether paramedic interventions increased the rate of return of spontaneous circulation in the victims of out of hospital cardiac arrest.MethodsA retrospective analysis of 276 out of hospital cardiac arrests was made. Data analysed included age, sex, presenting rhythm, ambulance response time, presence of a pulse at any point, interventions performed by the ambulance crews, and survival to discharge.Results146 patients were treated by paramedics and 130 by technicians. There was no difference in the rate of return of spontaneous circulation or survival to discharge in patients presenting in ventricular fibrillation (VF). In non-VF arrests there was no increase in survival to discharge, but 15% of patients in non-VF arrests achieved a return of spontaneous circulation when treated by paramedics compared to none treated by technicians. There were no other significant differences in any of the variables assessed.ConclusionsOut of hospital cardiac arrests presenting in VF are managed equally well by paramedics and technicians. However, in non-VF arrests there is a significantly increased rate of return of spontaneous circulation in those patients attended by paramedics.

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