• M Shuster and J L Keller.
• Department of Emergency Medicine, Chedoke-McMaster Hospitals, Hamilton, Ontario, Canada.
• Ann Emerg Med. 1993 Apr 1;22(4):721-7.

Study ObjectiveTo examine the effect of fire department first-responder defibrillation on time to defibrillation in a mid-sized community with two tiers of emergency medical services (EMS) ambulance response.DesignRetrospective cohort.SettingThe study area was the region of Hamilton-Wentworth, which has more than 445,000 inhabitants and covers 1,136 km2 (438 square miles).Type Of ParticipantsWe studied 297 victims of out-of-hospital cardiac arrest presenting to the EMS system between May 1, 1990, and April 30, 1991.Measurements And Main ResultsThe mean defibrillation interval was decreased from 11.96 minutes to 8.50 minutes (P < .001) by the introduction of fire first-responder defibrillation. Survival was significantly greater with bystander-witnessed arrest, initial rhythm of ventricular fibrillation, and presence of a pulse on arrival in the emergency department.ConclusionIn our EMS system, fire first-responders were able to provide defibrillation in significantly shorter times than ambulance attendants. Other EMS systems should review their response times and consider instituting first-responder defibrillation as one means of reducing defibrillation intervals.

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