Advanced search
Publication Cover
Prehospital Emergency Care Volume 15, 2011 - Issue 3
Submit an article Journal homepage
460
Views
15
CrossRef citations to date
0
Altmetric
Research Article

Immediate Defibrillation or Defibrillation After Cardiopulmonary Resuscitation

Soichi Koike From the Department of Planning, Information and Management (SK, SM), the University of Tokyo Hospital, Bunkyo, Japan; the Foundation for Ambulance Service Development, Emergency Life-Saving Technique Academy of Tokyo (ST), Hachioji, Japan; the Department of Public Health, Health Management and Policy (TO, MA, TI), Nara Medical University School of Medicine, Kashihara, Japan; and the Graduate School of Medicine, Department of Health Management and Policy (HY, HH), University of Tokyo, Bunkyo, Japan. Revision received February 11, 2011; accepted for publication February 14, 2011.Correspondence[email protected]
, MD, PhD,
Seizan Tanabe From the Department of Planning, Information and Management (SK, SM), the University of Tokyo Hospital, Bunkyo, Japan; the Foundation for Ambulance Service Development, Emergency Life-Saving Technique Academy of Tokyo (ST), Hachioji, Japan; the Department of Public Health, Health Management and Policy (TO, MA, TI), Nara Medical University School of Medicine, Kashihara, Japan; and the Graduate School of Medicine, Department of Health Management and Policy (HY, HH), University of Tokyo, Bunkyo, Japan. Revision received February 11, 2011; accepted for publication February 14, 2011.
, MD,
Toshio Ogawa From the Department of Planning, Information and Management (SK, SM), the University of Tokyo Hospital, Bunkyo, Japan; the Foundation for Ambulance Service Development, Emergency Life-Saving Technique Academy of Tokyo (ST), Hachioji, Japan; the Department of Public Health, Health Management and Policy (TO, MA, TI), Nara Medical University School of Medicine, Kashihara, Japan; and the Graduate School of Medicine, Department of Health Management and Policy (HY, HH), University of Tokyo, Bunkyo, Japan. Revision received February 11, 2011; accepted for publication February 14, 2011.
, MS,
Manabu Akahane From the Department of Planning, Information and Management (SK, SM), the University of Tokyo Hospital, Bunkyo, Japan; the Foundation for Ambulance Service Development, Emergency Life-Saving Technique Academy of Tokyo (ST), Hachioji, Japan; the Department of Public Health, Health Management and Policy (TO, MA, TI), Nara Medical University School of Medicine, Kashihara, Japan; and the Graduate School of Medicine, Department of Health Management and Policy (HY, HH), University of Tokyo, Bunkyo, Japan. Revision received February 11, 2011; accepted for publication February 14, 2011.
, MD, PhD,
Hideo Yasunaga From the Department of Planning, Information and Management (SK, SM), the University of Tokyo Hospital, Bunkyo, Japan; the Foundation for Ambulance Service Development, Emergency Life-Saving Technique Academy of Tokyo (ST), Hachioji, Japan; the Department of Public Health, Health Management and Policy (TO, MA, TI), Nara Medical University School of Medicine, Kashihara, Japan; and the Graduate School of Medicine, Department of Health Management and Policy (HY, HH), University of Tokyo, Bunkyo, Japan. Revision received February 11, 2011; accepted for publication February 14, 2011.
, MD, PhD,
Hiromasa Horiguchi From the Department of Planning, Information and Management (SK, SM), the University of Tokyo Hospital, Bunkyo, Japan; the Foundation for Ambulance Service Development, Emergency Life-Saving Technique Academy of Tokyo (ST), Hachioji, Japan; the Department of Public Health, Health Management and Policy (TO, MA, TI), Nara Medical University School of Medicine, Kashihara, Japan; and the Graduate School of Medicine, Department of Health Management and Policy (HY, HH), University of Tokyo, Bunkyo, Japan. Revision received February 11, 2011; accepted for publication February 14, 2011.
, PhD,
Shinya Matsumoto From the Department of Planning, Information and Management (SK, SM), the University of Tokyo Hospital, Bunkyo, Japan; the Foundation for Ambulance Service Development, Emergency Life-Saving Technique Academy of Tokyo (ST), Hachioji, Japan; the Department of Public Health, Health Management and Policy (TO, MA, TI), Nara Medical University School of Medicine, Kashihara, Japan; and the Graduate School of Medicine, Department of Health Management and Policy (HY, HH), University of Tokyo, Bunkyo, Japan. Revision received February 11, 2011; accepted for publication February 14, 2011.
, BS &
Tomoaki Imamura From the Department of Planning, Information and Management (SK, SM), the University of Tokyo Hospital, Bunkyo, Japan; the Foundation for Ambulance Service Development, Emergency Life-Saving Technique Academy of Tokyo (ST), Hachioji, Japan; the Department of Public Health, Health Management and Policy (TO, MA, TI), Nara Medical University School of Medicine, Kashihara, Japan; and the Graduate School of Medicine, Department of Health Management and Policy (HY, HH), University of Tokyo, Bunkyo, Japan. Revision received February 11, 2011; accepted for publication February 14, 2011.
, MD, PhD show all
Pages 393-400 | Published online: 26 Apr 2011
 
Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days

Abstract

Objectives. This study aimed to determine whether short cardiopulmonary resuscitation (CPR) by emergency medical services before defibrillation (CPR first) has a better outcome than immediate defibrillation followed by CPR (shock first) in patients with ventricular fibrillation/pulseless ventricular tachycardia (VF/pulseless VT) out-of-hospital cardiac arrest. Methods. We analyzed a national database between 2006 and 2008, and included patients aged 18 years or more who had witnessed cardiac arrests and whose first recorded rhythm was VF/pulseless VT. Those study subjects were divided into five groups in accordance with the CPR/defibrillation intervention sequence. Each group was subdivided into call-to-response intervals of <5 minutes and ≥5 minutes. We identified 267 patients in the shock-first group and 6,407 patients in the CPR-first group. One-month survival and neurologically favorable one-month survival rates were used for outcome measures. The association of intervention type on outcomes (one-month survival or neurologically favorable one-month survival) was analyzed using multivariate logistic regression analyses by adjusting potential confounding factors such as survey year, gender, age (years), bystander CPR, intubation, and call-to-response interval (min). Results. The overall one-month survival rate was 26.2% (3,125/11,941) and the neurologically favorable one-month survival rate was 16.6% (1,983/11,934). The CPR-first group had a one-month survival rate of 27.8% (1,780/6,407) and a neurologically favorable one-month survival rate of 17.8% (1,140/6,404), and the shock-first group had survival rates of 24.7% (66/267) and 18.4% (49/267), respectively. There were no significant differences in one-month survival and neurologically favorable one-month survival in these two primary comparison groups (odds ratio [95% confidence interval], 0.85 [0.64–1.13] and 1.04 [0.76–1.42], respectively). Logistic regression analysis showed that neither CPR first nor shock first was associated with the rate of one-month survival or neurologically favorable one-month survival, after adjusting for potential confounders. Conclusions. In our study, CPR prior to attempted defibrillation did not present a better outcome compared with shock first as measured by either one-month survival or neurologically favorable one-month survival, after adjusting for potential confounders. Further studies are required to determine whether CPR first has an advantage over shock first.

Log in via your institution

Access through your institution

Log in to Taylor & Francis Online

Restore content access

Restore content access for purchases made as guest
Purchase options * Save for later

PDF download + Online access

  • 48 hours access to article PDF & online version
  • Article PDF can be downloaded
  • Article PDF can be printed
USD 65.00 Add to cart

Issue Purchase

  • 30 days online access to complete issue
  • Article PDFs can be downloaded
  • Article PDFs can be printed
USD 85.00 Add to cart

* Local tax will be added as applicable

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.