Defibrillation by general practitioners

Resuscitation. 2002 Feb;52(2):143-8. doi: 10.1016/s0300-9572(01)00450-6.


Objective: To investigate the mode of cardiac arrest in patients with acute myocardial infarction attended by general practitioners, and the effectiveness of early defibrillation.

Design: Retrospective observational study.

Setting: British general practice.

Participants: General practitioners equipped with defibrillators by the British Heart Foundation.

Main outcome measures: Cardiac rhythm when first monitored, response to defibrillation assessed by survival to reach hospital alive and survival to hospital discharge.

Interventions: Defibrillation and standard cardiopulmonary resuscitation in patients with cardiac arrest complicating acute myocardial infarction attended by British general practitioners.

Results: When a doctor equipped with a defibrillator witnessed an arrest or was able to initiate resuscitation within 4 min of the patient collapsing, 90% of patients were found to have developed a rhythm likely to respond to a defibrillatory shock. Defibrillation under these circumstances was very successful with more than 70% of patients subsequently admitted to hospital alive and approximately 60% surviving to be discharged alive. When the doctor commenced resuscitation later, fewer patients were found to have rhythms likely to be responsive to a DC shock. A greater proportion was in asystole and resuscitation was less frequently successful under these circumstances. When the arrest occurred in the doctor's surgery, 85% of patients were admitted to hospital alive and three quarters survived to hospital discharge.

Conclusions: All those who provide the initial care for this vulnerable group of patients should be equipped with defibrillators. The more widespread deployment of defibrillators in the community may be a successful strategy for reducing unnecessary deaths from coronary heart disease.

MeSH terms

  • Aged
  • Cardiopulmonary Resuscitation
  • Electric Countershock*
  • Family Practice*
  • Female
  • Heart Arrest / etiology
  • Heart Arrest / mortality
  • Heart Arrest / therapy*
  • Humans
  • Male
  • Myocardial Infarction / complications
  • State Medicine
  • Time Factors
  • United Kingdom