Early defibrillation in out-of-hospital sudden cardiac death: an Australian experience

Arch Emerg Med. 1993 Mar;10(1):1-7. doi: 10.1136/emj.10.1.1.


All patients with primary cardiac disease presenting with out-of-hospital sudden cardiac death (OH-SCD) to a provincial hospital were reviewed retrospectively over a 5-year period from 1985 to 1989. This coincided with the introduction of out-of-hospital defibrillation (OH-DEFIB) by ambulance officers. Of 215 patients, 17 (9%) survived to leave hospital alive, 15 of whom underwent OH-DEFIB. There was an increase in survivors from 4%, prior to OH-DEFIB, to 9% of all cardiac arrests, but this was not statistically significant (P = 0.3). However, long term survival amongst immediate survivors was associated with a statistically significant improvement following the introduction of OH-DEFIB (15 of 30 (50%) vs. 2 of 19 (10.5%), P < 0.01). Mean call-out, at-scene and transfer times did not significantly vary between survivors and non-survivors. A total of 155 (72%) had a known cardiac history, with the majority (74%) of arrests occurring at home. Of 134 witnessed arrests, only 46 (34%) underwent bystander-initiated cardiopulmonary resuscitation (CPR). A programme in CPR aimed at relatives of known cardiac patients, and the adoption of a paramedic protocol which improves oxygenation at the time of arrest are recommended.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Allied Health Personnel
  • Ambulances
  • Australia / epidemiology
  • Death, Sudden, Cardiac*
  • Electric Countershock*
  • Emergency Medical Services*
  • Female
  • Heart Arrest / mortality
  • Heart Arrest / therapy
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome