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Importance of Rapid Provision and Implications for Program Planning

Mickey S. Eisenberg, MD, PhD; Lawrence Bergner, MD, MPH; Alfred Hallstrom, PhD

JAMA. 1979;241(18):1905-1907.

Abstract
Several time-related variables involving resuscitation from out-of-hospital cardiac arrest were studied. Short time intervals from collapse to initiation of cardiopulmonary resuscitation (CPR) and to provision of definitive care were significantly associated with survival from cardiac arrest. The two times were jointly related, and one short time without the other was unlikely to result in survival. If CPR was initiated within four minutes and if definitive care was provided within eight minutes, 43% of patients survived. If either time was exceeded, the chances of survival fell dramatically. The time to initiation of CPR and definitive care are factors directly influenced by emergency medical service program decisions. A realistic option to improve time to initiation of CPR is widespread citizen CPR training. A possible option to improve the time to definitive care is the training of emergency medical technicians in defibrillation.

(JAMA 241:1905-1907, 1979)

Author Affiliations
From the Department of Medicine University Hospital (Dr Eisenberg) and the Department of Biostatistics, School of Public Health and Community Medicine (Dr Hallstrom), University of Washington, and the Seattle-King County Department of Health (Drs Bergner and Eisenberg), Seattle. Portions of this research were done when Dr Eisenberg was a Robert Wood Johnson Clinical Scholar at the University of Washington.

Footnotes
The opinions expressed are those of the authors and do not necessarily reflect those of the Robert Wood Johnson Foundation.

Reprint requests to Emergency Medical Services Division, King County Department of Health, 508 Smith Tower, Seattle, WA 98104 (Dr Eisenberg).

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