The problem of cardiac arrest in the community

Flying Squad response to medical emergencies

The Flying Squad of the Accident and Emergency Department, of the Derbyshire Royal Infirmary, was established in 1955 by Collins. The initial function was to provide emergency care to victims of industrial accidents. However, the spectrum of emergencies they now respond to has expanded and includes predominantly road traffic accidents and medical emergencies. Despite the proliferation of Flying Squads their benefit has been difficult to quantify even in a trauma setting (Robertson & Steedman, 1985; Gorman & Coals, 1983). The outcome in medical emergencies is reported as dismal (Robertson & Steedman, 1985; Rowley & Collins, 1979) yet the number of calls for the flying squad to attend medical emergencies are many. Previous reports have recorded 20-30% of Squad calls responding to medical emergencies (Gorman & Coals, 1983; Rowley & Collins, 1979; Steedman & Robertson, 1986; Harrop & Bodiwala, 1983).

Targeted recruitment of senior citizens and cardiac patients to a mass CPR training course

CPR courses attract a predominance of young, healthy adults. Targeted recruitment of senior citizens and family members of cardiac patients has been suggested but inadequately studied. We used a targeted recruitment strategy for our annual mass CPR training course to determine if such an approach would be effective in attracting the target group. Targeting significantly increased the percentage of senior citizen participants and participants who took the course because they or a close friend or relative had cardiac disease (P less than .00001). These data have important implications regarding potential future CPR training course recruitment methods compared with nontargeted recruitment approaches.

Influence of emergency medical services systems and prehospital defibrillation on survival of sudden cardiac death victims

This article reviews the influence of emergency medical systems and prehospital defibrillation on survival of sudden cardiac death. The historical perspective and epidemiologic considerations of prehospital sudden cardiac death are highlighted. Factors predictive of successful resuscitation and impact of community activity on sudden death are discussed. Influences of emergency medical services on outcome of prehospital cardiac arrest are reviewed, with emphasis on the role of dispatchers, emergency medical technicians, and paramedics. The recent emergence of prehospital automatic defibrillation by emergency medical technicians, first responders, and lay persons is discussed in depth, as it has great potential to positively influence outcome of prehospital sudden cardiac death.