The place of general practitioners in the management of out-of-hospital cardiopulmonary resuscitation.

BACKGROUND

The involvement of general practitioners in community based resuscitation of out-of-hospital cardiac arrest has been found to be effective in improving survival rates. The aim of the study was to assess the potential for including general practitioners in Nottinghamshire in the resuscitation of out-of-hospital cardiac arrest victims by first determining whether they had the skill, experience and equipment to provide cardio-pulmonary resuscitation in the community; and second to ascertain what proportion of them would be prepared to establish a 'rapid response' scheme for patients requiring resuscitation.

METHODS

A postal questionnaire survey, between March and April 1997, of all 738 general practitioners in Nottinghamshire who serve, in total, a population of 1 million.

RESULTS

A total of 592 general practitioners (80%) responded to our survey. The majority worked in a predominantly urban environment and carried out their own out-of-hours on-call duties. Of them 93% had previous experience in cardiopulmonary resuscitation (median of 3 years), while 72.1% had experience of advanced life support, including use of a defibrillator but not recently (median of 8 years). General practitioners in rural practices were more likely to be trained in advanced life support (ALS), had more recent experience in cardiopulmonary resuscitation (including defibrillation) and were more willing to be involved in any proposed local resuscitation scheme. Only 9% of general practitioners carried a defibrillator when on-call and only 13% had access to a defibrillator within their practice premises. Of the general practitioners surveyed 349 (59%) reported a willingness to participate in a 'rapid response cardiac arrest' scheme and general practitioners who had no formal advanced life support training were as willing to become involved in such a scheme as those who were trained in ALS.

CONCLUSIONS

General practitioners may have an important role to play in improving the survival outcome of out-of-hospital cardiac arrest as many are ALS trained and have recent experience in resuscitation. However, few have access to a defibrillator and many do not have recent experience of defibrillation. Any proposed local resuscitation scheme would be particularly applicable to rural general practitioners as many have recent training in ALS, recent experience in advanced life support and most of all, are more willing to participate in such a scheme.