Haynes B E, Mendoza A, McNeil M, Schroeder J, Smiley D R
Kaiser-Permanente Medical Care Program, San Diego, CA 92120.
JAMA. 1991;266(4):545-7.
Rapid delivery of defibrillatory shocks increases survival in patients with cardiac arrest. The automated external defibrillator interprets cardiac rhythms and delivers electrical shocks, permitting appropriate defibrillation by persons with minimal training. California initiated a program for early defibrillation by basic emergency medical technicians, using manual or automated external defibrillators, and by public safety personnel (fire fighters, peace officers, and public lifeguards), using automated external defibrillators. The program includes a system for reporting outcomes statewide. In the first 46 months under this program, 1487 patients received defibrillatory shocks; 1009 (68%) of these patients had witnessed ventricular fibrillation. Of the latter group, 191 were discharged from the hospital, representing 19% of those with witnessed ventricular fibrillation and 13% of all patients who had had shocks applied. California also implemented a framework of training and medical direction for defibrillation by laypersons using automated external defibrillators. Early defibrillation by basic emergency medical technicians and public safety personnel, encouraged by appropriate regulatory changes, results in gratifying survival rates.
迅速给予除颤电击可提高心脏骤停患者的生存率。自动体外除颤器可解读心律并输送电击，使经过最少培训的人员也能进行适当的除颤操作。加利福尼亚州启动了一项计划，由基础急救医疗技术人员使用手动或自动体外除颤器，以及由公共安全人员（消防员、治安官和公共救生员）使用自动体外除颤器进行早期除颤。该计划包括一个用于报告全州结果的系统。在该计划实施的头46个月里，有1487名患者接受了除颤电击；其中1009名（68%）患者被目击为心室颤动。在后者中，191人出院，占目击心室颤动患者的19%，占所有接受电击患者的13%。加利福尼亚州还实施了一个由非专业人员使用自动体外除颤器进行除颤的培训和医疗指导框架。在适当的监管变革推动下，基础急救医疗技术人员和公共安全人员进行的早期除颤带来了令人满意的生存率。
