Weaver W D, Cobb L A, Hallstrom A P, Copass M K, Ray R, Emery M, Fahrenbruch C
Ann Emerg Med. 1986 Oct;15(10):1181-6. doi: 10.1016/s0196-0644(86)80862-9.
Since the implementation of a paramedic system in Seattle, yearly survival rates from out-of-hospital cardiac arrest due to ventricular fibrillation have averaged 25% without any significant increase over the years. Outcome for cardiac arrest associated with other rhythms has been poor: when asystole was the first rhythm recorded, only 1% of patients survived; when electromechanical dissociation was initially present, only 6% survived. For cases of electromechanical dissociation, neither the type of rhythm nor the rate appear to influence outcome. Survival from ventricular fibrillation can be improved by shortening the delay to initiation of CPR and to defibrillation. When outcome in 244 witnessed arrests was related to the times to beginning CPR and to initial defibrillation, mortality increased 3% each minute until CPR was begun and 4% a minute until the first shock was delivered. New strategies that minimize delays appear to have the greatest promise for improving survival after cardiac arrest.
自西雅图实施护理人员急救系统以来，因心室颤动导致的院外心脏骤停的年生存率平均为25%，多年来并无显著提高。与其他心律相关的心脏骤停预后较差：当首次记录的心律为心搏停止时，只有1%的患者存活；当初始出现电机械分离时，只有6%的患者存活。对于电机械分离的病例，心律类型和心率似乎均不影响预后。缩短开始心肺复苏和除颤的延迟时间可提高心室颤动的存活率。当244例目击心脏骤停的预后与开始心肺复苏和首次除颤的时间相关时，在开始心肺复苏前，死亡率每分钟增加3%，在首次电击前，死亡率每分钟增加4%。尽量减少延迟的新策略似乎最有希望提高心脏骤停后的存活率。
