Cardiac resuscitation in the community. Importance of rapid provision and implications for program planning.

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 changes 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.