Ornato J P, McNeill S E, Craren E J, Nelson N M
Ann Emerg Med. 1984 Dec;13(12):1096-9. doi: 10.1016/s0196-0644(84)80331-5.
First-responding emergency medical technicians (EMTs) trained to defibrillate have been shown to increase survival from prehospital ventricular fibrillation (VF) almost fourfold in Washington's King County. Using Nebraska ambulance rescue run data from 1982 and published information relating ambulance response time to the likelihood that a patient would be in VF, we constructed a model to analyze the difference in expected results for EMT defibrillation among communities of varying population. The model predicts that EMTs in urban Nebraska (mean population 242,000) will use the defibrillator once every six weeks. EMTs in intermediate cities (mean population 22,300) will defibrillate once a year. In rural Nebraska (mean population 1,500), the defibrillator will be used once every 5.6 years. Despite these figures, the model predicts relatively low cost per life saved (ranging from $566 in urban areas to $4,785 in rural Nebraska). The major problem with EMT defibrillation in rural areas is maintenance of skills and continuing education.
在华盛顿州金县，接受过除颤培训的急救医疗技术员（EMT）已被证明能将院外心室颤动（VF）患者的存活率提高近四倍。利用内布拉斯加州1982年救护车救援运行数据以及已发表的有关救护车响应时间与患者发生VF可能性的信息，我们构建了一个模型，以分析不同人口规模社区中EMT除颤预期结果的差异。该模型预测，内布拉斯加州城市地区（平均人口24.2万）的EMT每六周使用一次除颤器。中等城市（平均人口2.23万）的EMT每年除颤一次。在内布拉斯加州农村地区（平均人口1500），除颤器每5.6年使用一次。尽管有这些数据，但该模型预测每挽救一条生命的成本相对较低（从城市地区的566美元到内布拉斯加州农村地区的4785美元不等）。农村地区EMT除颤的主要问题是技能维护和继续教育。
