Killien S Y, Geyman J P, Gossom J B, Gimlett D
Department of Family Medicine, University of Washington, Seattle, USA.
Ann Emerg Med. 1996 Sep;28(3):294-300. doi: 10.1016/s0196-0644(96)70028-8.
To evaluate the effectiveness of the emergency medical services (EMS) system in a rural island community in resuscitating victims of out-of-hospital cardiac arrest over the past 16 years.
We conducted a retrospective analysis of all EMS responses to cardiac arrests on San Juan Island, a rural island community of 5,000 people in the Pacific Northwest. Data were collected between January 1977 and July 1994 on the basis of the Utstein criteria. From these data, we calculated survival rates and compared them with published data from other rural and nonrural areas in the United States.
During this study, 22% of all the patients who sustained a cardiac arrest of cardiac origin on the island survived to hospital discharge. The survival rate for witnessed cases of ventricular fibrillation and ventricular tachycardia was 43%.
The combined paramedic/emergency medical technician system used on San Juan Island has yielded survival rates comparable to those of urban areas. This system may serve as a model for other rural communities, especially those with well-defined geographic areas and established 911 central dispatching.
评估过去16年中农村岛屿社区的紧急医疗服务（EMS）系统对院外心脏骤停患者进行复苏的有效性。
我们对太平洋西北部一个拥有5000人的农村岛屿社区圣胡安岛上所有EMS对心脏骤停的响应进行了回顾性分析。根据乌斯坦标准，在1977年1月至1994年7月期间收集数据。从这些数据中，我们计算了生存率，并将其与美国其他农村和非农村地区公布的数据进行比较。
在本研究期间，岛上所有心源心脏骤停患者中有22%存活至出院。目击心室颤动和室性心动过速病例的生存率为43%。
圣胡安岛使用的护理人员/急救医疗技术员联合系统产生的生存率与城市地区相当。该系统可作为其他农村社区的典范，尤其是那些地理区域明确且设有911中央调度的社区。
