Seven years' experience with XXXX by police and paramedics in an emergency medical services system.

@entity1 @entity8658 @entity2655 @entity1425 @entity16 @entity2224 @entity1167
PRIMARY OBJECTIVE: To assess the outcome of @entity1 with out-of-hospital @entity1167 with @entity2224 as the presenting rhythm in an emergency medical services system utilizing a combined police/paramedic response to provide @entity8658 . MATERIALS AND METHODS: Police and paramedics were dispatched from law enforcement and ambulance communications centers, respectively. First-arriving personnel delivered initial shocks, all using automated external defibrillators. @entity1 were classified according to response to initial shocks: restoration of pulses with shocks only or in need of advanced life support, including @entity1425 . Discharge survival was defined as return to home without disabling @entity16 . RESULTS: Over the 7-year period of study 131 @entity1 presented with @entity2224 : 58 were first treated by police and 73 by paramedics. Restoration of pulses with shocks only and discharge survival were not different in police and paramedic groups, with overall survival of 40% (53 of 131 @entity1 ). Among the survivors, 19% (18/95 @entity1 ) obtained a spontaneous circulation only after administration of @entity1425 and other @entity2655 interventions. CONCLUSION: Both restoration of a functional circulation, without need for advanced life support interventions, and discharge survival without @entity16 are very dependent upon the rapidity with which defibrillation is accomplished, regardless of who delivers the shocks. In addition, a smaller but significant number of @entity1 who require @entity2655 interventions, including @entity1425 , for restoration of a spontaneous circulation survive to discharge. Short time differences, on the order of 1 min, are significant determinants of both immediate response to shocks and discharge survival.
