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AUTOMATIC DEFIBRILLATION BY EMERGENCY MEDICAL TECHNICIAN

由紧急医疗技术人员自动除颤

基本信息

批准号：
3442431
负责人：
RICHARD CUMMINS
金额：
$ 7.21万
依托单位：
KING COUNTY REHABILITATIVE SERVICES DEPT
依托单位国家：
美国
项目类别：
财政年份：
1984
资助国家：
美国
起止时间：
1984-09-30 至 1986-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/3442431
关键词：
allied health personnel electric countershock heart resuscitation emergency care health care personnel performance health care service evaluation hospital utilization human subject

项目摘要

Hypothesis: this project will test the hypothesis that automatic external defibrillators (AEDs) used by emergency medical technicians (EMTs) to treat out-of-hospital cardiac arrest, can achieve outcomes (rhythm conversion, admission to hospital, and overall survival rates) comparable to manual defibrillators used by EMTs. Rationale: the most important intervention to resuscitate some of the more than 400,000 people who die annually from sudden cardiac death is early defibrillation. In Emergency Medical Systems where EMTs provide only basic life support, or where paramedic response times are long, a program of early defibrillation by EMTs, produces a large improvement in survival rates. Manual defibrillation by EMTs, however, requires expensive and time-consuming training, special enabling legislation in most states, and acceptance by medical authorities of advanced medical decisions and actions by non-professionals. The full potential of this approach has not been realized. Recently developed AEDs may overcome many barriers to the wide diffusion of defibrillation by EMTs: training and supervision is easier, less expensive, less time-consuming; increased acceptance by medical and EMS authorities. It must first be proven, however, that AEDs, when used by EMTs perform as well as manual defibrillators. Design: a total of 36 EMT units in King County, Washington will participate in a crossover, prospective, randomized, controlled study. 18 units will use AEDs to assess the rhythm in cardiac arrest patients, and to deliver electric countershocks to patients in ventricular fibrillation. 18 other units will use the standard manual defibrillators that require EMT-identification of the rhythm and an EMT-decision to deliver a countershock. After 75 days the 36 units will crossover to the other type of defibrillator. This design eliminates operator variables as each device will be used by the same operators, and demographic variables, as each device will be used in the same geographic locations. Seven of these 75-day cycles will occur. The allocation of patients to treatment by one device or the other will occur in a random fashion consistent with the random pattern of sudden cardiac death in King County.

假设：本项目将测试自动外部紧急医疗技术人员（EMT）使用的自动除颤器（AED）治疗院外心脏骤停，可以实现结果（节律转换，入院率和总生存率）与手动急救人员使用的呼吸机。理由：复苏一些人的最重要干预措施每年有超过40万人死于心脏性猝死，除颤在急救医疗系统中，EMT仅提供基本的生命支持，或者在护理人员响应时间较长的情况下，一个 EMT的早期除颤， rates. 然而，由EMT进行的手动除颤需要昂贵且耗时的培训，大多数州的特别授权立法，以及医疗机构接受先进的医疗决策和行动非专业人士。这种方法的全部潜力尚未得到充分发挥。实现了最近开发的AED可以克服许多障碍， EMT的除颤扩散：培训和监督更容易，成本更低，耗时更少;医疗和 EMS当局。然而，首先必须证明，当使用AED时，急救人员的表现和人工呼吸器一样好。设计：华盛顿金县共有36个EMT单位，参与一项交叉、前瞻性、随机、对照研究。 18 单位将使用AED来评估心脏骤停患者的心律，给心室颤动的病人提供电击。 18 其他单位将使用标准的手动制冷机， EMT-识别心律和EMT-决定提供反震 75天后，36个单位将交叉到另一种类型除颤器。这种设计消除了操作员变量，因为每个设备将由相同的运营商使用，人口统计变量，因为每个该设备将在相同的地理位置使用。其中七 75-日周期将发生。将患者分配到一个设备或另一个将以与随机发生的心脏性猝死