CPR and the single rescuer: at what age should you "call first" rather than "call fast"?

Abstract

Study objective: To determine whether the age-related frequency of ventricular fibrillation (VF) in cardiac arrest supports the guideline that single rescuers should "call first" for all victims of sudden collapse older than 8 years.

Design: Analysis of data on all nontraumatic cardiac arrests treated by emergency medical service (EMS) personnel in King County, Washington, between 1976 and 1992.

Measurements: Age, initial cardiac rhythm, witnessed versus unwitnessed status, whether patient was discharged alive.

Results: We analyzed 10,992 cardiac arrests. Initial rhythm was VF in 4,252 (40%) and non-VF in 6,740 (60%). VF frequencies were 3% (0 to 8 years old), 17% (8 to 30 years), and 42% (30 years or older).

Conclusion: Most patients under age 30 were not in VF at the time of EMS evaluation. Our data suggest that a "call fast" strategy may be more effective when a single rescuer is present and the victim is between 8 and 30 years old.