Do we know enough to introduce semi-automatic defibrillation by ambulancemen in Belgium?

Abstract

The application of semi-automatic external defibrillators by ambulancemen or emergency medical technicians is in the U.S.A. accepted as a substantial progress in the treatment of out-of-hospital sudden death. A retrospective estimation of the percentage of patients registered by the Belgian Cardio-Pulmonary-Cerebral-Resuscitation study group between 1983 and 1987 that could benefit from early defibrillation yielded a gain in good survival of 1% for the whole population. In 1991 a prehospital semi automatic external defibrillation program was started as a feasibility study in several two-tiered emergency physician staffed systems with an ongoing registry of cardiac arrest events. For Bruges and Ghent there was a non-significant increase in prolonged survival in the ventricular fibrillation subgroups with respectively 4.7% and 5.1% since the introduction of the semi-automatic external defibrillators. Apparent differences between our emergency medical systems and e.g. Seattle, such as the number of 1st tier units covering the population and a short delay between 1st and 2nd tier might account for a lack of a statistically significant improvement so far.