The Chain of Survival: Focus on Early Defibrillation

  • F. Kette
Conference paper


It is widely known that survival from cardiac arrest is critically time-related. The correctness of the cardio-pulmonary resuscitation maneuvers alone is not sufficient to preserve the full neurological function if too many minutes elapse from the moment of the collapse.


Cardiac Arrest Sudden Cardiac Death Ventricular Fibrillation Automate External Defibrillation Emergency Medical Technician 
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  1. 1.
    Cummins RO, Ornato JP, Thies WH, Pepe PE (1991) Improving survival from sudden cardiac arrest: the “Chain of Survival” concept. Circulation 83: 1832–1847PubMedCrossRefGoogle Scholar
  2. 2.
    Stults KR (1987) Phone first. J Emerg Med Services 12: 28Google Scholar
  3. 3.
    Mayron R, Long RS, Ruiz E (1984) The 911 emergency telephone number: impact on emergency medical system access in a metropolitan area. Am J Emerg Med 2: 491–493PubMedCrossRefGoogle Scholar
  4. 4.
    Graf WS, Polin SS, Pagel BL (1973) A community program for emergency cardiac care: a three-year coronary ambulance-paramedic evaluation. JAMA 226: 156–160PubMedCrossRefGoogle Scholar
  5. 5.
    Cummins RO, Eisenberg MS (1985) Prehospital cardiopulmonary resuscitation: is it effective? JAMA 253: 2408–2412PubMedCrossRefGoogle Scholar
  6. 6.
    Bossaert L, Van Hoeeyweghen R (1989) Cerebral resuscitation study group: bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest. Resuscitation [Suppl]17: S55 - S69Google Scholar
  7. 7.
    Bayes de Luna A, Coumel P, Leclercq JF (1989) Ambulatory sudden cardiac death: mechanisms of production of fatal arrhythmia on the basis of data from 157 cases. Am Heart J 117: 151–159CrossRefGoogle Scholar
  8. 8.
    Weaver WD, Cobb LA, Hallstrom AP et al (1986) Factors influencing survival after out-ofhospital cardiac arrest. J Am Coll Cardiol 7: 752–757PubMedCrossRefGoogle Scholar
  9. 9.
    Hossack KF, Hartwig R (1982) Cardiac arrest associated with supervised cardiac rehabilitation. J Cardiac Rehab 2: 402–408Google Scholar
  10. 10.
    Van Camp SP, Peterson RA (1986) Cardiovascular complications of outpatient cardiac rehabilitation programs. JAMA 256: 1160–1163PubMedCrossRefGoogle Scholar
  11. 11.
    Kette F, Sbrojavacca R, Rellini GL et al (1998) Epidemiology and survival rate of out-of-hospital cardiac arrest in north-east Italy: the FACS Study. Resuscitation 36: 153–159PubMedCrossRefGoogle Scholar
  12. 12.
    Roth R, Stewart RD, Rogers K, Cannon GM (1984) Out-of-hospital cardiac arrest: factors associated with survival. Ann Emerg Med 13: 237–243PubMedCrossRefGoogle Scholar
  13. 13.
    Wright D, James C, Marsden AK, Mackintosh AF (1989) Defibrillation by ambulance staff who have extended training. BMJ 299: 96–97PubMedCrossRefGoogle Scholar
  14. 14.
    Eisenberg MS, Horwood BT, Cummins RO et al (1990) Cardiac arrest and resuscitation: a tale of 29 cities. Ann Emerg Med 19: 179–186PubMedCrossRefGoogle Scholar
  15. 15.
    Eisenberg MS, Hallstrom AP, Copass MK et al (1984) Treatment of ventricular fibrillation: emergency medical technicians defibrillation and paramedic services. JAMA 251: 1723–1726PubMedCrossRefGoogle Scholar
  16. 16.
    Stults KR, Brown DD, Schug VL, Bean JA (1984) Prehospital defibrillation performed by emergency medical technicians in rural communities. N Engl J Med 310: 219–223PubMedCrossRefGoogle Scholar
  17. 17.
    Eisenberg MS, Copass MK, Hallstrom AP (1980) Treatment of out-of-hospital cardiac arrest with rapid defibrillation by emergency medical technicians. N Engl J Med 302: 1379–1383PubMedCrossRefGoogle Scholar
  18. 18.
    Bachman JW, McDonald GS, O’Brien PC (1986) A study of out-of-hospital cardiac arrests in northeastern Minnesota. JAMA 256: 477–483PubMedCrossRefGoogle Scholar
  19. 19.
    Walters G, D’Auria D, Glucksman E (1992) Automated external defibrillation: implications for training qualified ambulance staff. Ann Emerg Med 21: 692–697PubMedCrossRefGoogle Scholar
  20. 20.
    Bardy GH, Gliner BE, Kudenchuk PJ et al (1995) Truncated biphasic pulses for transthoracic defibrillation. Circulation 91: 1768–1774PubMedCrossRefGoogle Scholar
  21. 21.
    Greene HL, Di Marco JP, Kudenchuk PJ et al (1195) Comparison of monophasic and biphasic defibrillating pulse waveform for transthoracic cardioversion. Am J Coll Cardiol 75: 11351139Google Scholar
  22. 22.
    Bardy GH, Marchlinski FE, Sharma AD et al (1996) Multicenter comparison of truncated biphasic shocks and standard damped sine wave monophasic shocks for transthoracic ventricular defibrillation. Circulation 94: 2507–2514PubMedCrossRefGoogle Scholar
  23. 23.
    Jones JL, Jones RE, Balasky G (1987) Microlesion formation in myocardial cells by high intensity electric field stimulation. Am J Physiol 253: H480 - H486PubMedGoogle Scholar
  24. 24.
    Sato Y, Weil MH, Sun S et al (1997) Adverse effects of interrupting precordial compression during cardiopulmonary resuscitation. Crit Care Med 25: 733–736PubMedCrossRefGoogle Scholar

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© Springer-Verlag Italia 2000

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  • F. Kette

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