Bystander/first responder CPR: ten years experience in a paramedic system.

The effectiveness of bystander CPR recently has been challenged. We undertook a ten-year retrospective review of our prehospital experience with witnessed cardiorespiratory arrest to ascertain save rates in patients receiving and not receiving CPR before paramedic advanced life support (ALS). Traumatic and poisoning arrests and children less than 18 years old were excluded.

The effectiveness of calcium chloride in refractory electromechanical dissociation.

The effectiveness of calcium in electromechanical dissociation (EMD) has been challenged. Retrospective studies have been contradictory. To determine its effectiveness a prospective, randomized, blinded study comparing calcium chloride and saline in refractory EMD was carried out in the pre-hospital setting from October 1982 to October 1983.

Lack of effectiveness of calcium chloride in refractory asystole.

The effectiveness of calcium chloride in asystole has been challenged; retrospective studies have not supported its use. We conducted a prospective, randomized, blinded study comparing the effectiveness of calcium chloride with saline in the prehospital paramedic setting. Seventy-three patients who had received epinephrine, bicarbonate, and atropine and were in refractory asystole were included in the study, which was conducted from October 1982 to October 1983.

Atropine in asystole: human studies.

Current research supporting the use of atropine for asystole is limited. Reported in the literature are the cases of 26 patients who presented with a rhythm of asystole. Of these, only eight were clearly in refractory asystole after epinephrine and sodium bicarbonate, only seven were prehospital patients, and only two were delineated as being intubated.