Bystander-Initiated Cardiopulmonary Resuscitation in the Management of Ventricular Fibrillation

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Abstract
The influence of bystander-initiated cardiopulmonary resuscitation the outcome of 316 patients treated for out-of-hospital ventricular fibrillation was studied. Of 109 patients who received bystander-initiated cardiopulmonary resuscitation, 47 (43%) were discharged. Of 207 patients for whom resuscitation was delayed until arrival of fire department personnel, 43 (21%) survived (P < 0.001). Improved survival was due to a reduction in subsequent hospital mortality rather than to a higher rate of initially effective resuscitation. In a separate analysis of 118 patients treated at a single institution after resuscitation, the reduced hospital mortality reflected a decrease in deaths due to shock and to anoxic encephalopathy. Neurologic dysfunction was significantly less common if bystanders had initiated cardiopulmonary resuscitation. Bystander participation in cardiopulmonary resuscitation represents an important adjunct to a rapid-response emergency care system.

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