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Ambulance paramedics in Sweden prospectively surveyed 38 750 out of
hospital
cardiac arrests from 1990 to 2001. In 16 712 patients who were in
non-shockable
rhythm (that is, not ventricular fibrillation) and in whom
cardiopulmonary
resuscitation was attempted before the paramedics' arrival, overall
survival to one
month was 1% compared with 8% in patients in a shockable rhythm. None of
the
non-shockable group survived if the arrest was at home and not
witnessed, if there
was no bystander cardiopulmonary resuscitation, and if it took more than
12 minutes
for the ambulance to arrive. No patient over 80 survived when the delay
was more
than eight minutes. The authors say their findings provide evidence on
which to
base non-resuscitation protocols, and they note the possible adverse
psychological
impact on families of an! y such lack of action.

Heart 2004;90: 1114-8

Why was this not done here? And now it HAS been done will we implement
it?

Rowley.