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Shorter ambulance response times would cut heart attack deaths

Effect of reducing ambulance response times on deaths from out of hospital cardiac arrest: cohort study

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Reducing ambulance response times to 5 minutes could almost double the survival rate for cardiac arrests not witnessed by ambulance crews, finds a study in this week's BMJ.

All out of hospital cardiopulmonary arrests due to cardiac disease attended by the Scottish Ambulance Service during May 1991 to March 1998 were analysed to determine the association between ambulance response times and survival from cardiac arrest in the community. Two predictive models were then developed to assess the potential impact on survival of reducing response times.

The team found that ambulance response times are independently associated with defibrillation (administering an electric shock to restore a normal heartbeat) and survival. Currently, ambulances in the United Kingdom are required to respond to 90% of emergency calls within 14 minutes. Our models suggest that increasing this target to 8 minutes would increase survival from 6% to 8%, explain the authors, while responding to 90% of calls within 5 minutes would increase survival to 10-11%.

Reducing response times would inevitably require additional resources, add the authors. However, previous studies suggest that the additional cost would be less if the reduced times were achieved by equipping other first line responders (such as fire fighters and the police) with defibrillators.

Contact:

Stuart Cobbe, Walton Professor of Medical Cardiology, University of Glasgow, Glasgow Royal Infirmary, Scotland.

Tel: 44-0-141-211-4721 or 4722
Email: stuart.cobbe@clinmed.gla.ac.uk

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