Electrocardiography in out-of-hospital cardiopulmonary arrest was recorded at the emergency scene from 1993 to 1999 in Nagaoka City, which encompasses 320km2 with a population of 202000. Of 871 consecutive cardiopulmonary arrests, electrocardiography was recorded in 797 cases (91.5%) at the emergency scene; 599 cases were classified as intrinsic disorder and the remainder extrinsic disorder. Electrocardiography in the intrinsic disorder showed ventricular fibrillation in 57 (9.5%), electromechanical dissociation in 124 (20.7%), and cardiac standstill in 418 (69.8%). The extrinsic disorder group showed ventricular fibrillation in 3 (1.5%), electromechanical dissociation in 45 (22.7%), and cardiac standstill in 150 (75.8%). Cardiopulmonary resuscitation was initiated by a bystander in 16.4% of intrinsic disorders and 22.2% of extrinsic disoreder. Ventricular fibrillation was therefore relatively rare in the overall population of out-of-hospital cardiopulmonary arrests in Japan. To save more of those undergoing out-of-hospital cardiopulmonary arrest, resuscitation using drugs by emergency life-saving technicians may be necessary at the emergency scene.
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