Flying squad response to out of hospital cardiac arrest — A decade of experience

Paramedics and technicians are equally successful at managing cardiac arrest outside hospital

“…With the passage of time, coarse ventricular fibrillation progressively decreases in amplitude and is associated with a reduction in the probability of successful defibrillation 20. The other electrocardiographic rhythms associated with cardiac arrest—asystole and electromechanical dissociation—are accompanied by dismal outcomes irrespective of treatment given 3 5 7 10 12 18. Furthermore, defibrillation as a treatment will not influence survival in this group 21 22.…”

“…Hospital based teams led by physicians who are able to provide immediate support to ambulance crews is one solution which has been shown to be effective in Edinburgh6 7 and Belfast 36. More radical solutions, such as providing automatic defibrillators at public places for use by lay persons or those with minimal training, still have to obtain widespread acceptance and need to be shown to be safe and efficacious.…”

“…Within Edinburgh and the surrounding area some patients are treated by a hospital based medical team (Medic 1), which operates closely in conjunction with the Scottish Ambulance Service 6 7. These patients were also excluded from analysis.…”

Brief history of Pre-Hospital Emergency Medicine

“…In contrast to many European countries, nationwide physician-based or nurse-based response systems had not been formally developed to meet these needs 17. As a consequence, many of the physician-based flying squads and immediate care schemes formed in the early 1970s continued to operate and new services emerged to fill the ‘therapeutic vacuum’ such as the Edinburgh Royal Infirmary Medic One flying squad in 198018 and the physician-staffed London Helicopter Emergency Medical service in 1990 19. Many of these services have flourished and have developed a worldwide reputation for operational, clinical and academic excellence in pre-hospital care.…”