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Q J Med 2000; 93: 191-195
© 2000 Association of Physicians


Commentary

Cheating sudden death: how to do it, and what life's like after it

N.R. GRUBB and P. BLOOMFIELD

From the Department of Cardiology, Royal Infirmary of Edinburgh, Edinburgh, UK


    Introduction
 
Before the development of portable external defibrillators and the adoption of this technology by the emergency medical services, survival from out-of-hospital cardiac arrest was a very rare occurrence. Although CPR could be administered by ambulance crews, the delays involved in moving the victim to hospital prior to defibrillation were too great to allow many to survive. The first major advance in prehospital care occurred when Frank Pantridge addressed possible ways of reducing the high mortality rate associated with myocardial infarction. He recognized that most individuals who died did so within an hour of the onset of symptoms. Despite opposition from colleagues and the authorities, he and his resident, John Geddes, implemented the world's first mobile coronary care unit (MCCU) in Belfast in 1966. During the first 15 months of operation, the MCCU attended 10 patients who had ventricular fibrillation outside hospital, and all were successfully defibrillated.1 Soon after, MCCUs were . . . [Full Text of this Article]


    Reducing mortality
 
Educating the public

    Basic life support
 

    Rapid defibrillation, emergency services infrastructure
 

    Morbidity—the hidden cost
 

    Summary
 

    Notes
 

    References
 

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