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ARTICLE |

The Utility of CPR in Elderly Persons-Reply FREE

W. T. Longstreth, Jr, MD; Leonard A. Cobb, MD; Carol E. Fahrenbruch, MSPH; Michael K. Copass, MD
JAMA. 1991;265(7):867-867. doi:10.1001/jama.1991.03460070048028
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In Reply.—  Dr Weston's concern is appropriate. In the review by Greene,1 the derived 75% proportion is inflated due to his misinterpretation of a previous report.2 The 37% incidence in our study is similar to that in previous reports from Seattle (39% and 42%)3,4 and is comparable to the experience that Dr Weston describes.5 The 63% proportion reported by Eisenberg and associates6 from suburban King County described findings in selected patients. More recent data from that emergency medical services system indicate that ventricular fibrillation was present in 37.6% of several thousand consecutive arrests, excluding trauma-related events (Mickey S. Eisenberg, MD, PhD, Richard O. Cummins, MD, and Mary Pat Larsen, MA, written communication, December 1990). Hence, 35% to 40% is a reasonable approximation of the proportion of out-of-hospital arrest victims who have ventricular fibrillation as the first recorded rhythm.The figure will differ depending on the

REFERENCES

Greene HL.  Sudden arrhythmic cardiac death—mechanisms, resuscitation and classification: the Seattle perspective . Am J Cardiol. 1990;;65:4B-12B.
Weaver WD, Cobb LA, Hallstrom AP, et al.  Considerations for improving survival from out-of-hospital cardiac arrest . Ann Emerg Med. 1986;;15:1181-1186.
Weaver WD, Hill D, Fahrenbruch CE, et al.  Use of automatic external defibrillator in the management of out-of-hospital cardiac arrest . N Engl J Med. 1988;;319:661-666.
Weaver WD, Hill DL, Fahrenbruch CE, et al.  Automatic external defibrillators: importance of field testing to evaluate performance . J Am Coll Cardiol. 1987;;10:1259-1264.
Weston CFM, Stephens MR, Organ P.  Resuscitation by ambulance staff . BMJ 1990;;301:928-929.
Eisenberg M, Bergner L, Hallstrom A.  Paramedic programs and out-of-hospital cardiac arrest, I: factors associated with successful resuscitation . Am J Public Health. 1979;;69:30-38.
Murphy DJ, Murray AM, Robinson BE, Campion EW.  Outcomes of cardiopulmonary resuscitation in the elderly . Ann Intern Med. 1989;;111:199-205.
Tresch DD, Thakur RK, Hoffmann RG, Olson D, Brooks HL.  Should the elderly be resuscitated following out-of-hospital cardiac arrest? Am J Med. 1989;;86:145-150.

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Greene HL.  Sudden arrhythmic cardiac death—mechanisms, resuscitation and classification: the Seattle perspective . Am J Cardiol. 1990;;65:4B-12B.
Weaver WD, Cobb LA, Hallstrom AP, et al.  Considerations for improving survival from out-of-hospital cardiac arrest . Ann Emerg Med. 1986;;15:1181-1186.
Weaver WD, Hill D, Fahrenbruch CE, et al.  Use of automatic external defibrillator in the management of out-of-hospital cardiac arrest . N Engl J Med. 1988;;319:661-666.
Weaver WD, Hill DL, Fahrenbruch CE, et al.  Automatic external defibrillators: importance of field testing to evaluate performance . J Am Coll Cardiol. 1987;;10:1259-1264.
Weston CFM, Stephens MR, Organ P.  Resuscitation by ambulance staff . BMJ 1990;;301:928-929.
Eisenberg M, Bergner L, Hallstrom A.  Paramedic programs and out-of-hospital cardiac arrest, I: factors associated with successful resuscitation . Am J Public Health. 1979;;69:30-38.
Murphy DJ, Murray AM, Robinson BE, Campion EW.  Outcomes of cardiopulmonary resuscitation in the elderly . Ann Intern Med. 1989;;111:199-205.
Tresch DD, Thakur RK, Hoffmann RG, Olson D, Brooks HL.  Should the elderly be resuscitated following out-of-hospital cardiac arrest? Am J Med. 1989;;86:145-150.
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