CPR and the Single Rescuer: At What Age Should You "Call First" Rather Than "Call Fast?", ,

See related editorial, "Is Pediatric Resuscitation Unique? Relative Merits of Early CPR and Ventilation Versus Early Defibrillation for Young Victims of Prehospital Cardiac Arrest" Study objective: To determine whether the age-related frequency of ventricular fibrillation (VF) in cardiac arrest supports the guideline that single rescuers should "call first" for all victims of sudden collapse older than 8 years. Design: Analysis of data on all nontraumatic cardiac arrests treated by emergency medical service (EMS) personnel in King County, Washington, between 1976 and 1992. Measurements: Age, initial cardiac rhythm, witnessed versus unwitnessed status, whether patient was discharged alive. Results: We analyzed 10,992 cardiac arrests. Initial rhythm was VF in 4,252 (40%) and non-VF in 6,740 (60%). VF frequencies were 3% (0 to 8 years old), 17% (8 to 30 years), and 42% (30 years or older). Conclusion: Most patients under age 30 were not in VF at the time of EMS evaluation. Our data suggest that a "call fast" strategy may be more effective when a single rescuer is present and the victim is between 8 and 30 years old. [Appleton GO, Cummins RO, Larson MP, Graves JR: CPR and the single rescuer: At what age should you "call first" rather than "call fast?" Ann Emerg Med April 1995;25:492-494.]