Cardiac arrest outcomes at the Melbourne Cricket Ground and Shrine of Remembrance using a tiered response strategy-a forerunner to public access defibrillation[1]
Summary
Outcome series of 28 consecutive cardiac arrests December 1989 - December 1997 at the Melbourne Cricket Ground and Shrine of Remembrance (including three at ANZAC Day parades), managed by St John Ambulance Australia volunteers under a tiered response strategy — a forerunner of public-access defibrillation. Arrest incidence at the MCG was 1 per 500,000 attendances. All arrests presented in ventricular fibrillation; 26 of 28 patients (93%) were defibrillated within 5 minutes of documented collapse. 24 patients (86%) left the venue alive and 20 (71%) were discharged home from hospital.
So what
The best-case benchmark for venue resuscitation: 71% survival to discharge — several-fold better than contemporaneous community OHCA — achieved by volunteers, because the venue system delivered defibrillation inside 5 minutes to a 100% VF cohort. It converts the "AEDs at venues" argument from plausible to demonstrated, gives a citable arrest-incidence denominator (1:500,000 attendances), and is the historical bridge from staffed tiered response to the public-access defibrillation trials (Hallstrom). Design lesson: survival is a property of the response geometry, not the responder's profession.
Key findings
- 28 consecutive venue arrests 1989-1997; incidence 1 per 500,000 attendances at the MCG
- 100% presented in VF; 93% defibrillated within 5 minutes of collapse
- 86% left the venue alive; 71% survival to hospital discharge
- Volunteer-delivered tiered response; explicit forerunner of public-access defibrillation
Read the paper
- Publisher (DOI) ↗may be paywalled
- PubMed ↗abstract · free