The organization of the medical emergency system in Poland has been revised substantially since 2007. Rescuers were able to perform certain life-saving procedures and to administrate some drugs without doctor's order.

The efficiency of advanced life support (ALS) performed by emergency medical service with paramedics (without doctor) was assessed for cases of cardiac arrest (CA) in prehospital conditions. It was correlated with quantity of basic life support (BLS) procedures undertaken by casual witnesses and with the knowledge of automated external defibrillation (AED) in people without medical training.

Forty-eight cases of CA were analyzed, which took place in District Siedlce in the first three quarters of 2009. Data were collected retrospectively, from medical reports. Advanced life support procedures adhering to the guidelines of the European Resuscitation Council were investigated in terms of pharmaco-and electrotherapy. Additionally, the study of the knowledge of AED was conducted through a survey, in which 103 randomly selected persons without medical training took part.

Adrenaline and amiodarone were given by paramedics correctly in 94% of patients. Defibrillation was performed in all patients with documented ventricular fibrillation or pulseless ventricular tachycardia valid values of energy. Cardiopulmonary resuscitation was successful in 33% of the cases. At the scene of the accident BLS was performed before the arrival of ambulance in only 7% of cases. Of the respondents, 41% (non-medic) could use the AED safely, but only 13% of them knew the guidelines for using defibrillators.

Paramedics were properly implementing ALS procedures for prehospital CA. The percent of effective cardiopulmonary resuscitations may improve the early implementation of BLS, including the use of AED. It is necessary to educate people without medical training in this field.