Public-access automated external defibrillators and defibrillation for out-of-hospital cardiac arrest

2016 ◽  
Vol 34 (10) ◽  
pp. 2041-2042 ◽  
Author(s):  
Shinji Nakahara ◽  
Ayako Taniguchi ◽  
Tetsuya Sakamoto
Keyword(s):  
Cardiac Arrest ◽  
Public Access ◽  
Automated External Defibrillators ◽  
Hospital Cardiac Arrest

Abstract 150: AED Transportation System With Smartphone Application Cooperating With Dispatch Center

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Takeyuki Kiguchi ◽  
Tomonari Shimamoto ◽  
Yosuke Homma ◽  
Chika Nishiyama ◽  
Takashi Kawamura ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Case Series ◽  
Smartphone Application ◽  
Transportation System ◽  
Public Access ◽  
Automated External Defibrillators ◽  
Shortest Route ◽  
System Activation ◽  
Research Period ◽  
Hospital Cardiac Arrest

Background: Although public access automated external defibrillators (AEDs) have been widely installed in Japan, defibrillation by public access AEDs was still rare. Methods: Study design: Case series. We developed an AED transportation system with smartphone application cooperating with dispatch center. When a cardiac arrest occurs and lay-person call the emergency service, the dispatcher share information of out-of-hospital cardiac arrest OHCA locations and near-by AEDs via the application with pre-registered volunteers near the victim. This application presents the shortest route to the OHCA scene via nearby AED, and the volunteers bring AED to the OHCA scene. The purpose of this study is to use this system in real settings and to make the task of the system clear. We conducted the experimental study in Owariasahi city, Aichi and Kashiwa city, Chiba. Research period were from January 2017 to March 2019 in Owariasahi city, and from December 2018 to March 2019 in Kashiwa city. We collected the number of registered volunteers, the timeline data of system activation, and the number of responses to occurrence of OHCA by registered volunteers during the study period. Results: In Owariasahi city, total of 304 volunteers were registered. 276 suspected OHCAs occurred, 179 cases were eligible excluding the hazardous cases in the scene, and of which 169 cases actually activated the system by the dispatcher. The average time from call to send notification was 3:11 (minutes and seconds) and from call to emergency medical service (EMS) arrival 6:37 (minutes and seconds). The registered volunteer took actions in 94/169 cases (55.6%), transported AEDs in 6 cases, and arrived on the scene in 10 cases. A registered volunteer arrived on the scene earlier than EMS personnel in one case. In Kashiwa city, total of 636 volunteers were registered, and the system was activated in 17 suspected OHCA cases. In one case, a volunteer arrived earlier than EMS and attempted resuscitation. Conclusions: This AED transportation system worked well and safe on the actual emergency scene. By increasing the number of registered volunteers, it is expected to increase the number of AED use.

scholarly journals Use of Public Automated External Defibrillators in Out-of-Hospital Cardiac Arrest in Poland

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 298
Author(s):  
Przemysław Żuratyński ◽  
Daniel Ślęzak ◽  
Sebastian Dąbrowski ◽  
Kamil Krzyżanowski ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Public Space ◽  
Public Awareness ◽  
Fire Service ◽  
Public Access ◽  
Automated External Defibrillator ◽  
Public Place ◽  
Automated External Defibrillators ◽  
Hospital Cardiac Arrest ◽  
External Defibrillator

Background and objectives: National medical records indicate that approximately 350,000–700,000 people die each year from sudden cardiac arrest. The guidelines of the European Resuscitation Council (ERC) and the International Liaison Committee on Resuscitation (ILCOR) indicate that in addition to resuscitation, it is important—in the case of so-called defibrillation rhythms—to perform defibrillation as quickly as possible. The aim of this study was to assess the use of public automated external defibrillators in out of hospital cardiac arrest in Poland between 2008 and 2018. Materials and Methods: One hundred and twenty cases of use of an automated external defibrillator placed in a public space between 2008 and 2018 were analyzed. The study material consisted of data on cases of use of an automated external defibrillator in adults (over 18 years of age). Only cases of automated external defibrillators (AED) use in a public place other than a medical facility were analysed, additionally excluding emergency services, i.e., the State Fire Service and the Volunteer Fire Service, which have an AED as part of their emergency equipment. The survey questionnaire was sent electronically to 1165 sites with AEDs and AED manufacturers. A total of 298 relevant feedback responses were received. Results: The analysis yielded data on 120 cases of AED use in a public place. Conclusions: Since 2016, there has been a noticeable increase in the frequency of use of AEDs located in public spaces. This is most likely related to the spread of public access to defibrillation and increased public awareness.

scholarly journals Outcomes of Out‐of‐Hospital Cardiac Arrest by Public Location in the Public‐Access Defibrillation Era

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Yukiko Murakami ◽  
Taku Iwami ◽  
Tetsuhisa Kitamura ◽  
Chika Nishiyama ◽  
Tatsuya Nishiuchi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Public Access ◽  
The Public ◽  
Public Access Defibrillation ◽  
Hospital Cardiac Arrest

Abstract 25: Cost-Effectiveness of Public Automated External Defibrillators

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Lars W Andersen ◽  
Mathias J Holmberg ◽  
Asger Granfeldt ◽  
Lyndon P James ◽  
Lisa Caulley
Keyword(s):  
Public Health ◽  
Cardiac Arrest ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Cost Effective ◽  
Incremental Cost Effectiveness Ratio ◽  
Cost Effectiveness Ratio ◽  
Automated External Defibrillators ◽  
The Us ◽  
Hospital Cardiac Arrest

Introduction: Despite a consistent association with improved outcomes, automated external defibrillators (AEDs) are used in only approximately 10% of public out-of-hospital cardiac arrest. One of the barriers towards increased use might be cost. The objective of this study was to provide a contemporary cost-effectiveness analysis on the use of public AEDs in the United States (US) to inform guidelines and public health initiatives. Methods: We compared the cost-effectiveness of public AEDs to no AEDs for out-of-hospital cardiac arrest in the US over a life-time horizon. The analysis assumed a societal perspective and results are presented as costs (in 2017 US dollars) per quality-adjusted life year (QALY). Model inputs were based on reviews of the literature. For the base case, we modelled an annual cardiac arrest incidence per AED of 20%. It was assumed that AED use was associated with a 52% relative increase in survival to hospital discharge with a favorable neurological outcome in those with a shockable rhythm. A probabilistic sensitivity analysis was conducted to account for joint parameter uncertainty. Consistent with recent guidelines from the American Heart Association, we used a willingness-to-pay threshold of $150,000 per QALY gained. Results: The no AED strategy resulted in 1.63 QALYs at a cost of $42,757. The AED strategy yielded an additional 0.26 QALYs for an incremental increase in cost of $13,793 per individual. The AED strategy yielded an incremental cost-effectiveness ratio of $53,797 per QALY gained. The yearly incidence of cardiac arrests occurring in the presence of an AED had minimal effect on the incremental cost-effectiveness ratio except at very low incidences. At an incidence of 1%, the incremental cost-effectiveness ratio was $101,040 per QALY gained. In sensitivity analyses across a plausible range of health-care and societal estimates, the AED strategy remained cost-effective. In the probabilistic sensitivity analysis, the AED strategy was cost-effective in 43%, 85%, and 91% of the scenarios at a threshold of $50,000, $100,000, and $150,000 per QALY gained, respectively. Conclusion: Public AEDs are a cost-effective public health intervention in the US. These findings support widespread dissemination of public AEDs.

Abstract 18: Analyzing Heart Rhythm During Chest Compressions in Out-of-Hospital Cardiac Arrest Patients Using New Algorithm for Automated External Defibrillators

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Corina de Graaf ◽  
Stefanie G Beesems ◽  
Ronald E Stickney ◽  
Paula Lank ◽  
Fred W Chapman ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Negative Impact ◽  
Pulseless Electrical Activity ◽  
Heart Rhythm ◽  
Chest Compressions ◽  
Study Region ◽  
Automated External Defibrillators ◽  
Conventional Analysis ◽  
Hospital Cardiac Arrest ◽  
Conventional Algorithm

Purpose: Automated external defibrillators (AED) prompt the rescuer to stop cardiopulmonary resuscitation (CPR) for ECG analysis. Any interruption of CPR has a negative impact on outcome. We prospectively evaluated a new algorithm (cprINSIGHT) which can analyse the ECG while rescuers continue CPR. Methods: We analysed data from patients with attempted resuscitation from OHCA who were connected to an AED with cprINSIGHT (Stryker Physio-Control LIFEPAK CR2) between June 2017 and June 2018 in the Amsterdam Resuscitation Study region. The first analysis in the CR2 is a conventional analysis; subsequent analyses use the cprINSIGHT algorithm. This algorithm classifies the rhythm as shockable (S), non-shockable (NS), or no decision. If no decision, the AED prompts for a pause in CPR and uses its conventional algorithm. The characteristics of the first 3 cprINSIGHT analyses (analyses 2-4) were analysed. Ventricular fibrillation (VF) cases were both coarse and fine VF with a lower threshold of 0.08 mV. Results: Data from 132 consecutive OHCA cases were analysed. The initial recorded rhythm was VF or pulseless ventricular tachycardia (VT) in 35 cases (27%), pulseless electrical activity in 34 cases (25%) and asystole in 63 cases (48%). In 114 cases (86%), 1 or more cprINSIGHT analyses were done. Analyses 2-4 covered 90% of all cprINSIGHT analyses. The analyzed rhythm was VF/VT in 12-17%, organised QRS rhythm in 29-35% and asystole in 51-56% (see table). cprINSIGHT reached a S or NS decision in 65-74% of cases, with a sensitivity of 90-100% and a specificity of 100%. When it reached no decision, the rhythm was asystole in 65-79% of analyses, VF/VT in 0-9% and QRS rhythm in 18-27%; conventional analysis followed. Chest compression fraction was 85-88%, CPR fraction was 99%. Conclusion: This new algorithm analysed the ECG without need for a pause in chest compressions 65-74% of the time and had 90-100% sensitivity and 100% specificity when it made a shock or a no shock decision.

Sign in / Sign up

Export Citation Format

Share Document