Longer Retrieval Distances to the Automated External Defibrillator Reduces Survival After Out-of-Hospital Cardiac Arrest

Introduction: Survival after out-of-hospital cardiac arrest (OHCA) is dependent on early defibrillation. To increase bystander defibrillation in OHCAs, a first-responder program dispatching lay rescuers (Heart Runners) through a smartphone application (Heart Runner-app) was implemented in the Capital Region of Denmark. We investigated the proportion of Heart Runners arriving prior to the Emergency Medical Services (EMS) and rates of bystander defibrillation. Methods: The Capital Region of Denmark comprises 1.8 mil. inhabitants and 19,048 Heart Runners were registered. In cases of suspected OHCA, the Heart Runner-app was activated by the Emergency Medical Dispatch Center. Up to 20 Heart Runners < 1.8 km from the OHCA were dispatched to either start cardiopulmonary resuscitation (CPR) or to retrieve and use a publicly accessible automated external defibrillator (AED). Through an electronic survey, Heart Runners reported if they arrived before EMS and if they applied an AED. OHCAs where at least one Heart Runner arrived before EMS were compared with OHCAs where EMS arrived first. All OHCAs from September 2017 to May 2018, where Heart Runners had been dispatched, were included. Results: Of 399 EMS treated OHCAs, 78% (n=313/399) had a matching survey. A Heart Runner arrived before EMS in 47% (n=147/313) of the cases, and applied an AED in 41% (n=61/147) of these cases. Rate of bystander defibrillation was 2.5-fold higher compared to cases where the EMS arrived first (Table 1). Conclusions: By activation of the Heart Runner-app, Heart Runners arrived prior to EMS in nearly half of all the OHCA cases. Bystander defibrillation rate was significantly higher when Heart Runners arrived prior to EMS.

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Changes in automated external defibrillator use and survival after out-of-hospital cardiac arrest in the Nijmegen area

Netherlands Heart Journal ◽

10.1007/s12471-018-1162-9 ◽

2018 ◽

Vol 26 (12) ◽

pp. 600-605 ◽

Cited By ~ 9

Author(s):

J. Nas ◽

J. Thannhauser ◽

J. J. Herrmann ◽

K. van der Wulp ◽

P. M. van Grunsven ◽

...

Keyword(s):

Cardiac Arrest ◽

Automated External Defibrillator ◽

Hospital Cardiac Arrest ◽

External Defibrillator

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What Do Adolescents Learn from a 50 Minute Cardiopulmonary Resuscitation/Automated External Defibrillator Education in a Rural Area: A Pre-Post Design

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16061053 ◽

2019 ◽

Vol 16 (6) ◽

pp. 1053

Author(s):

Ming-Fen Tsai ◽

Li-Hsiang Wang ◽

Ming-Shyan Lin ◽

Mei-Yen Chen

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Education Program ◽

Individual Performance ◽

Automated External Defibrillator ◽

Quasi Experimental ◽

Rescue Time ◽

The Impact ◽

Hospital Cardiac Arrest ◽

External Defibrillator

Background: Literature indicates that patients who receive cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) from bystanders have a greater chance of surviving out-of-hospital cardiac arrest (OHCA). A few evaluative studies involving CPR/AED education programs for rural adolescents have been initiated. This study aimed to examine the impact of a 50 min education program that combined CPR with AED training in two rural campuses. Methods: A quasi-experimental pre-post design was used. The 50 min CPR/AED training and individual performance using a Resusci Anne manikin was implemented with seventh grade students between August and December 2018. Results: A total of 336 participants were included in this study. The findings indicated that the 50 min CPR/AED education program significantly improved participant knowledge of emergency responses (p < 0.001), correct actions at home (p < 0.01) and outside (p < 0.001) during an emergency, and willingness to perform CPR if necessary (p < 0.001). Many participants described that “I felt more confident to perform CPR/AED,” and that “It reduces my anxiety and saves the valuable rescue time.” Conclusions: The brief education program significantly improved the immediate knowledge of cardiac emergency in participants and empowered them to act as first responders when they witnessed someone experiencing a cardiac arrest. Further studies should consider the study design and explore the effectiveness of such brief programs.

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How to use an automated external defibrillator following out-of-hospital cardiac arrest

Nursing Standard ◽

10.7748/ns.2017.e10784 ◽

2017 ◽

Vol 31 (32) ◽

pp. 38-43

Author(s):

Elizabeth Simpson

Keyword(s):

Cardiac Arrest ◽

Automated External Defibrillator ◽

Hospital Cardiac Arrest ◽

External Defibrillator

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Neighborhood characteristics, bystander automated external defibrillator use, and patient outcomes in public out-of-hospital cardiac arrest

Resuscitation ◽

10.1016/j.resuscitation.2018.02.021 ◽

2018 ◽

Vol 126 ◽

pp. 72-79 ◽

Cited By ~ 10

Author(s):

Lars W. Andersen ◽

Mathias J. Holmberg ◽

Asger Granfeldt ◽

Bo Løfgren ◽

Kimberly Vellano ◽

...

Keyword(s):

Cardiac Arrest ◽

Patient Outcomes ◽

Automated External Defibrillator ◽

Neighborhood Characteristics ◽

Hospital Cardiac Arrest ◽

External Defibrillator

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Significance of blood pH value and automated external defibrillator shock in determining the outcomes of out-of-hospital cardiac arrest patients

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907917749480 ◽

2017 ◽

Vol 25 (2) ◽

pp. 73-82

Author(s):

Li-Heng Tsai ◽

Chen-Bin Chen ◽

Peng-Huei Liu ◽

Chung-Hsien Chaou ◽

Chien-Hsiung Huang ◽

...

Keyword(s):

Cardiac Arrest ◽

Troponin I ◽

Chang Gung Memorial Hospital ◽

Time Interval ◽

Automated External Defibrillator ◽

Clinical Practices ◽

Blood Ph ◽

Hospital Cardiac Arrest ◽

Defibrillator Shock ◽

External Defibrillator

Background: The prognosis of out-of-hospital cardiac arrest is generally poor. It is known that the survival of out-of-hospital cardiac arrest patients depends on treatments delivered in a very short time frame. Identifying outcome-associated factors may provide valuable information for decision-making in clinical practices. Aim: The objective of the present study was to assess the associations between various factors (e.g. serum biomarker levels and prehospital factors) and outcomes in adult, non-traumatic out-of-hospital cardiac arrest patients. Methods: Data from 386 consecutive out-of-hospital cardiac arrest patients treated from January 2012 to December 2015 at Taoyuan Chang Gung Memorial Hospital (Taiwan, ROC) were collected. While performing cardiopulmonary resuscitation in the emergency room, the levels of creatinine, aspartate aminotransferase, sodium, potassium, troponin-I, hydrogen bicarbonate and haemoglobin were determined, blood pH and pCO2 were measured and the white blood cell count was calculated. The response time and scene time interval were also recorded. Results: Here we found that out-of-hospital cardiac arrest patients with blood pH values of <7.34 had a lower chance of survival to 24 h (Odds Ratio (OR) = 2.77), survival to discharge (OR = 7.06) and a good neurological outcome (OR = 64.59). Moreover, patients without an automated external defibrillator shock had a lower chance of being discharged (OR = 4.27) and enjoying good neurological outcomes (OR = 25.09). Conclusion: Our data suggest that the blood pH and an automated external defibrillator shockable rhythm are two easily measurable factors strongly associated with the outcomes of out-of-hospital cardiac arrest patients.

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