Prescribing an automated external defibrillator for children at increased risk of sudden arrhythmic death

2017 ◽  
Vol 27 (7) ◽  
pp. 1271-1279
Author(s):  
Karen A. McLeod ◽  
Eileen Fern ◽  
Fiona Clements ◽  
Ruth McGowan
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Polymorphic Ventricular Tachycardia ◽  
Automated External Defibrillator ◽  
Automated External Defibrillators ◽  
Arrhythmic Death ◽  
Shockable Rhythm ◽  
Increased Risk ◽  
External Defibrillator

AbstractBackgroundAutomated external defibrillators can be life-saving in out-of-hospital cardiac arrest.ObjectiveOur aim was to review our experience of prescribing automated external defibrillators for children at increased risk of sudden arrhythmic death.MethodsWe reviewed all automated external defibrillators issued by the Scottish Paediatric Cardiac Electrophysiology Service from 2005 to 2015. All parents were given resuscitation training according to the Paediatric Resuscitation Guidelines, including the use of the automated external defibrillator.ResultsA total of 36 automated external defibrillators were issued to 36 families for 44 children (27 male). The mean age at issue was 8.8 years. Diagnoses at issue included long QT syndrome (50%), broad complex tachycardia (14%), hypertrophic cardiomyopathy (11%), and catecholaminergic polymorphic ventricular tachycardia (9%). During the study period, the automated external defibrillator was used in four (9%) children, and in all four the automated external defibrillator correctly discriminated between a shockable rhythm – polymorphic ventricular tachycardia/ventricular fibrillation in three patients with one or more shocks delivered – and non-shockable rhythm – sinus rhythm in one patient. Of the three children, two of them who received one or more shocks for ventricular fibrillation/polymorphic ventricular tachycardia survived, but one died as a result of recurrent torsades de pointes. There were no other deaths.ConclusionParents can be taught to recognise cardiac arrest, apply resuscitation skills, and use an automated external defibrillator. Prescribing an automated external defibrillator should be considered for children at increased risk of sudden arrhythmic death, especially where the risk/benefit ratio of an implantable defibrillator is unclear or delay to defibrillator implantation is deemed necessary.

Abstract 183: Public-Access Automated External Defibrillator Pad Application and Favorable Neurological Outcome After Out-of-Hospital Cardiac Arrest in Public Locations; A Prospective Population-Based Propensity-Score Matched Study

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Takefumi Kishimori ◽  
Takeyuki Kiguchi ◽  
Kosuke Kiyohara ◽  
Tasuku Matsuyama ◽  
Haruka Shida ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Neurological Outcome ◽  
Public Access ◽  
Automated External Defibrillator ◽  
Shockable Rhythm ◽  
Favorable Neurological Outcome ◽  
Hospital Cardiac Arrest ◽  
External Defibrillator

Background: Randomized control trials or observational studies showed that the use of public-access automated external defibrillator (AED) was effective for patients with out-of-hospital cardiac arrest (OHCA). However, it is unclear whether public-access AED use is effective for all patients with OHCA irrespective of first documented rhythm. We aimed to evaluate the effect of public-access AED use for OHCA patients considering first documented rhythm (shockable or non-shockable) in public locations. Methods: From the Utstein-style registry in Osaka City, Japan, we obtained information on adult patients with OHCA of medical origin in public locations before emergency-medical-service personnel arrival between 2011 and 2015. The primary outcome was one-month survival with favorable neurological outcome. Multivariable logistic regression analysis was used to assess the association between the public-access AED pad application and favorable neurological outcome after OHCA by using one-to-one propensity score matching analysis. Results: Among 1743 eligible patients, a total of 336 (19.3%) victims received public-access AED pad application. The proportion of patients who survived one-month with favorable neurological outcome was significantly higher in the pad application group than in the non-pad application group (29.8% vs. 9.7%; adjusted odds ratio [AOR], 2.85; 95% confidence interval [CI], 1.73-4.68, AOR after propensity score matching, 2.83; 95% CI, 1.40-5.72). In a subgroup analysis, the AOR of patients with shockable or non-shockable rhythms was 3.36 (95% CI, 1.78-6.35) and 2.38 (95% CI, 0.89-6.34), respectively. Conclusions: Public-access AED pad application was associated with better outcome among OHCA patients with shockable rhythm and the trend was the same among those with non-shockable rhythm.

A Poor Association Between Out-of-Hospital Cardiac Arrest Location and Public Automated External Defibrillator Placement

2013 ◽  
Vol 28 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Matthew J. Levy ◽  
Kevin G. Seaman ◽  
Michael G. Millin ◽  
Richard A. Bissell ◽  
J. Lee Jenkins
Keyword(s):  
Cardiac Arrest ◽  
Assisted Living ◽  
Assisted Living Facilities ◽  
Automated External Defibrillator ◽  
Nursing Facilities ◽  
Publication Type ◽  
Skilled Nursing ◽  
Automated External Defibrillators ◽  
Hospital Cardiac Arrest ◽  
External Defibrillator

AbstractIntroductionMuch attention has been given to the strategic placement of automated external defibrillators (AEDs). The purpose of this study was to examine the correlation of strategically placed AEDs and the actual location of cardiac arrests.MethodsA retrospective review of data maintained by the Maryland Institute for Emergency Medical Services Systems (MIEMSS), specifically, the Maryland Cardiac Arrest Database and the Maryland AED Registry, was conducted. Location types for AEDs were compared with the locations of out-of-hospital cardiac arrests in Howard County, Maryland. The respective locations were compared using scatter diagrams and r2 statistics.ResultsThe r2 statistics for AED location compared with witnessed cardiac arrest and total cardiac arrests were 0.054 and 0.051 respectively, indicating a weak relationship between the two variables in each case. No AEDs were registered in the three most frequently occurring locations for cardiac arrests (private homes, skilled nursing facilities, assisted living facilities) and no cardiac arrests occurred at the locations where AEDs were most commonly placed (community pools, nongovernment public buildings, schools/educational facilities).ConclusionA poor association exists between the location of cardiac arrests and the location of AEDs.LevyMJ, SeamanKG, MillinMG, BissellRA, JenkinsJL. A poor association between out-of-hospital cardiac arrest location and public automated external defibrillator placement. Prehosp Disaster Med. 2013;28(4):1-6.

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.

Mismatches Between the Number of Installed Automated External Defibrillators and the Annual Rate of Automated External Defibrillator Use Among Places

2021 ◽  
pp. 1-6
Author(s):  
Je Hyeok Oh ◽  
Gyu Chong Cho ◽  
Seung Mok Ryoo ◽  
So Hyun Han ◽  
Seon Hee Woo ◽  
...  
Keyword(s):  
South Korea ◽  
Medical Center ◽  
Annual Rate ◽  
Current Status ◽  
Automated External Defibrillator ◽  
Automated External Defibrillators ◽  
The Law ◽  
National Emergency ◽  
Apartment Complexes ◽  
External Defibrillator

Abstract Aim: In South Korea, the law concerning automated external defibrillators (AEDs) states that they should be installed in specific places including apartment complexes. This study was conducted to investigate the current status and effectiveness of installation and usage of AEDs in South Korea. Methods: Installation and usage of AEDs in South Korea is registered in the National Emergency Medical Center (NEMC) database. Compared were the installed number, usage, and annual rate of AED use according to places of installation. All data were obtained from the NEMC database. Results: After excluding AEDs installed in ambulances or fire engines (n = 2,003), 36,498 AEDs were registered in South Korea from 1998 through 2018. A higher number of AEDs were installed in places required by the law compared with those not required by the law (20,678 [56.7%] vs. 15,820 [43.3%]; P <.001). Among them, 11,318 (31.0%) AEDs were installed in apartment complexes. The overall annual rate of AED use was 0.38% (95% CI, 0.33-0.44). The annual rate of AED use was significantly higher in places not required by the law (0.62% [95% CI, 0.52-0.72] versus 0.21% [95% CI, 0.16-0.25]; P <.001). The annual rate of AED use in apartment complexes was 0.13% (95% CI, 0.08-0.17). Conclusion: There were significant mismatches between the number of installed AEDs and the annual rate of AED use among places. To optimize the benefit of AEDs in South Korea, changes in the policy for selecting AED placement are needed.

scholarly journals Impact of Onsite or Dispatched Automated External Defibrillator Use on Survival After Out-of-Hospital Cardiac Arrest

Circulation ◽  
2011 ◽  
Vol 124 (20) ◽  
pp. 2225-2232 ◽  
Author(s):  
Jocelyn Berdowski ◽  
Marieke T. Blom ◽  
Abdennasser Bardai ◽  
Hanno L. Tan ◽  
Jan G.P. Tijssen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Automated External Defibrillator ◽  
Hospital Cardiac Arrest ◽  
External Defibrillator

Automated External Defibrillator Arrhythmia Detection in a Model of Cardiac Arrest due to Commotio Cordis

2003 ◽  
Vol 14 (1) ◽  
pp. 83-87 ◽  
Author(s):  
MARK S. LINK ◽  
BARRY J. MARON ◽  
RONALD E. STICKNEY ◽  
BRIAN A. VANDERBRINK ◽  
WEI ZHU ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Automated External Defibrillator ◽  
Arrhythmia Detection ◽  
Commotio Cordis ◽  
External Defibrillator

Abstract 01: Dispatching Lay Rescuers Through a Smartphone Application is Associated With Increased Bystander Defibrillation in Out-of-Hospital Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Linn Andelius ◽  
Carolina Malta Hansen ◽  
Freddy Lippert ◽  
Lena Karlsson ◽  
Christian Torp-Pedersen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Smartphone Application ◽  
Automated External Defibrillator ◽  
Early Defibrillation ◽  
Emergency Medical Dispatch ◽  
Capital Region ◽  
Electronic Survey ◽  
Emergency Medical ◽  
Hospital Cardiac Arrest ◽  
External Defibrillator

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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