Kendo Protective Equipment Prevents Quick Access for Resuscitation During Sudden Cardiac Arrest: A Cross-Over Manikin Study

2020 ◽  
Vol 25 (4) ◽  
pp. 197-202
Author(s):  
Shota Tanaka ◽  
Hiroki Ueta ◽  
Ryo Sagisaka ◽  
Shuji Sakanashi ◽  
Takahiro Hara ◽  
...  

Protective equipment in sports can be a barrier to sudden cardiac arrest (SCA) treatment, but no Kendo-related data are available. In order to enhance the SCA survival rate, we aimed to determine whether Kendo protective equipment should be removed before or after an automated external defibrillator (AED) has arrived by measuring the quality and timeframe of cardiopulmonary resuscitation administration. Eighteen collegiate female Kendo players were instructed to treat the patient with SCA under two conditions: (a) equipment removal [ER] condition; (b) no equipment removal [NER] condition. Chest compression initiation was delayed during simulated cardiac arrest situations in Kendo, but the SCA quality was much better without protective equipment. When a layperson is only a nonhealthcare professional female, Kendo protective equipment becomes a barrier for quick access during SCA treatment of Kendo players.

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Karam ◽  
W Bougouin ◽  
V Waldmann ◽  
F Dumas ◽  
D Jost ◽  
...  

Abstract Background Survival rate remains extremely low in sudden cardiac arrest (SCA) and death may occur at all stages of its management. We hypothesized that different medical care providers have different visions of the SCA population characteristics. Purpose To assess SCA characteristics among four groups: all-comers SCA, resuscitated SCA, SCA admitted alive to intensive care unit (ICU), and SCA admitted to cardiology. Methods Data was taken from the Paris Sudden Cardiac Death Expertise Center prospective registry that includes all adults presenting SCA in Paris and suburbs (6.7 millions). We compared SCA characteristics according to the management phase where the population was assessed. Results Of 18,622 out-of-hospital cardiac arrests occurring between 2011 and 2016, 15,207 fulfilled SCA criteria and had known resuscitation status. Among them, 9,721 SCA (63.9%) underwent resuscitation, leading to 3,349 SCA (22.0%) admitted to ICU, then 735 (4.8%) admitted to Cardiology. Mean age was highest in the global population (70.7yrs), and decreased progressively throughout the phases to 57.0yrs in cardiology (P<0.001). Ratio of male victims and rates of witnessed SCA and bystanders' cardiopulmonary resuscitation and automated external defibrillator use increased gradually (all P<0.001). No flow duration decreased by a third (9.1min overall to 3.0min in cardiology, P<0.001). The rate of shockable initial rhythm increased drastically, from 19.5% overall to 26.8% in resuscitated patients, 48.9% in ICU-admitted SCA, and 89.4% in cardiology-admitted (Table). Sudden cardiac arrests characteristics Entire SCA population SCA with attempted resuscitation SCA admitted to ICU SCA admitted to Cardiology P value n=15,207 n=9,721 n=3349 n=735 Age (years ± SD) 70.7±16.9 65.8±16.1 59.7±15.7 57.0±14.5 <0.001 Male sex, n (%) 9,353 (61.6) 6607 (68.0) 2395 (71.5) 599 (81.5) <0.001 Home location, n (%) 12,297 (81.1) 7075 (73.0) 1906 (56.9) 269 (36.6) <0.001 Bystander, n (%) 10,546 (71.2) 7545 (78.7) 3037 (90.7) 715 (97.3) <0.001 Bystander CPR, n (%) 5,684 (39.1) 4504 (47.7) 2120 (63.5) 583 (81.2) <0.001 Public AED use, n (%) 155 (1.0) 142 (1.5) 116 (3.5) 51 (6.9) <0.001 No flow, (min ± SD) 9.1±12.5 7.5±10.4 5.3±6.6 3.0±3.8 <0.001 EMS call-to-arrival delay, (min ± SD) 10.2±5.8 10.1±5.7 10.1±6.1 9.6±6.4 0.068 Initial Shockable rhythm, n (%) 2,643 (19.5) 2529 (26.8) 1635 (48.9) 657 (89.4) <0.001 SCA: sudden cardiac arrest; AED: automated external defibrillator; CPR: cardiopulmonary resuscitation; EMS: emergency medical service; ICU: intensive care unit. Conclusion Characteristics of SCA change considerably according to the assessed population, leading to different views on SCA reality. Keeping in mind the SCA population considered is paramount for a non-biased view of SCA.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Mengqi Gao ◽  
Chenguang Liu ◽  
Dawn Jorgenson

Background: Early defibrillation with an automated external defibrillator (AED) is crucial for improving the survival rate in out-of-hospital resuscitation from sudden cardiac arrest (SCA). Chance of survival decreases by 7% to 10% for every minute that defibrillation is delayed. While simulation studies have been used to assess AED usability factors, our objective was to report the actual operating time for three Philips AED models used in SCA responses. Methods: A convenience dataset recorded by Philips AEDs (HS1, FRx, or FR3) was obtained from Europe and the United States from 2007 - 2018. The HS1 is intended for minimally trained or untrained individuals, the FRx is for Basic Life Support (BLS), and the FR3 is for both BLS and Advanced Life Support (ALS) responders. A retrospective analysis was conducted to report the operating time intervals for cases where a shock was delivered after initial rhythm analysis. The study analyzed 90 HS1, 46 FRx and 32 FR3 cases. Results: Compared with HS1, both FRx (p < 0.001) and FR3 (p = 0.001) responders spent less time in placing pads on the patient after powering on the AED (Figure 1) as expected. Similarly, time intervals from the start of shock advised prompt to first shock delivery for FRx (p = 0.02) and FR3 (p < 0.01) are shorter than for HS1. Time from AED power-on to first shock was within 90 seconds in 74.4% (67 of 90) HS1 cases, 97.8% (45 of 46) FRx cases, and 100% (32 of 32) FR3 cases. On average, the FR3 and FRx responders were able to deliver the first shock within 48 seconds. Conclusions: The analysis shows that responders were able to quickly apply the AEDs and respond to the shock advisory prompt for all three AED models despite different training levels. This real-world performance is better than most reported simulation studies, however, this analysis cannot convey variety of activities that account for the differences in timing (e.g. pads applied before power-on, or compressions began before applying pads, etc.).


Author(s):  
Ming-Fen Tsai ◽  
Li-Hsiang Wang ◽  
Ming-Shyan Lin ◽  
Mei-Yen Chen

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.


2013 ◽  
Vol 48 (2) ◽  
pp. 242-247 ◽  
Author(s):  
Brett G. Toresdahl ◽  
Kimberly G. Harmon ◽  
Jonathan A. Drezner

Context: School-based automated external defibrillator (AED) programs have demonstrated a high survival rate for individuals suffering sudden cardiac arrest (SCA) in US high schools. Objective: To examine the relationship between high schools having an AED on campus and other measures of emergency preparedness for SCA. Design: Cross-sectional study. Setting: United States high schools, December 2006 to September 2009. Patients or Other Participants: Principals, athletic directors, school nurses, and certified athletic trainers represented 3371 high schools. Main Outcome Measure(s): Comprehensive surveys on emergency planning for SCA submitted by high school representatives to the National Registry for AED Use in Sports from December 2006 to September 2009. Schools with and without AEDs were compared to assess other elements of emergency preparedness for SCA. Results: A total of 2784 schools (82.6%) reported having 1 or more AEDs on campus, with an average of 2.8 AEDs per school; 587 schools (17.4%) had no AEDs. Schools with an enrollment of more than 500 students were more likely to have an AED (relative risk [RR] = 1.12, 95% confidence interval [CI] = 1.08, 1.16, P &lt; .01). Suburban schools were more likely to have an AED than were rural (RR = 1.08, 95% CI = 1.04, 1.11, P &lt; .01), urban (RR = 1.13, 95% CI = 1.04, 1.16, P &lt; .01), or inner-city schools (RR = 1.10, 95% CI = 1.04, 1.23, P &lt; .01). Schools with 1 or more AEDs were more likely to ensure access to early defibrillation (RR = 3.45, 95% CI = 2.97, 3.99, P &lt; .01), establish an emergency action plan for SCA (RR = 1.83, 95% CI = 1.67, 2.00, P &lt; .01), review the emergency action plan at least annually (RR = 1.99, 95% CI = 1.58, 2.50, P &lt; .01), consult emergency medical services to develop the emergency action plan (RR = 1.18, 95% CI = 1.05, 1.32, P &lt; .01), and establish a communication system to activate emergency responders (RR = 1.06, 95% CI = 1.01, 1.08, P &lt; .01). Conclusions: High schools with AED programs were more likely to establish a comprehensive emergency response plan for SCA. Implementing school-based AED programs is a key step associated with emergency planning for young athletes with SCA.


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