scholarly journals Identifying and overcoming barriers to automated external defibrillator use by GoodSAM volunteer first responders in out-of-hospital cardiac arrest using the Theoretical Domains Framework and Behaviour Change Wheel: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034908
Author(s):  
Christopher M Smith ◽  
Frances Griffiths ◽  
Rachael T Fothergill ◽  
Ivo Vlaev ◽  
Gavin D Perkins
Keyword(s):  
Cardiac Arrest ◽  
Behaviour Change ◽  
Clinical Importance ◽  
Theoretical Domains Framework ◽  
First Responders ◽  
Public Access ◽  
Automated External Defibrillator ◽  
Telephone Interviews ◽  
Behaviour Change Wheel ◽  
External Defibrillator

ObjectivesGoodSAM is a mobile phone app that integrates with UK ambulance services. During a 999 call, if a call handler diagnoses cardiac arrest, nearby volunteer first responders registered with the app are alerted. They can give cardiopulmonary resuscitation (CPR) and/or use a public access automated external defibrillator (AED). We aimed to identify means of increasing AED use by GoodSAM first responders.MethodsWe conducted semistructured telephone interviews, using the Theoretical Domains Framework to identify and classify barriers to AED use. We analysed findings using the Capability, Opportunity, Motivation, Behaviour (COM-B) model and subsequently used the Behaviour Change Wheel to develop potential interventions to improve AED use.SettingLondon, UK.ParticipantsGoodSAM first responders alerted in the previous 7 days about a cardiac arrest.ResultsWe conducted 30 telephone interviews in two batches in July and October 2018. A public access AED was taken to scene once, one had already been attached on scene another time and three participants took their own AEDs when responding. Most first responders felt capable and motivated to use public access AEDs but were concerned about delaying CPR if they retrieved one and frustrated when arriving after the ambulance service. They perceived lack of opportunities due to unavailable and inaccessible AEDs, particularly out of hours. We subsequently developed 13 potential interventions to increase AED use for future testing.ConclusionsGoodSAM first responders used AEDs occasionally, despite a capability and motivation to do so. Those operating volunteer first responder systems should consider our proposed interventions to improve AED use. Of particular clinical importance are: highlighting AED location and providing route/time estimates to the patient via the nearest AED. This would help single responders make appropriate decisions about AED retrieval. As AED collection may extend time to reach the patient, where there is sufficient density of potential responders, systems could send one responder to initiate CPR and another to collect an AED.

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.

In-hospital first-responder automated external defibrillation: what critical care practitioners need to know

1998 ◽  
Vol 7 (4) ◽  
pp. 314-319 ◽  
Author(s):  
ME Mancini ◽  
W Kaye
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Basic Life Support ◽  
Life Support ◽  
Survival Rates ◽  
First Responders ◽  
Critical Care Nurses ◽  
Automated External Defibrillator ◽  
Coronary Care ◽  
External Defibrillator

Despite the development and widespread implementation of Basic Life Support and Advanced Cardiac Life Support, the percentage of patients who survive in-hospital cardiac arrest has remained stable at approximately 15%. Although survival rates may approach 90% in coronary care units, survival rates plummet outside of these units. The lower survival rates for cardiac arrest that occur outside of the coronary care unit may relate to the time elapsed between the onset of ventricular fibrillation and first defibrillation. The advent of automated external defibrillators has made it possible to decrease the time elapsed before first defibrillation in non-critical care areas of the hospital. First responders need only recognize that the patient is unresponsive, apneic, and pulseless before attaching and activating the automated external defibrillator. Our research shows that, as part of Basic Life Support training, non-critical care nurses can learn to use the device and can retain the knowledge and skill over time. Establishing an in-hospital automated external defibrillator program requires commitment from administration, physicians, and nursing personnel. Critical care practitioners should be aware of this technology and the literature that supports its safety and effectiveness when used by non-critical care first responders. Critical care nurses are in a unique position to effect changes that will decrease the time between the onset of cardiac arrest and first defibrillation.

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 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
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