scholarly journals Public access defibrillation remains out of reach for most victims of out-of-hospital sudden cardiac arrest

Heart ◽  
2014 ◽  
Vol 100 (8) ◽  
pp. 619-623 ◽  
Author(s):  
Charles D Deakin ◽  
Elizabeth Shewry ◽  
Huon H Gray
Keyword(s):  
Cardiac Arrest ◽  
Weak Link ◽  
Public Awareness ◽  
Sudden Cardiac Arrest ◽  
Public Access ◽  
Public Access Defibrillation ◽  
South Central ◽  
Public Areas ◽  
Chain Of Survival ◽  
The Uk

IntroductionPublic access defibrillation (PAD) prior to ambulance arrival is a key determinant of survival from out-of-hospital (OOH) cardiac arrest. Implementation of PAD has been underway in the UK for the past 12 years, and its importance in strengthening the chain of survival has been recognised in the government's recent ‘Cardiovascular Disease Outcomes Strategy’. The extent of use of PAD in OOH cardiac arrests in the UK is unknown. We surveyed all OOH cardiac arrests in Hampshire over a 12-month period to ascertain the availability and effective use of PAD.MethodsA retrospective review of all patients with OOH cardiac arrest attended by South Central Ambulance Service (SCAS) in Hampshire during a 1-year period (1 September 2011 to 31 August 2012) was undertaken. Emergency calls were reviewed to establish the known presence of a PAD. Additionally, a review of all known PAD locations in Hampshire was undertaken, together with a survey of public areas where a PAD may be expected to be located.ResultsThe current population of Hampshire is estimated to be 1.76 million. During the study period, 673 known PADs were located in 278 Hampshire locations. Of all calls confirmed as cardiac arrest (n=1035), the caller reported access to an automated external defibrillator (AED) on 44 occasions (4.25%), successfully retrieving and using the AED before arrival of the ambulance on only 18 occasions (1.74%).ConclusionsDespite several campaigns to raise public awareness and make PADs more available, many public areas have no recorded AED available, and in those where an AED was available it was only used in a minority of cases by members of the public before arrival of the ambulance. Overall, a PAD was only deployed successfully in 1.74% OOH cardiac arrests. This weak link in the chain of survival contributes to the poor survival rate from OOH cardiac arrest and needs strengthening.

Locations of Cardiac Arrest: Affirmation for Community Public Access Defibrillation (PAD) Program

2002 ◽  
Vol 17 (4) ◽  
pp. 202-205 ◽  
Author(s):  
J.C. Fedoruk ◽  
Wayne L. Currie ◽  
Meikel Gobet
Keyword(s):  
Cardiac Arrest ◽  
Annual Incidence ◽  
Public Access ◽  
Optimal Placement ◽  
The Public ◽  
Public Access Defibrillation ◽  
Average Annual Incidence ◽  
Prehospital Emergency ◽  
Chain Of Survival ◽  
The City

AbstractBackground:The purpose of this study was to describe the regional locations of cardiac arrest, and to identify public locations and the annual incidence of arrests within the identified locations, in order to help to determine optimal placement of Automatic External Defibrillators (AEDs) under the regional Public Access Defibrillation (PAD) Program. This is a retrospective study.Methods:The locations of cardiac arrest were abstracted from Ambulance Call Reports (ACRs) collected by the Essex-Kent Base Hospital Centre from regional ambulance services throughout the City of Windsor, and the Counties of Essex and Kent, Ontario, Canada, from 01 January 1994 through 31 December 2000. Arrest locations were grouped into five categories, and then the number of public venues was determined. Public sites were grouped into 28 Public Locations. Also included in the Public Sites were both General Industry and Outdoors categories. Categories identified but excluded from Public Sites were Institutions and Private Residences.Results:During the study, 2,295 arrests occurred, 152 cases were excluded, 2,142 arrests were categorized, (average annual incidence of 306 ±50.4 cardiac arrests), 329 (15.4%) of which were in Public Sites. Nineteen public venues had an average of >1 arrest/year, and nine public venues had an average of ≤1 arrest/year during the study, period. Calculations of the annual incidence of arrests for each public location were completed.Conclusions:These findings have significant prehospital emergency cardiac care implications for communities that wish to strengthen/improve their responses to out-of-hospital cardiac arrests. Public Access Defibrillation Programs should identify the site-specific incidence of arrest within their communities in order to provide legitimacy for funding and planning of programs. Training and availability of AEDs will reduce the time to first shock, thus strengthening the chain-of-survival and will save more lives.

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

O153 Public access defibrillation- Results from the Victorian Ambulance Cardiac Arrest Registry (VACAR)

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e41-e42
Author(s):  
Marijana Lijovic ◽  
Stephen Bernard ◽  
Ziad Nehme ◽  
A/Prof Tony Walker ◽  
A/Prof Karen Smith
Keyword(s):  
Cardiac Arrest ◽  
Public Access ◽  
Public Access Defibrillation

Abstract 181: An Analysis of Worldwide Public Access Defibrillator Usage Since October 2012. Does CPR Prior to Defibrillation Improve Survival Outcomes?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Hannah Torney ◽  
Adam Harvey ◽  
Olibhear McAlister ◽  
Amy Kernaghan ◽  
Laura Davis ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Sudden Cardiac Arrest ◽  
Public Spaces ◽  
Public Access ◽  
Survival Outcomes ◽  
Summary Statistics ◽  
Demographic Information ◽  
Chain Of Survival ◽  
Bystander Cpr ◽  
Cpr Quality

Introduction: As outlined by the Chain of Survival, effective cardiopulmonary resuscitation (CPR) and rapid defibrillation are vital to improve survival from sudden cardiac arrest (SCA). Placement of public access defibrillators (PADs) is becoming more common in public spaces, and they are more frequently used by untrained lay-users. The objective of this analysis was to assess the effect of CPR prior to defibrillation, and the success of PAD usage in terms of first shock success and survival to hospital admission. Methods: This dataset was composed of voluntarily submitted demographic information and electronic PAD files collected from October 2012 - June 2018. Summary statistics were calculated, and proportions were determined with 95% confidence intervals (CI) where appropriate. The association between CPR prior to defibrillation and survival was investigated by fitting a logistical model with survival as the dependent variable and CPR as covariate. Results: A total of 2812 PAD events were analyzed. Mean (SD) patient age was 61 (19) years and males comprised 72.5% (1922 of 2650 events where gender was known) of the events reported. The most common locations of SCA were the home (1039, 36.9%), public (719, 25.6%) and medical facility (328, 11.7%). Median (IQR) time to PAD delivery was 5 (3, 11) minutes. Ventricular fibrillation or tachycardia was present in 1010 (35.9%) patients, and 979 received a shock, with 87.2% (95%CI [85.0%, 89.3%]) achieving first shock success. Of the 849 shockable patients for whom survival was known, 565 (66.5%, (95%CI [63.3%, 69.7%]) survived to hospital admission. Survival outcome was known for 2150 patients, and 681 (31.7%, 95%CI [29.7%, 33.69%]) survived to hospital admission. A total of 1649 (58.6%) SCAs were witnessed and 1293 (78.4%) patients received bystander CPR prior to defibrillation. Bystander CPR prior to defibrillation was significantly associated with survival to hospital admission (OR = 2.17, 95%CI [1.69, 2.81], p<0.001). Conclusion: These results suggest that CPR application prior to application of a PAD significantly increases a patient’s chances of surviving to hospital admission. This study did not assess CPR quality, but it is intuitive that good quality CPR would align with higher survival outcomes.

Location of arrest and survival from out-of-hospital cardiac arrest among children in the public-access defibrillation era in Japan

Resuscitation ◽  
2019 ◽  
Vol 140 ◽  
pp. 150-158 ◽  
Author(s):  
Satoshi Matsui ◽  
Tetsuhisa Kitamura ◽  
Junya Sado ◽  
Kosuke Kiyohara ◽  
Daisuke Kobayashi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Public Access ◽  
The Public ◽  
Public Access Defibrillation ◽  
Hospital Cardiac Arrest
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