Abstract 14089: Reduced Pain External Defibrillation (RPD) and MRI-conditional RPD: Reduced Pain ind Equivalent Efficiency Validation in Swine

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ehud J Schmidt ◽  
Hassan Elahi ◽  
Ryan Baumgaertner ◽  
Henry R Halperin
Keyword(s):  
Cardiac Arrest ◽  
Low Power ◽  
Acute Stroke ◽  
Sudden Cardiac Arrest ◽  
Spinal Trauma ◽  
Peak Amplitude ◽  
Acceleration Rate ◽  
Biphasic Pulse ◽  
Mri Conditional ◽  
External Defibrillator

Introduction: External defibrillators are used for cardioversion and resuscitation after sudden cardiac arrest (SCA). External defibrillators are also required for emergency MRI (acute stroke, spinal trauma). Low-power (9 Joule) ICD RPDs [1], and MRI-conditional external defibrillator prototypes exist [2]. An RPD external defibrillator was constructed, consisting of a Zoll defibrillator integrated with a tetanizing unit. The tetanizing waveform slowly compressed chest musculature prior to the strong biphasic defibrillating pulse, reducing chest contraction during the biphasic pulse, the major pain source. This RPD system (Fig. 1A-D) was evaluated for pain reduction and defibrillation effectiveness in swine. Method: The tetanizing unit consisted of a programmable generator that delivered a triangular 1-KHz pulse of 250-2000msec duration and 10-100 Volt peak amplitude, and subsequently triggered the conventional defibrillator to send out standard short (8msec) powerful (20-400 J) biphasic pulses. Forward limb motion (Fig. 1E), an established pain measure [3], was evaluated by measuring limb acceleration, acceleration rate and work (energy). 5 swine were arrested electrically and then defibrillated. RPD was repeated 15-20 times/swine, varying tetanizing parameters and biphasic energy. Results: Fig. 1F-H compare an RPD defibrillation and equivalent biphasic defibrillation, showing smaller accelerations and acceleration rates. Fig. 1J shows work results, at 30-200J biphasic energy, demonstrating an 83 + 15% limb work reduction with the RPD waveforms. Optimal tetanizing parameters were 15-25V amplitude and 500-750msec duration. Rhythm recovery for RPD and conventional defibrillation was identical. Conclusions: Reduced pain defibrillation may allow cardioversion without anesthesia and faster defibrillation after SCA. References: [1] Hunter DW 2016. [2] Schmidt EJ 2016. [3] Boriani G, 2005.

Abstract 147: Rapid Responder Operating Times for Out-of-hospital Cardiac Arrest Using Three Automated External Defibrillator Models

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Mengqi Gao ◽  
Chenguang Liu ◽  
Dawn Jorgenson
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Operating Time ◽  
Sudden Cardiac Arrest ◽  
The United States ◽  
Automated External Defibrillator ◽  
Simulation Studies ◽  
Time Intervals ◽  
Shock Delivery ◽  
External Defibrillator

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.).

scholarly journals The Role of Automated External Defibrillators in Athletics

2009 ◽  
Vol 1 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Justin D. Rothmier ◽  
Jonathan A. Drezner
Keyword(s):  
Cardiac Arrest ◽  
Action Plan ◽  
Sudden Cardiac Arrest ◽  
Public Access ◽  
Time Interval ◽  
Athletic Programs ◽  
Early Defibrillation ◽  
Automated External Defibrillators ◽  
External Defibrillator

Context: Sudden cardiac arrest is the leading cause of death in young athletes. The purpose of this review is to summarize the role of automated external defibrillators and emergency planning for sudden cardiac arrest in the athletic setting. Evidence Acquisition: Relevant studies on automated external defibrillators, early defibrillation, and public-access defibrillation programs were reviewed. Recommendations from consensus guidelines and position statements applicable to automated external defibrillators in athletics were also considered. Results: Early defibrillation programs involving access to automated external defibrillators by targeted local responders have demonstrated a survival benefit for sudden cardiac arrest in many public and athletic settings. Conclusion: Schools and organizations sponsoring athletic programs should implement automated external defibrillators as part of a comprehensive emergency action plan for sudden cardiac arrest. In a collapsed and unresponsive athlete, sudden cardiac arrest should be suspected and an automated external defibrillator applied as soon as possible, as decreasing the time interval to defibrillation is the most important priority to improve survival in sudden cardiac arrest.

scholarly journals High School Automated External Defibrillator Programs as Markers of Emergency Preparedness for Sudden Cardiac Arrest

2013 ◽  
Vol 48 (2) ◽  
pp. 242-247 ◽  
Author(s):  
Brett G. Toresdahl ◽  
Kimberly G. Harmon ◽  
Jonathan A. Drezner
Keyword(s):  
High School ◽  
Cardiac Arrest ◽  
High Schools ◽  
Emergency Preparedness ◽  
Action Plan ◽  
Sudden Cardiac Arrest ◽  
Emergency Planning ◽  
Automated External Defibrillator ◽  
School Based ◽  
External Defibrillator

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.

scholarly journals Automated Monitoring System for Heart Patients using Ambubot

2019 ◽  
Vol 8 (4) ◽  
pp. 11760-11765
Keyword(s):  
Cardiac Arrest ◽  
Fundamental Problem ◽  
Sudden Cardiac Arrest ◽  
Robotic Systems ◽  
Human Beings ◽  
Biomedical Sensors ◽  
Heart Patients ◽  
Affected Person ◽  
Automated Monitoring System ◽  
External Defibrillator

Robotic systems are one of the key options for presenting clever services. Time is a fundamental problem when dealing with human beings who face a sudden cardiac arrest that regrettably may want to die due to inaccessibility of the emergency treatment. Therefore, an on the spot treatment the usage of Automated External Defibrillator (AED) should be administered to the victim inside a few minutes after collapsing. Hence we have designed and developed the Ambulance Robot, shortened as AMBUBOT, which brings along an AED in a surprising tournament of cardiac arrest and helps various modes of operation .The prototype with biomedical sensors are utilized for monitoring the affected person health continuously, the region of the patient can also be tracked in case of emergency by using GSM.

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 ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Sudden Cardiac Arrest ◽  
Protective Equipment ◽  
Automated External Defibrillator ◽  
Related Data ◽  
External Defibrillator ◽  
Condition B

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.

scholarly journals Is Cluster Analysis the Appropriate Statistical Method for Planning the Optimal Locations for Automated External Defibrillators?

2020 ◽  
Vol 64 (1) ◽  
pp. 7-14
Author(s):  
Rafał Milewski ◽  
Gabriela Sokołowska ◽  
Barbara Jankowiak ◽  
Beata Kowalewska ◽  
Marcin Milewski ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Cardiac Arrest ◽  
Statistical Method ◽  
Medical Training ◽  
Sudden Cardiac Arrest ◽  
Cardiac Conduction ◽  
Automated External Defibrillators ◽  
Initial Cluster ◽  
Normal Heart Rate ◽  
External Defibrillator

AbstractThe Automated External Defibrillator (AED) is an intuitive device used by witnesses of an incident without medical training in cases of sudden cardiac arrest. Its operation consists in delivering an electrical pulse to the cardiac conduction system, as a result of which normal heart rate is restored. The lack of awareness in society concerning the usefulness of the device and the inadequate deployment of AEDs result in their too infrequent application by witnesses of incidents. The aim of this paper is to verify whether cluster analysis is the appropriate statistical method to determine the appropriate deployment of AED devices on the basis of cases of sudden cardiac arrest in out-of-hospital conditions. The initial cluster analysis showed the validity of using the method in question for planning the appropriate locations of AEDs.

P2827Different views of sudden cardiac arrest characteristics according to the assessed population

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Karam ◽  
W Bougouin ◽  
V Waldmann ◽  
F Dumas ◽  
D Jost ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Sudden Cardiac Arrest ◽  
Population Characteristics ◽  
P Value ◽  
Automated External Defibrillator ◽  
Care Providers ◽  
External Defibrillator

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.

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