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 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.

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.

Abstract 53: Aerial Drone versus Ground Search for Delivery of an Automated External Defibrillator (AED) for Out-of-hospital Cardiac Arrest: A Comparison of Elapsed Time and Bystander Experience in a Community Setting

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Wayne D Rosamond ◽  
Anna Johnson ◽  
Brittany Bogle ◽  
Evan Arnold ◽  
Chris Cunningham ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Average Distance ◽  
Community Setting ◽  
The United States ◽  
Automated External Defibrillator ◽  
Delivery Time ◽  
Probability Of Survival ◽  
Post Trial ◽  
Hospital Cardiac Arrest ◽  
External Defibrillator

Background: An estimated 350,000 individuals experience out-of-hospital cardiac arrest (OHCA) in the United States (US) annually; only approximately 10% survive. The probability of survival after OHCA doubles when a bystander uses an automated external defibrillator (AED) before emergency management services arrives; however, bystander AED use is less than 2% in the US. We conducted a series of randomized trials in a community setting comparing the delivery of an AED by aerial drone to that of a bystander searching for and retrieving an AED from fixed locations in the area. Methods: We conducted 35 simulation trials of an OHCA using a life-sized manikin accompanied by two participants, paired by gender and age (18-34, 35-49, 50-65 years), in a community setting, with seven trials per zone in five distinct zones. Zones represented different environmental challenges to drone navigation and pedestrian acquisition of an AED and varied in number of fixed AEDs in the area (range 1-8 AEDs in a 600 ft radius from the OHCA site). We used a DJI Matrice 600 Pro drone, modified to carry a standard AED, flying autonomously from a preprogrammed flight path to the OHCA site. Drone launch sites varied by zone and ranged from 800 to 1300 ft from the OHCA site. We randomized participants either to call a mock 9-1-1 telecommunicator who would initiate the drone’s flight sequence, or to conduct a ground search to locate and retrieve an AED from a fixed location. We compared the delivery time of an AED by drone to that of an AED acquired by ground search. We conducted pre- and post-trial interviews with each participant to query perceptions. Results: We conducted 18 trials with women and 17 with men. These included 15, 11, and 9 trials across the three age strata, respectively. The average time (minutes: seconds) from onset of the simulated OHCA to AED delivery was 1:21 faster by drone (4:45, standard deviation (SD) = 0.34) compared to ground search (6:06, SD = 3:21). In 71% of trials (n=25 of 35), the drone delivered the AED to the event site within 5 minutes, compared to 51% (n=18 of 35) of ground searches (p=0.09). Median AED delivery time was faster by drone than by ground search in four of the five zones (range 0:17 to 2:56). Ground search was faster than the drone in one zone with 7 AEDs within 600 ft of the simulated OHCA event site and the shortest average distance to an AED (254 ft) of all the five zones. Among participants randomized to call for the drone, 89% reported that they felt comfortable as the drone approached, and 72% reported having no safety concerns. Nearly half of participants randomized to conduct a ground search reported difficulty finding an AED. Conclusion: Our study suggests that drone delivery of an AED to the site of an OHCA is feasible and acceptable in a community setting. Drones may provide more timely access to early defibrillation compared to bystander search and acquisition of an AED from the surrounding area.

Challenges in Basic Life Support and Automated External Defibrillator Training of Deaf People

2020 ◽  
Author(s):  
Matej Strnad ◽  
Zdenko Šalda ◽  
Boštjan Jerko ◽  
Vida Vrečar ◽  
Vesna Borovnik Lesjak ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Basic Life Support ◽  
Life Support ◽  
Deaf People ◽  
Automated External Defibrillator ◽  
Knowledge Test ◽  
Rescue Service ◽  
Study Results ◽  
And Performance ◽  
External Defibrillator

Abstract BackgroundBasic life support (BLS) with the use of an automated external defibrillator (AED) is a fundamental link to a successful chain of survival of patients with cardiac arrest. However, the BLS protocol is not tailored for deaf people who encounter many challenges during BLS training. MethodsAfter an ergonomic analysis and modifications of the BLS and AED protocol, a practical course was conducted. A pre-course BLS and AED knowledge was tested with a questionnaire. After the course, each participant practically solved a cardiac arrest scenario on a manikin and qualitative and quantitative data on BLS and AED performance were collected with a modified Cardiff test and the QCPR mobile application. Results of the knowledge test and performance were presented with frequencies and correlations between pre- and post-course BLS and AED knowledge and performance were analyzed and presented with Spearman’s rho. Results51 deaf volunteers from seven Slovenian societies for deaf people participated in the study. Results on the pre-course knowledge test were poor (3.5 points out of 10). BLS performance according to the modified Cardiff test post-course was also poor: 52.9 % of the participants used a safe approach, 58.8 % checked responsiveness and 51.0 % sent a text message to the rescue service. Only 43.1 % of them opened the airway and 49.0% checked initial breathing. 80.4% of the deaf rescuers performed chest compressions on the lower half of the sternum but only 52.9 % of them compressed with adequate depth. According to the QCPR application the best performance was achieved with the compression score of 61.1 % and flow fraction 74.9%.ConclusionsThis study shows that a more comprehensive and assidiuous approach is needed for effective BLS and AED training courses for deaf people.

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.

Interprofessional education and social interaction: The use of automated external defibrillators in team-based basic life support

2017 ◽  
Vol 25 (1) ◽  
pp. 139-148
Author(s):  
Arif Onan ◽  
Nurettin Simsek
Keyword(s):  
Interprofessional Education ◽  
Basic Life Support ◽  
Life Support ◽  
Healthcare Providers ◽  
Sudden Cardiac Arrest ◽  
Heart Association ◽  
Automated External Defibrillator ◽  
Automated External Defibrillators ◽  
Significant Difference ◽  
External Defibrillator

Automated external defibrillators are pervasive computing devices designed for the treatment and management of acute sudden cardiac arrest. This study aims to explain users’ actual use behavior in teams formed by different professions taken after a short time span of interaction with automated external defibrillator. Before the intervention, all the participants were certified with the American Heart Association Basic Life Support for healthcare providers. A statistically significant difference was revealed in mean individual automated external defibrillator technical skills between uniprofessional and interprofessional groups. The technical automated external defibrillator team scores were greater for groups with interprofessional than for those with uniprofessional education. The nontechnical automated external defibrillator skills of interprofessional and uniprofessional teams revealed differences in advantage of interprofessional teams. Students positively accept automated external defibrillators if well-defined and validated training opportunities to use them expertly are available. Uniprofessional teams were successfully supported by their members and, thereby, used automated external defibrillator effectively. Furthermore, the interprofessional approach resulted in as much effective teamwork as the uniprofessional approach.

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.

Sign in / Sign up

Export Citation Format

Share Document