Sudden Cardiac Arrest and Automated External Defibrillators

Introduction: Time-to-treatment plays a pivotal role in survival from sudden cardiac arrest (SCA). Every minute delay in defibrillation results in a 7-10% reduction in survival. This is particularly problematic in rural and remote regions, where bystander and EMS response is often prolonged and automated external defibrillators (AED) are often not available. Our objective was to examine the feasibility of a novel AED drone delivery method for rural and remote SCA. A secondary objective was to compare times between AED drone delivery and ambulance response to various mock SCA resuscitations. Methods: We conducted 6 simulations in two different rural communities in southern Ontario. During phase 1 (4 simulations) a “mock” call was placed to 911 and a single AED drone and an ambulance were simultaneously dispatched from the same location to a pre-determined destination. Once on scene, trained first responders retrieved the AED from the drone and initiated resuscitative efforts on a manikin. The second phase (2 scenarios) were done in a similar manner save for the drone being dispatched from a regionally optimized location for drone response. Results: Phase 1: The distance from dispatch location to scene varied from 6.6 km to 8.8 km. Mean (SD) response time from 911 call to scene arrival was 11.2 (+/- 1.0) minutes for EMS compared to 8.1 (+/- 0.1) for AED drone delivery. In all four simulations, the AED drone arrived before EMS, ranging from 2.1 to 4.4 minutes faster. The mean time for trained responders to retrieve the AED and apply it to the manikin was 35 (+/- 5) sec. No difficulties were encountered in drone activation by dispatch, drone lift off, landing or removal of the AED from the drone by responders. Phase 2: The ambulance response distance was 20km compared to 9km for the drone. Drones were faster to arrival at the scene by 7 minutes and 8 minutes with AED application 6 and 7 minutes prior to ambulance respectively. Conclusion: This implementation study suggests AED drone delivery is feasible with improvements in response time during a simulated SCA scenario. These results suggest the potential for AED drone delivery to decrease time to first defibrillation in rural and remote communities. Further research is required to determine the appropriate distance for drone delivery of an AED in an integrated EMS system as well as optimal strategies to simplify bystander application of a drone delivered AED.

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Prepared for sudden cardiac arrest? A cross-sectional study of automated external defibrillators in amateur sport

British Journal of Sports Medicine ◽

10.1136/bjsports-2013-092919 ◽

2013 ◽

Vol 47 (18) ◽

pp. 1171-1174 ◽

Cited By ~ 11

Author(s):

Owen Cronin ◽

Joseph Jordan ◽

Fionnuala Quigley ◽

Michael G Molloy

Keyword(s):

Cardiac Arrest ◽

Sudden Cardiac Arrest ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Automated External Defibrillators ◽

Amateur Sport

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The Role of Automated External Defibrillators in Athletics

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738108326979 ◽

2009 ◽

Vol 1 (1) ◽

pp. 16-20 ◽

Cited By ~ 8

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.

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Abstract 147: AED on the Fly: A Drone Delivery Feasibility Study for Rural and Remote Out-Of-Hospital Cardiac Arrest

Circulation ◽

10.1161/circ.140.suppl_2.147 ◽

2019 ◽

Vol 140 (Suppl_2) ◽

Cited By ~ 1

Author(s):

Sheldon Cheskes ◽

Paul Snobelen ◽

Shelley McLeod ◽

Steven Brooks ◽

Christian Vaillancourt ◽

...

Keyword(s):

Cardiac Arrest ◽

Response Time ◽

Sudden Cardiac Arrest ◽

Optimal Strategies ◽

Rural And Remote ◽

Remote Communities ◽

Automated External Defibrillators ◽

Secondary Objective ◽

Public Setting ◽

Lift Off

Introduction: Time-to-treatment plays a pivotal role in survival from sudden cardiac arrest (SCA). Every minute of delay in defibrillation results in a 7-10% reduction in survival. Time to defibrillation is particularly problematic in rural and remote regions, where traditional bystander and EMS response is often prolonged and automated external defibrillators (AED) are often not available. The objective of this study was to examine the feasibility of a novel AED drone delivery method for rural and remote SCA. A secondary objective was to compare times between AED drone delivery and ambulance response to various mock SCA resuscitations. Methods: We conducted four simulations to determine the feasibility of AED drone delivery to mock SCA resuscitations in a rural public setting in Ontario, Canada. During each simulation, a “mock” call was placed to 911 and a single AED drone and an ambulance were simultaneously dispatched from the same location to a pre-determined destination for a mock SCA. Once on scene, trained first responders retrieved the AED from the drone and initiated resuscitative efforts on a manikin until paramedics arrived. Results: The distance from dispatch location to scene varied from 6.6 kms to 8.8 kms. Mean (SD) response time from 911 call to arrive at mock code location was 11.2 (1.0) for EMS compared to 8.1 (0.1) minutes for AED drone delivery. In all four simulations, the AED drone arrived before EMS, ranging from 2.1 minutes to 4.4 minutes faster. Mean (SD) time from AED removal from drone to application to manikin by a trained responder was 35(5) sec. No difficulties were encountered in drone activation by dispatch, drone lift off, landing or removal of the AED from the drone by responders. Conclusions: This implementation study suggests AED drone delivery is feasible with improvements in response time during a simulated SCA scenario. These results suggest the potential for AED drone delivery to decrease time to first defibrillation in rural and remote communities. Further research is required to determine the appropriate distance for drone delivery of an AED in an integrated EMS system as well as optimal strategies to simplify bystander application of a drone delivered AED.

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Sudden Cardiac Arrest and the Use of Automated External Defibrillators

Risk Management in Sport and Recreation ◽

10.5040/9781492595823.ch-007 ◽

2006 ◽

Keyword(s):

Cardiac Arrest ◽

Sudden Cardiac Arrest ◽

Automated External Defibrillators

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Automated external defibrillators location in the context of sudden cardiac arrest in the West Pomeranian voivodeship

Europa Regionum ◽

10.18276/er.2018.37-05 ◽

2018 ◽

Vol 37 ◽

pp. 67-83

Author(s):

Maria Adamczyk ◽

Tomasz Zalewski ◽

Apoloniusz Kurylczyk

Keyword(s):

Cardiac Arrest ◽

Sudden Cardiac Arrest ◽

The West ◽

Automated External Defibrillators

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Abstract 287: Simulating the Effects of Sudden Cardiac Arrest Responders Embedded in a Marathon Cohort

Circulation ◽

10.1161/circ.138.suppl_2.287 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Jessica E Salerno ◽

Connor J Willson ◽

Leonard S Weiss ◽

David D Salcido

Keyword(s):

Cardiac Arrest ◽

Sudden Cardiac Arrest ◽

Public Access ◽

Walking Distance ◽

Marathon Runners ◽

Automated External Defibrillators ◽

Weighted Distribution ◽

Practical Utility ◽

Pure Chance ◽

Baseline Coverage

Introduction: Risk of sudden cardiac arrest may increase during distance running. In marathons, this risk is typically mitigated by deployment of medical resources, e.g. automated external defibrillators (AED), at fixed locations, potentially leaving racers vulnerable for periods of the race. We investigated utilization of marathon runners themselves as mobile emergency resources (R-AEDs). We hypothesized that systematic R-AED deployment would increase AED coverage of a race cohort over baseline coverage from static public AEDs. Methods: A simulation was constructed in MATLAB (vR2018a) incorporating the route of the 2018 Pittsburgh Marathon, detailed publicly available runner performance data from a nearby local marathon (N=1536), and known locations of S-AEDs with 1/8 th mile of any part of the Pittsburgh Marathon course (N = 47). During each simulation run, participants were randomly selected based on several distribution schemes (including age, pace category and pure chance) to carry an R-AED. R-AED coverage was assessed per minute by determining the proportion of racers up to 3 minutes ahead of each R-AED. S-AED coverage was calculated similarly based on whether runners were within 3-minutes of a public AED. All simulation variants were repeated 100 times and aggregated. Results: At baseline, 44% of the Pittsburgh Marathon course was within 3-minute walking distance of a public AED. Full coverage could be achieved with an additional 54 S-AEDs. Of the schemes we tested, when R-AEDs were deployed to random participants, optimal overall coverage was achieved with 1 R-AED per 25 runners (61 total for 57%), with 10% of race time achieving over 95% coverage. Weighted distribution of R-AEDs within age categories or pace categories achieved 72% coverage (155 AEDs) and 71% coverage, and over 95% coverage for 33% and 32% of the race duration, respectively. Conclusion: R-AEDs provided varying levels of additional coverage over baseline public access AED coverage during a simulated marathon. More work is necessary to fully determine the practical utility of this approach.

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