scholarly journals Public use of external defibrillator in Hangzhou of China

2021 ◽  
Vol 12 (6) ◽  
pp. 6-11
Author(s):  
Jin Xiao Sheng ◽  
Ye Kan ◽  
Zhang Gai ◽  
Zhang Hao
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Treatment Effect ◽  
Heart Rhythm ◽  
First Aid ◽  
Public Places ◽  
The Public ◽  
First Aid Training ◽  
Public Areas ◽  
Hospital Cardiac Arrest

Background: Ventricular fibrillation (VF) is one of the causes of out-of-hospital cardiac arrest (OHCA). The increase in survival after out-of-hospital cardiac arrest is closely related to early detection and shortening the first defibrillation time. The implementation of AEDs deployment plan in public places in Hangzhou City provides an opportunity to improve the survival rate after out-of-hospital cardiac arrest, and the benefits and potentials are enormous. Aims and Objective: Placing AEDs in public areas can effectively treat patients with pre-hospital cardiac arrest, by evaluating the configuration and usage of public AEDs in Hangzhou during the past five years, to provide the basis for improving the public areas’ configuration AEDs network layout and related training management. Materials and Methods: The number of AEDs in public areas, the use of AEDs and the treatment effect in Hangzhou city from 2015 to 2020 were collected. Results: The number of AEDs in public areas, the use of AEDs and the treatment effect in Hangzhou city from 2015 to 2020 were collected. In 5 years, a total of 1201 AEDs were configured, Placed in densely populated areas such as transportation hubs, schools, and scenic spots as the main locations. 32 patients suffered prehospital cardiac arrest and used AEDs, the average age of the patients was 40.56 ± 17.20, and the ratio of male to female was 3.57:1, In 26 cases, the initial heart rhythm was ventricular fibrillation and defibrillation, Before the first aid personnel arrived, the first witnesses Implement rescue, 22 patients with ventricular fibrillation were resuscitated successfully, 10 cases failed to ROSC. In 6 patients with suspected cardiac arrest, there was no electric shock defibrillation, and the device correctly indicates that the problem is not caused by ventricular fibrillation, In 4 cases, there was no defibrillating rhythm. Conclusion: AEDs in public areas are effectively used to assist in the treatment of patients with cardiac arrest; It can increase the rate of main circulation recovery. We will further increase the number of AEDs in public places, promote first aid training programs for non-professionals, Improving the public health emergency network system is essential to improve the prognosis of patients with cardiac arrest.

Abstract 252: Resuscitation in Prehospital Stage: Effectiveness and Influencing Factors

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Anita Abula ◽  
Aija Maca ◽  
Oskars Kalejs
Keyword(s):  
Cardiac Arrest ◽  
Influencing Factors ◽  
Sudden Cardiac Arrest ◽  
Heart Rhythm ◽  
Public Health Issue ◽  
Public Places ◽  
Successful Resuscitation ◽  
The Public ◽  
Significant Difference ◽  
Hospital Cardiac Arrest

Background: Sudden cardiac arrest or sudden cardiac death is one of the leading causes of death all over the world. Of particular importance is out-of-hospital cardiac arrest (OHCA) - an important overworld public health issue. In order to help these people and improve their chances of survival, it is necessary to provide assistance as soon as possible. Bystanders are usually non-medical persons why it is more complicated to implement. The objectives of the study were to research effectiveness and influencing factors of resuscitation in prehospital stage and create suggestions and methodical recommendations as possible. Materials and Methods: A retrospective study was developed, which summarizes and analyzes the electronic call cards (IEK) of the Emergency Medical service of Latvia (EMS) for 2018 and 2019. IEK were selected that identified “successful resuscitation” and “unsuccessful resuscitation” as a complication of diagnosis (classification developed and validated by EMS of Latvia). Results: Overall 2538 resuscitations were performed, of which 27,6% were successful resuscitation. About a quarter (24,2%) of all resuscitations happened in a public place. The increase in the number of successful resuscitations is observed for resuscitation events that happened in public places. In most of cardiac arrest cases, bystanders did not perform CPR (60,3%). Arrival time of EMS in 2018 was 7,52 - 8,44 minutes and in 2019 was 7,75 - 8,23 minutes. The research shows that approximately 23% of cases the first monitored rhythm by EMS were VF/pVT. There is a significant difference in the increase in successful resuscitations if EMS performed defibrillation during the call. Conclusions: The most important influencing factors in the outcome of resuscitation are the patient’s age, the location, the first aid provided by bystanders, the time until the arrival of EMS and the first observed heart rhythm in a patient with cardiac arrest. It is necessary to create a register of AED (automated external defibrillator) devices in Latvia and their locations, to ensure the availability of data to the EMS service and the public.

Outcomes and In-hospital Treatment of Out-of-Hospital Cardiac Arrest Patients Resuscitated From Ventricular Fibrillation by Early Defibrillation

2004 ◽  
Vol 79 (5) ◽  
pp. 613-619 ◽  
Author(s):  
T. Jared Bunch ◽  
Roger D. White ◽  
Bernard J. Gersh ◽  
Win-Kuang Shen ◽  
Stephen C. Hammill ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Treatment ◽  
Early Defibrillation ◽  
Hospital Cardiac Arrest

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

Abstract 16924: Initial AMSA and Increased AMSA After CPR Predict Second Shock Success in Initially Shock-resistant VF During Out-of-hospital Cardiac Arrest

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ulrich Herken ◽  
Weilun Quan
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Success Rate ◽  
Fourier Transformation ◽  
Amplitude Spectrum ◽  
Fast Fourier Transformation ◽  
Shock Delivery ◽  
Spectrum Area ◽  
Hospital Cardiac Arrest

Purpose: Amplitude spectrum area (AMSA), which is calculated from the ventricular fibrillation (VF) waveform using fast Fourier transformation, has been recognized as a predictor of successful defibrillation (DF) and as an index of myocardial perfusion and viability during resuscitation. In this study, we investigated whether a change in AMSA occurring during CPR would predict DF outcome for subsequent DF attempts after a failed DF. We hypothesized that a patient responding to CPR with an increase in AMSA would have an increased likelihood of DF success. Methods: This was a retrospective analysis of out-of-hospital cardiac arrest patients who received a second DF due to initially shock-resistant VF. A total of 193 patients with an unsuccessful first DF were identified in a manufacturer database of electrocardiographic defibrillator records. AMSA was calculated for the first DF (AMSA1) and the second DF (AMSA2) during a 2.1 sec window ending 0.5 sec prior to DF. A successful DF attempt was defined as the presence of an organized rhythm with a rate ≥ 40 / min starting within 60 sec from the DF and lasting for > 30 sec. After the failed first DF, all patients received CPR for 2 to 3 minutes before delivery of the second DF. Change in AMSA (dAMSA) was calculated as dAMSA = AMSA2 - AMSA1. Results: The overall second DF success rate was 14.5%. Multivariable logistic regression showed that both AMSA1 and dAMSA were independent predictors of second DF success with odds ratios of 1.24 (95% CI 1.12 - 1.38, p<0.001) and 1.27 (95% CI 1.16 - 1.41, p<0.001) for each mVHz change in AMSA or dAMSA, respectively. Conclusions: In initially DF-resistant VF, a high initial AMSA value predicted an increased likelihood of second shock success. An increase of AMSA in response to CPR also predicted a higher second shock success rate. Monitoring of AMSA during resuscitation therefore may be useful to guide CPR efforts, possibly including timing of second shock delivery. These findings also further support the value of AMSA as indicator of myocardial viability.

Abstract 12769: Amplitude-Spectral Area of the Ventricular Fibrillation Waveform and Chest Compression Quality in Witnessed and Unwitnessed Out-Of-Hospital Cardiac Arrest: Can We Predict Who is Unlikely to Survive?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Julia Indik ◽  
Zacherie Conover ◽  
Meghan McGovern ◽  
Annemarie Silver ◽  
Daniel Spaite ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Discharge ◽  
Chest Compression ◽  
Stepwise Logistic Regression ◽  
Individual Subject ◽  
Spectral Area ◽  
Initial Rhythm ◽  
Hospital Cardiac Arrest

Background: Previous investigations in human out of hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF) have shown that the frequency-based waveform characteristic, amplitude spectral area (AMSA) predicts defibrillation success and is associated with survival to hospital discharge. We evaluated the relative strength of factors associated with hospital discharge including witnessed/unwitnessed status, chest compression (CC) quality and AMSA. We then investigated if there is a threshold value for AMSA that can identify patients who are unlikely to survive. Methods: Adult OHCA patients (age ≥18), with initial rhythm of VF from an Utstein-Style database (collected from 2 EMS systems) were analyzed. AMSA was measured from the waveform immediately prior to each shock, and averaged for each individual subject (AMSA-ave). Univariate and stepwise multivariable logistic regression, and receiver-operator-characteristic (ROC) analyses were performed. Factors analyzed: age, sex, witnessed status, time from dispatch to monitor/defibrillator application, number of shocks, mean CC rate, depth, and release velocity (RV). Results: 140 subjects were analyzed, [104 M (74%), age 62 ± 14 yrs, witnessed 65%]. Survival was 38% in witnessed and 16% in unwitnessed arrest. In univariate analyses, age (P=0.001), witnessed status (P=0.009), AMSA-ave (P<0.001), mean CC depth (P=0.025), and RV (P< 0.001) were associated with survival. Stepwise logistic regression identified AMSA-ave (P<0.001), RV (P=0.001) and age (P=0.018) as independently associated with survival. The area under the curve (ROC analysis) was 0.849. The probability of survival was < 5% in witnessed arrest for AMSA-ave < 5 mV-Hz, and in unwitnessed arrest for AMSA-ave < 15 mV-Hz. Conclusion: In OHCA with an initial rhythm of VF, AMSA-ave and CC RV are highly associated with survival. Further study is needed to evaluate whether AMSA-ave may be useful to identify patients highly unlikely to survive.

Abstract P75: Dissemination of CPR Skills to the Public - Can Schoolchildren Ensure Success?

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Tonje Lorem ◽  
Aud Palm ◽  
Lars Wik
Keyword(s):  
Cardiac Arrest ◽  
Large Fraction ◽  
Age Groups ◽  
Health Benefit ◽  
School Students ◽  
The Public ◽  
Group 3 ◽  
Second Tier ◽  
Group 2 ◽  
Hospital Cardiac Arrest

Training a large fraction of the general population in CPR could have major public health benefit if those most likely to witness cardiac arrest are trained. Mass distribution of self-training manikins as a two-tiered strategy with school children as first tier has been described as successful, but without information on second tier age or information strategy to second tier. We studied three different attempts at reaching older second tier persons. In groups 1 and 2 first tier consisted of 7 th graders and in group 3 high school and medical school students. Information about the desirable second tier age group was given in writing prior to the distribution. In groups 1 and 3 information was only directed towards first tier. In group 2 both first tier, their parents and teachers were informed. The first tier participants reported the number of second tier trained for age-groups 12–25 years, 25–50 years, and >50 years. Approximately 64000 (group 1), 63000 (group 2) and 81 (group 3) self-education kits were provided with 2.7, 1.9, and 3.7 lay-rescuers trained per kit respectively (p<0.05) (Table 1 ). Informing also the parents of the first tier prior to the distribution did not positively impact the number of second tier trained lay-rescuers, but higher age of first tier did. We speculate that 7 th graders are too young to successfully disseminate CPR to those most likely to witness out of hospital cardiac arrest. Table 1. Percentage reported trained in first and second tier divided into age-groups.

Abstract 17847: Gasping is a Valid Predictor Of ROSC and Hospital Discharge for In-hospital Cardiac Arrest Occurring on the Ward

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Luca Marengo ◽  
Wolfgang Ummenhofer ◽  
Gerster Pascal ◽  
Falko Harm ◽  
Marc Lüthy ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hospital Discharge ◽  
Survival Data ◽  
Neurological Outcome ◽  
Rapid Response Team ◽  
Spontaneous Circulation ◽  
University Hospital ◽  
Data Set ◽  
Hospital Cardiac Arrest

Introduction: Agonal respiration has been shown to be commonly associated with witnessed events, ventricular fibrillation, and increased survival during out-of-hospital cardiac arrest. There is little information on incidence of gasping for in-hospital cardiac arrest (IHCA). Our “Rapid Response Team” (RRT) missions were monitored between December 2010 and March 2015, and the prevalence of gasping and survival data for IHCA were investigated. Methods: A standardized extended in-hospital Utstein data set of all RRT-interventions occurring at the University Hospital Basel, Switzerland, from December 13, 2010 until March 31, 2015 was consecutively collected and recorded in Microsoft Excel (Microsoft Corp., USA). Data were analyzed using IBM SPSS Statistics 22.0 (IBM Corp., USA), and are presented as descriptive statistics. Results: The RRT was activated for 636 patients, with 459 having a life-threatening status (72%; 33 missing). 270 patients (59%) suffered IHCA. Ventricular fibrillation or pulseless ventricular tachycardia occurred in 42 patients (16% of CA) and were associated with improved return of spontaneous circulation (ROSC) (36 (97%) vs. 143 (67%; p<0.001)), hospital discharge (25 (68%) vs. 48 (23%; p<0.001)), and discharge with good neurological outcome (Cerebral Performance Categories of 1 or 2 (CPC) (21 (55%) vs. 41 (19%; p<0.001)). Gasping was seen in 128 patients (57% of CA; 46 missing) and was associated with an overall improved ROSC (99 (78%) vs. 55 (59%; p=0.003)). In CAs occurring on the ward (154, 57% of all CAs), gasping was associated with a higher proportion of shockable rhythms (11 (16%) vs. 2 (3%; p=0.019)), improved ROSC (62 (90%) vs. 34 (55%; p<0.001)), and hospital discharge (21 (32%) vs. 7 (11%; p=0.006)). Gasping was not associated with neurological outcome. Conclusions: Gasping was frequently observed accompanying IHCA. The faster in-hospital patient access is probably the reason for the higher prevalence compared to the prehospital setting. For CA on the ward without continuous monitoring, gasping correlates with increased shockable rhythms, ROSC, and hospital discharge.

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