Out-of-hospital cardiac arrest survival in international airports

Masterson, Siobhán; McNally, Bryan; Cullinan, John; Vellano, Kimberly; Escutnaire, Joséphine; Fitzpatrick, David; Perkins, Gavin D.; Koster, Rudolph W.; Nakajima, Yuko; Pemberton, Katherine; Quinn, Martin; Smith, Karen; Jónsson, Bergþór Steinn; Strömsöe, Anneli; Tandan, Meera; Vellinga, Akke

doi:10.1016/j.resuscitation.2018.03.024

Cited by 16 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…International airports generally have a large flow of passengers and accordingly, an increased risk of OHCA. OHCA in Copenhagen International Airport was 0.21 OHCA per million passengers, which is comparable with the 0.24 OHCA per million passengers reported across 70 airports in 9 different countries by Masterson et al 13 A large flow of passengers increases the chance of a bystander witnessed arrest and early bystander interventions. As expected, we found a high proportion of bystander witnessed OHCAs at the airport (91.3% at the airport vs. 48.3% for Denmark) compared with the Danish Cardiac Arrest Registry.…”

Section: Discussionsupporting

confidence: 77%

“…Airports provide such a setting, and were therefore one of the earliest sites where use of publicly accessible AEDs was tested with a positive impact on OHCA survival. 12 Now, two decades later, AEDs have been placed in many international airports, 13 including Copenhagen International Airport. Copenhagen International Airport has a large flow of passengers and employees, with more than 30 million annual travellers, a high density of AEDs available 24 h a day, 7 days a week and a dedicated professional first responder response system aiming to arrive on site within 3 min.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bystander interventions and survival following out-of-hospital cardiac arrest at Copenhagen International Airport

et al. 2021

View full text Add to dashboard Cite

Aim: To examine incidence and outcome following out-of-hospital cardiac (OHCA) arrest in a high-risk area characterised by high density of potential bystanders and easy access to nearby automated external defibrillators (AEDs). Methods: This retrospective observational study investigated pre-hospital and in-hospital treatment, as well as survival amongst persons with OHCA at Copenhagen International Airport between May 25, 2015 and May 25, 2019. OHCA data from pre-and in-hospital medical records were obtained and compared with public bystander witnessed OHCAs in Denmark. Results: Of the 23 identified non-traumatic OHCAs, 91.3% were witnessed by bystanders, 73.9% received bystander cardiopulmonary resuscitation (CPR), and 43.5% were defibrillated by a bystander. Survival to hospital discharge was 56.5%, with 100% survival among persons with an initial shockable heart rhythm. Compared with nationwide bystander witnessed OHCAs, persons with OHCA at the airport were less likely to receive bystander CPR (73.9% vs. 89.4%, OR 0.33; 95% CI, 0.13À0.86), more likely to receive bystander defibrillation (43.5% vs. 24.8%, OR 2.32; 95% CI, 1.01À5.31), to achieve return of spontaneous circulation (78.2% vs. 50.6%, OR 3.51; 95% CI, 1.30À9.49), and survive to hospital discharge (56.5% vs. 45.2%, OR 1.58; 95% CI, 0.69À3.62). Conclusion: We found a high proportion of bystander defibrillation indicating that bystanders will quickly apply an AED, when accessible. Importantly, 56% of all persons, and all persons with a shockable heart rhythm survived. These findings suggest increased potential for survival following OHCA and support current guidelines to strategically deploy accessible AEDs in high-risk OHCA areas.

show abstract

Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Bystander interventions and survival following out-of-hospital cardiac arrest at Copenhagen International Airport

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Only fewer previous studies investigated potential association between such genetic conditions and outcomes on ECMO (21,29,30). Also, in the majority of eCPR patients in this study ECMO was implanted little time after cCPR commencement possibly having an additional negative impact on our outcome (31)(32)(33). In this context the key to survival may be timely recognition, rapid launching of cCPR protocol and strict timing of ECMO implantation.…”

Section: Discussionmentioning

confidence: 90%

Outcomes and factors associated with early mortality in pediatric and neonatal patients requiring extracorporeal membrane oxygenation for heart and lung failure

Azizov¹,

Merkle²,

Fatullayev³

et al. 2019

J. Thorac. Dis

View full text Add to dashboard Cite

Background: Mortality and morbidity after surgical repair for complex congenital heart defects and severe cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO) support remain high despite significant advances in medical management and technological improvements. We report on outcomes and factors after using ECMO in our surgical pediatric population including short-and long-term survival. Methods: A total of 45 neonatal and pediatric patients were identified who needed ECMO in our department between January 2008 and December 2016. In 41 cases (91%) a vaECMO (ECLS) was implemented, whereas 4 patients (9%) received vvECMO treatment for respiratory failure. In 33 cases vaECMO was implanted following cardiac surgery for congenital heart disease (CHD), whereas in 8 patients ECMO was utilized by means of extracorporeal cardiopulmonary resuscitation (eCPR) following refractory cardiac arrest. The primary endpoint of the present study was survival to discharge and long-term survival free from neurological impairments. Univariate and bivariate analysis was performed to address predictors for outcome. Kaplan-Meier survival analysis was used to address mid-and long-term survival. Results: Median [IQR] duration of ECMO support was 3 [2, 5] days (range, 1-17 days). Median age at ECMO implantation was 128 [14, 1,813] days, median weight of patients was 5.4 [3.3, 12] kg. Totally 10 patients included in this study were diagnosed with concomitant genetic conditions. A total of 20 (44%) patients were successfully weaned off ECMO (survived >24 h after ECMO explantation), whereas 15 (33%) of them survived to discharge. Single ventricle (SV) repair was performed in 14, biventricular repair in 19 patients. Neonates (<30 days of age), female patients, patients with genetic conditions, SV repair patients, and eCPR patient cohort showed lower odds of survival on ECMO. Failed myocardial recovery (P=0.001), profound circulatory failure despite a high dose of catecholamines (P<0.001), neurological impairment pre-ECMO and post-ECMO (P=0.04 and P<0.001, respectively), and severe pulmonary failure despite high respiratory pressure settings were most common mortality reasons. Conclusions: ECMO provides efficient therapy opportunities for life-threatening conditions. Nevertheless, neonates and pediatric patients who underwent ECMO were at high risk for cerebrovascular events and poor survival. Appropriate patient selection using predictors of outcome reducing complications might improve outcomes of this patient cohort.

show abstract

“…If all of the supermarkets had a PAD available to provide early defibrillation and applying the Victorian state‐wide PAD survival rate of 55.5% to those patient found in a shockable rhythm, an additional 12 patients could have survived. However, a recently published study of cardiac arrests in international airports found that the strongest predictor of survival was an initial shockable rhythm (AOR 36.7, 95% CI 15.5–87.0) and for witnessed arrests the strongest predictor of survival was shocked by a PAD (AOR 4.8, 95% CI 3.0–7.8) . We therefore hypothesise that the number of survivors would be even higher than 12, as the percentage of patients found in a shockable rhythm would be greater given the immediate application of a PAD .…”

Section: Introductionmentioning

confidence: 91%

Coles and Woolworths have installed public access defibrillators in all their stores: It is time other Australian businesses followed their lead

Haskins

Nehme

Cameron

et al. 2019

Emerg Medicine Australasia

Self Cite

View full text Add to dashboard Cite

We welcome the recent announcement by Coles and Woolworths that public access defibrillators (PADs) are now available in their stores, as early defibrillation with PADs is associated with significantly increased survival from out-of-hospital cardiac arrests (OHCAs). From 2008 to 2018 there were 120 OHCAs in Victorian supermarkets, overall 26.6% survived; however, when defibrillated by a PAD 66.6% survived. For all OHCA in Victoria, survival for defibrillation by a PAD was also higher at 55.5%, compared to 28.8% for paramedic defibrillation. Using this state-wide PAD survival rate, we estimate an additional 12 patients could have survived had PADs been available in all supermarkets. In Victoria last year there were 421 potentially viable OHCAs in public locations, of these 132 patients survived; however, had PADs been available an additional 101 patients could have survived. We therefore strongly encourage local businesses to install PADs, to safeguard the well-being of their employees, customers and local communities.

show abstract

Out-of-hospital cardiac arrest survival in international airports

Cited by 16 publications

References 26 publications

Bystander interventions and survival following out-of-hospital cardiac arrest at Copenhagen International Airport

Bystander interventions and survival following out-of-hospital cardiac arrest at Copenhagen International Airport

Outcomes and factors associated with early mortality in pediatric and neonatal patients requiring extracorporeal membrane oxygenation for heart and lung failure

Coles and Woolworths have installed public access defibrillators in all their stores: It is time other Australian businesses followed their lead

Contact Info

Product

Resources

About