Public-access automated external defibrillator pad application and favorable neurological outcome after out-of-hospital cardiac arrest in public locations: A prospective population-based propensity score-matched study

Kishimori, Takefumi; Kiyohara, Kosuke; Matsuyama, Tasuku; Shida, Haruka; Nishiyama, Chika; Kobayashi, Daisuke; Okabayashi, Satoe; Shimamoto, Tomonari; Hayashida, Sumito; Kitamura, Tetsuhisa; Kawamura, Takashi; Iwami, Taku

doi:10.1016/j.ijcard.2019.07.061

Cited by 10 publications

(7 citation statements)

References 36 publications

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“…In countries where educating school children in cardiopulmonary resuscitation (CPR) is mandatory, lay resuscitation is done in 60-75% of cases [4]. In places where public access to defibrillation programs have been successfully implemented, survival has increased almost threefold [5].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the quality of chest compressions during resuscitation in an understaffed team — randomised crossover manikin study

Kłosiewicz

Puslecki

Zalewski

et al. 2020

Disaster Emerg Med J

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InTRoduCTIon:According to the chain of survival, chest compressions (CCs) are crucial in every cardiac arrest patient. It is very challenging to provide high-quality resuscitation in a two-paramedic team. The task of an automatic chest compression device (ACCD) is to relieve the rescuer and improve the quality of CCs. Its influence on the quality of the whole resuscitation as well as the survival of patients is still subject to discussion worldwide. This study aimed to assess the quality of CCs during resuscitation in a two-paramedic team using ACCD. MATeRIAl And MeThodS:This research was designed as a prospective, randomised, cross-over, high-fidelity simulation study. Fifty-two double paramedic teams took part in the research. The role of the participants was to conduct full advanced resuscitation in a human patient's simulator. Each team provided resuscitation twice. Once with an ACCD and once using manual compressions. Chest compression quality parameters, as well as chest compression fraction (CCF), were measured.ReSulTS: Statistically significant differences were found between manual and automated compressions in: mean depth (48 ± 4 mm vs. 56 ± 3 mm, p < 0.0001), mean rate (117 ± 9 mm vs. 103 ± 1 mm, p < 0.0001), percentage of CC with correct depth (46 ± 25 vs. 87 ± 13, p < 0.0001), rate (72 ± 22 vs. 96 ± 4, p < 0.0001), and recoil (55 ± 23 vs. 89 ± 13, p < 0.0001). CCF was also higher when the ACCD was used (74 ± 7% vs. 83 ± 2%, p < 0.0001). ConCluSIonS:The use of an ACCD increases the quality of compressions by improving CCF, chest recoil, and the percentage of compressions performed with adherence to guidelines.

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Section: Introductionmentioning

confidence: 99%

Analysis of the quality of chest compressions during resuscitation in an understaffed team — randomised crossover manikin study

Kłosiewicz

Puslecki

Zalewski

et al. 2020

Disaster Emerg Med J

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“…in fewer neurological complications and consequently, enhanced quality of life. 11 It is considered that the interval between the call to the emergency medical services (EMS) and the defibrillation should be less than 5 min, as each minute of delay in AED usage reduces survival rates by 10%-12%. 12 13 In some places, especially in rural areas, this time can exceed 6 min.…”

Section: Open Accessmentioning

confidence: 99%

“…Immediate bystander-initiated CPR has been demonstrated to double or even triple survival in out-of-hospital cardiac arrest (OHCA) 10. Moreover, a recent study in Japan observed that AED usage by witnesses increased the survival rates of individuals affected by OHCA, resulting in fewer neurological complications and consequently, enhanced quality of life 11…”

Section: Introductionmentioning

confidence: 99%

Online platform for cardiopulmonary resuscitation and automated external defibrillator training in a rural area: a community clinical trial protocol

Taverna-Llauradó,

Martínez-Torres,

Granado-Font

et al. 2024

BMJ Open

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IntroductionSudden death resulting from cardiorespiratory arrest carries a high mortality rate and frequently occurs out of hospital. Immediate initiation of cardiopulmonary resuscitation (CPR) by witnesses, combined with automated external defibrillator (AED) use, has proven to double survival rates. Recognising the challenges of timely emergency services in rural areas, the implementation of basic CPR training programmes can improve survival outcomes. This study aims to evaluate the effectiveness of online CPR-AED training among residents in a rural area of Tarragona, Spain.MethodsQuasi-experimental design, comprising two phases. Phase 1 involves assessing the effectiveness of online CPR-AED training in terms of knowledge acquisition. Phase 2 focuses on evaluating participant proficiency in CPR-AED simulation manoeuvres at 1 and 6 months post training. The main variables include the score difference between pre-training and post-training test (phase 1) and the outcomes of the simulated test (pass/fail; phase 2). Continuous variables will be compared using Student’s t-test or Mann-Whitney U test, depending on normality. Pearson’s χ2test will be applied for categorical variables. A multivariate analysis will be conducted to identify independent factors influencing the main variable.Ethics and disseminationThis study adheres to the tenets outlined in the Declaration of Helsinki and of Good Clinical Practice. It operated within the Smartwatch project, approved by the Clinical Research Ethics Committee of the Primary Care Research Institute IDIAP Jordi Gol i Gurina Foundation, code 23/081-P. Data confidentiality aligns with Spanish and European Commission laws for the protection of personal data. The study’s findings will be published in peer-reviewed journals and presented at scientific meetings.Trial registration numberNCT05747495.

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“…The survival rate significantly increases with early cardiopulmonary resuscitation (CPR) and defibrillation with bystander use of automated external defibrillators (AEDs) . To increase rates of bystander CPR and AED use, many developed countries have implemented CPR training for the public and initiated public-access automated external defibrillation (PAD) programs . Although these efforts have yielded substantial progress toward improved survival following OHCA, governmental legislation can help by mandating CPR training or providing a disclaimer for bystander CPR and AED use, which is a key contributor to the effectiveness of an implementation strategy .…”

Section: Introductionmentioning

confidence: 99%

Survival After Out-of-Hospital Cardiac Arrest Before and After Legislation for Bystander CPR

Li,

Qin,

Zhang

et al. 2024

JAMA Netw Open

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ImportanceThe lack of evidence-based implementation strategies is a major contributor to increasing mortality due to out-of-hospital cardiac arrest (OHCA) in developing countries with limited resources.ObjectiveTo evaluate whether the implementation of legislation is associated with increased bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use and improved clinical outcomes for patients experiencing OHCA and to provide policy implications for low-income and middle-income settings.Design, Setting, and ParticipantsThis observational cohort study analyzed a prospective city registry of patients with bystander-witnessed OHCA between January 1, 2010, and December 31, 2022. The Emergency Medical Aid Act was implemented in Shenzhen, China, on October 1, 2018. An interrupted time-series analysis was used to assess changes in outcomes before and after the law. Data analysis was performed from May to October 2023.ExposureThe Emergency Medical Aid Act stipulated the use of AEDs and CPR training for the public and provided clear legal guidance for OHCA rescuing.Main Outcomes and MeasuresThe primary outcomes were rates of bystander-initiated CPR and use of AEDs. Secondary outcomes were rates of prehospital return of spontaneous circulation (ROSC), survival to arrival at the hospital, and survival at discharge.ResultsA total of 13 751 patients with OHCA (median [IQR] age, 59 [43-76] years; 10 011 men [72.83%]) were included, with 7858 OHCAs occurring during the prelegislation period (January 1, 2010, to September 30, 2018) and 5893 OHCAs occurring during the postlegislation period (October 1, 2018, to December 31, 2022). The rates of bystander-initiated CPR (320 patients [4.10%] vs 1103 patients [18.73%]) and AED use (214 patients [4.12%] vs 182 patients [5.29%]) increased significantly after legislation implementation vs rates before the legislation. Rates of prehospital ROSC (72 patients [0.92%] vs 425 patients [7.21%]), survival to arrival at the hospital (68 patients [0.87%] vs 321 patients [5.45%]), and survival at discharge (44 patients [0.56%] vs 165 patients [2.80%]) were significantly increased during the postlegislation period. Interrupted time-series models demonstrated a significant slope change in the rates of all outcomes.Conclusions and RelevanceThese findings suggest that implementation of the Emergency Medical Aid Act in China was associated with increased rates of CPR and public AED use and improved survival of patients with OHCA. The use of a systemwide approach to enact resuscitation initiatives and provide legal support may reduce the burden of OHCA in low-income and middle-income settings.

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Public-access automated external defibrillator pad application and favorable neurological outcome after out-of-hospital cardiac arrest in public locations: A prospective population-based propensity score-matched study

Cited by 10 publications

References 36 publications

Analysis of the quality of chest compressions during resuscitation in an understaffed team — randomised crossover manikin study

Analysis of the quality of chest compressions during resuscitation in an understaffed team — randomised crossover manikin study

Online platform for cardiopulmonary resuscitation and automated external defibrillator training in a rural area: a community clinical trial protocol

Survival After Out-of-Hospital Cardiac Arrest Before and After Legislation for Bystander CPR

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