Treatment for Out-of-Hospital Cardiac Arrest

Nichol, Graham; Elrod, Jo Ann Broeckel; Becker, Lance B.

doi:10.1161/circulationaha.114.013263

Cited by 11 publications

(5 citation statements)

References 24 publications

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“…28 The bystander defibrillation rate worldwide was 2%-9% of all OHCA. [29][30][31][32] The much lower utility of public access defibrillator may be explained by the inaccessibility, difficulty in locating AEDs and a lack of awareness among untrained bystanders of the need of AED use in resuscitation. Actions should be taken to improve the PAD rate, including strategies to optimise AED deployment in the community and mobile applications to shorten the time in locating the nearest AED.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, low survival and ROSC rate may also be explained by a low rate of bystander defibrillation, which is another key factor associated with OHCA survival 28 . The bystander defibrillation rate worldwide was 2%–9% of all OHCA 29–32 . The much lower utility of public access defibrillator may be explained by the inaccessibility, difficulty in locating AEDs and a lack of awareness among untrained bystanders of the need of AED use in resuscitation.…”

Section: Discussionmentioning

confidence: 99%

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Impact of post-dispatch advice on bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest in Hong Kong

Wong

Choi

Lam

et al. 2023

Hong Kong Journal of Emergency Medicine

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Background: In Hong Kong, the post-dispatch advice on cardiopulmonary resuscitation has been implemented since October 2018. Our study aimed to (1) evaluate the impact of post-dispatch advice on the bystander cardiopulmonary resuscitation rate and out-of-hospital cardiac arrest survival and (2) characterise the reasons for not providing dispatch-assisted cardiopulmonary resuscitation, which have important implications in public cardiopulmonary resuscitation education. Method: We retrospectively analysed the records of 749 adult patients with out-of-hospital cardiac arrest between 1 September 2021 and 31 October 2021. The primary outcome was survival to hospital discharge. The secondary outcomes included return of spontaneous circulation and survival to hospital admission. Results: The overall dispatch-assisted cardiopulmonary resuscitation rate was 49.6%. Patients who received dispatch-assisted cardiopulmonary resuscitation had a higher proportion of witnessed cardiac arrest (37.7% vs 24.7%, p < 0.001) and a shorter time interval from recognition of cardiac arrest to chest compression (median 3.0 min vs 13.0 min, p < 0.001) compared with patients without dispatch-assisted cardiopulmonary resuscitation. 16.8% of out-of-hospital cardiac arrest victims had return of spontaneous circulation before or upon arrival at the hospital. Patients who received dispatch-assisted cardiopulmonary resuscitation had a higher return of spontaneous circulation (18.3% vs 15.4%), survival to hospital admission (15.9% vs 13.3%) and survival to hospital discharge (2.7% vs 1.3%) rates compared with those who did not. However, the differences did not reach statistical significance. Conclusion: Post-dispatch advice improved the overall bystander cardiopulmonary resuscitation rate in out-of-hospital cardiac arrest and shortened the time from out-of-hospital cardiac arrest recognition to chest compression, but the improvement in survival did not reach statistical significance. Further public education on cardiac arrest recognition and dispatch-assisted cardiopulmonary resuscitation is necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of post-dispatch advice on bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest in Hong Kong

Wong

Choi

Lam

et al. 2023

Hong Kong Journal of Emergency Medicine

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“… 25 26 According to a statistics annual report of the national emergency medical center, public access defibrillation and its installation were mandated since 2007, which led to 21,015 (prevalence of 4.1 per 100,000 person) installations. 27 However, the number is marginal compared with the 440,000 and 2,400,000 installations in Japan 28 and the USA, 29 respectively. The evaluation of the effectiveness of Automated External Defibrillator (AED) is challenging due to underutilization.…”

Section: Discussionmentioning

confidence: 99%

Effect of National Implementation of Telephone CPR Program to Improve Outcomes from Out-of-Hospital Cardiac Arrest: an Interrupted Time-Series Analysis

et al. 2018

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BackgroundIn cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program.MethodsData from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention.ResultsOf 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1–3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3–2.9 [1.6%]; 1.4–1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes.ConclusionThe nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.

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“…Large numbers of AEDs have been placed in public locations to improve the community response to cardiac arrest 5. It is sometimes difficult to determine whether these devices are maintained in a state of readiness for use or whether they functioned as intended when applied to someone in presumed cardiac arrest.…”

Section: Discussionmentioning

confidence: 99%

“…Since the effectiveness of use of AEDs by laypersons was demonstrated more than a decade ago, more than 2.4 million AEDs have been sold for use by laypersons in the USA 5. As more of these AEDs are placed in the community, the Food and Drug Administration (FDA) has received reports of potential adverse events associated with them.…”

Section: Introductionmentioning

confidence: 99%

Public health surveillance of automated external defibrillators in the USA: protocol for the dynamic automated external defibrillator registry study

et al. 2017

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IntroductionLay use of automated external defibrillators (AEDs) before the arrival of emergency medical services (EMS) providers on scene increases survival after out-of-hospital cardiac arrest (OHCA). AEDs have been placed in public locations may be not ready for use when needed. We describe a protocol for AED surveillance that tracks these devices through time and space to improve public health, and survival as well as facilitate research.Methods and analysisIncluded AEDs are installed in public locations for use by laypersons to treat patients with OHCA before the arrival of EMS providers on scene. Included cases of OHCA are patients evaluated by organised EMS personnel and treated for OHCA. Enrolment of 10 000 AEDs annually will yield precision of 0.4% in the estimate of readiness for use. Enrolment of 2500 patients annually will yield precision of 1.9% in the estimate of survival to hospital discharge. Recruitment began on 21 Mar 2014 and is ongoing. AEDs are found by using multiple methods. Each AED is then tagged with a label which is a unique two-dimensional (2D) matrix code; the 2D matrix code is recorded and the location and status of the AED tracked using a smartphone; these elements are automatically passed via the internet to a secure and confidential database in real time. Whenever the 2D matrix code is rescanned for any non-clinical or clinical use of an AED, the user is queried to answer a finite set of questions about the device status. The primary outcome of any clinical use of an AED is survival to hospital discharge. Results are summarised descriptively.Ethics and disseminationThese activities are conducted under a grant of authority for public health surveillance from the Food and Drug Administration. Results are provided periodically to participating sites and sponsors to improve public health and quality of care.

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Treatment for Out-of-Hospital Cardiac Arrest

Cited by 11 publications

References 24 publications

Impact of post-dispatch advice on bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest in Hong Kong

Impact of post-dispatch advice on bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest in Hong Kong

Effect of National Implementation of Telephone CPR Program to Improve Outcomes from Out-of-Hospital Cardiac Arrest: an Interrupted Time-Series Analysis

Public health surveillance of automated external defibrillators in the USA: protocol for the dynamic automated external defibrillator registry study

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