Trends in survival from out-of-hospital cardiac arrests defibrillated by paramedics, first responders and bystanders

Nehme, Ziad; Andrew, Emily; Bernard, Stephen; Haskins, Brian; Smith, Karen

doi:10.1016/j.resuscitation.2019.08.018

Cited by 41 publications

(24 citation statements)

References 28 publications

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“…Although this ‘supermarket’ survival rate is based on a small sample, it is supported by our recently published research using Victorian Ambulance Cardiac Arrest Registry data from 2000–2017, which examined the survival rates for OHCAs when defibrillation was provided by paramedics, first responders or bystanders using a PAD . We found that when bystanders shocked the patient using a PAD, they had higher unadjusted rates of survival to hospital discharge compared to those shocked by paramedics, 55.5% versus 28.8%, respectively.…”

Section: Introductionmentioning

confidence: 78%

“…For patients in VF/VT, early defibrillation in the minutes directly after a cardiac arrest greatly increase their chances of survival . Early defibrillation is most effective when provided by a member of the public using a public access defibrillator (PAD) prior to the arrival of paramedics . This requires PADs to be readily available in multiple locations within our communities, as the probability of a PAD being used by a bystander decreases rapidly when it is located more than 100 m from a cardiac arrest .…”

Section: Introductionmentioning

confidence: 99%

“…We found that when bystanders shocked the patient using a PAD, they had higher unadjusted rates of survival to hospital discharge compared to those shocked by paramedics, 55.5% versus 28.8%, respectively. Furthermore, when adjusted for known confounders, patients initially shocked by a PAD were more than twice as likely to survive to hospital discharge compared to those shocked by paramedics (adjusted odds ratio [AOR] 2.11, 95% confidence interval [CI] 1.72–2.59; P < 0.001) . 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.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

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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.

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Section: Introductionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

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“…For the critical outcome of survival to hospital discharge, we identified moderate-certainty evidence (downgraded for risk of bias) from 1 RCT 206 enrolling 235 OHCA patients showing improved survival with PAD compared with no PAD (RR, 2.0; 95% CI, 1.07–3.77) and low-certainty evidence (downgraded for risk of bias) from 16 observational studies enrolling 40 243 patients showing improved survival associated with PAD programs (OR, 3.24; 95% CI, 2.13–4.92). 195 , 196 , 197 , 198 , 201 , 207 , 208 , 209 , 210 , 211 , 212 , 213 , 215 , 216 , 217 …”

Section: Defibrillationmentioning

confidence: 99%

Adult Basic Life Support

Berg¹,

Soar²,

Andersen³

et al. 2020

Resuscitation

100

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This 2020 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science With Treatment Recommendations on basic life support summarizes evidence evaluations performed for 20 topics that were prioritized by the Basic Life Support Task Force of the International Liaison Committee on Resuscitation. The evidence reviews include 16 systematic reviews, 3 scoping reviews, and 1 evidence update. Per agreement within the International Liaison Committee on Resuscitation, new or revised treatment recommendations were only made after a systematic review. Systematic reviews were performed for the following topics: dispatch diagnosis of cardiac arrest, use of a firm surface for CPR, sequence for starting CPR (compressions-airway-breaths versus airway-breaths-compressions), CPR before calling for help, duration of CPR cycles, hand position during compressions, rhythm check timing, feedback for CPR quality, alternative techniques, public access automated external defibrillator programs, analysis of rhythm during chest compressions, CPR before defibrillation, removal of foreign-body airway obstruction, resuscitation care for suspected opioid-associated emergencies, drowning, and harm from CPR to victims not in cardiac arrest. The topics that resulted in the most extensive task force discussions included CPR during transport, CPR before calling for help, resuscitation care for suspected opioid-associated emergencies, feedback for CPR quality, and analysis of rhythm during chest compressions. After discussion of the scoping reviews and the evidence update, the task force prioritized several topics for new systematic reviews.

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“…Out-of-hospital cardiac arrest (OHCA) is a life-threatening event and intensive efforts have increased the number of patients that survive the initial event [1]. However, at the same time the rates of patients that can be discharged from hospital or the intensive care unit (ICU) with favorable neurological function, i.e.…”

Section: Introductionmentioning

confidence: 99%

Proteomics-based Multimarker Model Improves Neurofilament Light Chain for Predicting Neurological Outcome after Cardiac Arrest

Wurm

Arfsten

Muqaku

et al. 2020

Preprint

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Background: Out of hospital cardiac arrest (OHCA) is a life-threatening event. Continuous advances in management increased initial survival, but the rate of favorable neurological outcome remains low. We have previously shown the usefulness of proteomics to identify novel biomarkers to predict this outcome. Neurofilament light chain (NfL), a marker of axonal damage, has since emerged as a promising single marker. The aim of this study was thus to assess the predictive value of NfL and compare it to our established model.Methods: NfL was measured in plasma samples from OHCA drawn at 48 hours after the event using single molecule assays. Neurological function at discharge from ICU was recorded on the cerebral performance category (CPC) scale. Predictive ability was assessed for NfL and compared to an established multimarker model.Results: Seventy patients were included into this analysis, of whom 21 (30%) showed a favorable outcome (CPC 1-2) compared to 49 (70%) with an unfavorable outcome (CPC 3 - 5). NfL increased from CPC 1 to 5 (16.5 pg/ml to 641 pg/ml, p<0.001). NfL alone performed moderately well with an area under the ROC (AUROC) of 79.4%. Prediction was significantly improved by combination of NfL with the established best performing model (F = 6.83, p = 0.01) with an AUROC to 89.7% (p for comparison = 0.017).Conclusion:The combination of NfL with other plasma and clinical markers is superior to that of either model alone and achieves a very good AUROC in this relatively small sample. Trial registration: ClinicalTrials.gov NCT01960699. Registered 08 October 2013.

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Trends in survival from out-of-hospital cardiac arrests defibrillated by paramedics, first responders and bystanders

Cited by 41 publications

References 28 publications

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

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

Adult Basic Life Support

Proteomics-based Multimarker Model Improves Neurofilament Light Chain for Predicting Neurological Outcome after Cardiac Arrest

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