Bystander automated external defibrillator application in non-shockable out-of-hospital cardiac arrest.
Resuscitation
; 137: 168-174, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30790694
ABSTRACT
BACKGROUND:
An increasing proportion of patients with OHCA present with non-shockable rhythms, among whom the benefit from AED application is not known.METHODS:
We performed a retrospective analysis of adults with non-traumatic, public, bystander-witnessed, non-shockable OHCA occurring between 2005-2015 at 9 locations participating in the Resuscitation Outcomes Consortium. Non-shockable arrest was defined as when no shock was administered by a bystander applied AED and confirmed by the initial rhythm on EMS arrival. Outcomes were compared between patients with non-shockable OHCA in whom a bystander AED was or was not applied.RESULTS:
Among 2809 patients with non-shockable public, witnessed OHCA, 8.4% had an AED applied. CPR was more often performed in the AED-applied group (99% vs. 51% of patients, p < 0.001). Among patients in whom an AED was not applied, 39.8% had any pre-hospital ROSC, 29.6% had a pulse at ED arrival and 11.1% survived to hospital discharge compared to 44.1%, 29.6% and 9.7%, respectively with AED application. After adjustment for the Utstein variables excluding bystander CPR, the OR for survival to hospital discharge for AED application was 0.90 (95% CI0.57-1.42); when adjusted for the higher frequency of CPR in the AED group the OR was 0.92 (95% CI0.57-1.47).CONCLUSIONS:
The application of an AED in non-shockable public witnessed OHCA was associated with a higher frequency of bystander CPR. The probabilities of pre-hospital ROSC, pulse at ED arrival, and survival to hospital discharge were not altered by the application of an AED.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Efeito Espectador
/
Desfibriladores
/
Parada Cardíaca Extra-Hospitalar
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article