Alert system-supported lay defibrillation and basic life-support for cardiac arrest at home.
Eur Heart J
; 43(15): 1465-1474, 2022 04 14.
Article
en En
| MEDLINE
| ID: mdl-34791171
ABSTRACT
AIMS:
Automated external defibrillators (AEDs) are placed in public, but the majority of out-of-hospital cardiac arrests (OHCA) occur at home. METHODS ANDRESULTS:
In residential areas, 785 AEDs were placed and 5735 volunteer responders were recruited. For suspected OHCA, dispatchers activated nearby volunteer responders with text messages, directing two-thirds to an AED first and one-third directly to the patient. We analysed survival (primary outcome) and neurologically favourable survival to discharge, time to first defibrillation shock, and cardiopulmonary resuscitation (CPR) before Emergency Medical Service (EMS) arrival of patients in residences found with ventricular fibrillation (VF), before and after introduction of this text-message alert system. Survival from OHCAs in residences increased from 26% to 39% {adjusted relative risk (RR) 1.5 [95% confidence interval (CI) 1.03-2.0]}. RR for neurologically favourable survival was 1.4 (95% CI 0.99-2.0). No CPR before ambulance arrival decreased from 22% to 9% (RR 0.5, 95% CI 0.3-0.7). Text-message-responders with AED administered shocks to 16% of all patients in VF in residences, while defibrillation by EMS decreased from 73% to 39% in residences (P < 0.001). Defibrillation by first responders in residences increased from 22 to 40% (P < 0.001). Use of public AEDs in residences remained unchanged (6% and 5%) (P = 0.81). Time from emergency call to defibrillation decreased from median 11.7 to 9.3 min; mean difference -2.6 (95% CI -3.5 to -1.6).CONCLUSION:
Introducing volunteer responders directed to AEDs, dispatched by text-message was associated with significantly reduced time to first defibrillation, increased bystander CPR and increased overall survival for OHCA patients in residences found with VF.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Reanimación Cardiopulmonar
/
Servicios Médicos de Urgencia
/
Paro Cardíaco Extrahospitalario
Tipo de estudio:
Etiology_studies
Límite:
Humans
Idioma:
En
Revista:
Eur Heart J
Año:
2022
Tipo del documento:
Article
País de afiliación:
Países Bajos