Analysis of the Way and Correctness of Using Automated External Defibrillators Placed in Public Space in Polish Cities-Continuation of Research.

Immediate resuscitation is required for any sudden cardiac arrest. To improve the survival of the patient, a device to be operated by witnesses of the event-automated external defibrillator (AED)-has been produced. The aim of this study is to analyze the way and correctness of use of automated external defibrillators placed in public spaces in Polish cities. The data analyzed (using Excel 2019 and R 3.5.3 software) are 120 cases of use of automated external defibrillators, placed in public spaces in the territory of Poland in 2008-2018. The predominant location of AED use is in public transportation facilities, and the injured party is the traveler. AED use in non-hospital settings is more common in male victims aged 50-60 years. Owners of AEDs inadequately provide information about their use. The documentation that forms the basis of the emergency medical services intervention needs to be refined. There is no mention of resuscitation performed by a witness of an event or of the use of an AED. In addition, Poland lacks the legal basis for maintaining a register of automated external defibrillators. There is a need to develop appropriate documents to determine the process of reporting by the owners of the use of AEDs in out-of-hospital conditions (OHCA).

Transfer of essential AED information to treating hospital (TREAT).

BACKGROUND: Defibrillation in out-of-hospital cardiac arrest (OHCA) is increasingly performed by using an Automated External Defibrillator (AED). Therefore presence of a shockable rhythm is recurrently only documented by the AED. However, AED-information is rarely available to the treating physician. PURPOSE: To determine (1) how often a shockable rhythm was recorded only in the AED; (2) if so, how often information that a shockable rhythm had been present reached the physician. METHODS: Data on OHCA patients with (presumed) cardiac cause with an AED connected in the years 2012-2014 (Study period 1) and 2016 (Study period 2) in the Amsterdam Resuscitation Study (ARREST) database were collected. We determined how often only the AED had defibrillated. In these patients, we retrospectively analyzed EMS run sheets and hospital discharge letters to determine if a shockable rhythm and/or AED use was correctly noted. In Study period 2, we prospectively contacted the physicians to study whether AED defibrillation was known. RESULTS: In Study period 1, of 2840 OHCA CPR attempts with (presumed) cardiac cause, 1521 (54%) patients had a shockable rhythm, with 356 patients (13%) receiving AED defibrillation only. Of these patients, 11 hospital discharge letters (4%) contained no information about a shockable rhythm. In Study period 2, 125/1128 patients (11%) received AED defibrillation only; of these, in two cases the shockable rhythm was unknown by the physician. CONCLUSION: In 11-13% of OHCAs, a shockable rhythm is only seen on the AED-ECG. Adequate transfer to the physician of vital AED-information is essential but not always accomplished.