Abstract
Background
In Stockholm, a first responder system and a Public Access Defibrillation (PAD) program
has been implemented. Additionally, the number of “unregulated” public Automated External
Defibrillators (AEDs) sold “over-the-counter” has increased. The aim of this study
was to evaluate the impact on survival from different defibrillation strategies in
cases of out-of-hospital cardiac arrest (OHCA) available for PAD.
Methods and Results
Design: Retrospective study of all OHCAs in Stockholm, 2006–2012. Witnessed OHCAs
occurring outside home with cardiac origin and ventricular fibrillation were considered
subjects for PAD. The sites within the PAD program increased from 60 to 135 while
the number of unregulated AEDs outside the PAD program increased from 178 to 5016.
Of 6532 OHCAs, 7% (n = 474) were defined as subjects for PAD. Of these, 69% (n = 326) were defibrillated by the EMS, 11% (n = 53) by first responders and 16% (n = 74) by public AEDs. Survival to one month was 31% (n = 101) for cases defibrillated by the EMS, 42% (n = 22) when defibrillated by first responders and 70% (n = 52) when defibrillated by a public AED. The AEDs within the PAD program constituted
2.6% of all public AEDs and were used in 28% (n = 21) of cases when a public AED was used.
Conclusions
In OHCAs available for PAD, 70% of patients survived if a public AED was used. Both
the structured AED program as well as the spread of unregulated AEDs was associated
with very high survival rates, but the structured approach was more efficient in relation
to the number of AEDs used.
Keywords
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References
- Meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. AVID, CASH and CIDS studies. Antiarrhythmics vs implantable defibrillator study. Cardiac arrest study Hamburg. Canadian implantable defibrillator study.Eur Heart J. 2000; 21: 2071-2078
- Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos.N Engl J Med. 2000; 343: 1206-1209
- Characteristics and outcome among patients suffering from out of hospital cardiac arrest of non-cardiac aetiology.Resuscitation. 2003; 57: 33-41
- Survival models for out-of-hospital cardiopulmonary resuscitation from the perspectives of the bystander, the first responder, and the paramedic.Resuscitation. 2001; 51: 113-122
- Difference in survival after out-of-hospital cardiac arrest between the two largest cities in Sweden: a matter of time?.J Intern Med. 2005; 257: 247-254
- Police AED programs: a systematic review and meta-analysis.Resuscitation. 2013; 84: 1184-1191
- Impact of community-wide police car deployment of automated external defibrillators on survival from out-of-hospital cardiac arrest.Circulation. 2002; 106: 1058-1064
- Public access defibrillation.Curr Opin Crit Care. 2008; 14: 275-278
- Nationwide public-access defibrillation in Japan.N Engl J Med. 2010; 362: 994-1004
- Location of cardiac arrest in a city center: strategic placement of automated external defibrillators in public locations.Circulation. 2009; 120: 510-517
- Results from Austria's nationwide public access defibrillation (ANPAD) programme collected over 2 years.Resuscitation. 2008; 77: 195-200
- Dual dispatch early defibrillation in out-of-hospital cardiac arrest: the SALSA-pilot.Eur Heart J. 2009; 30: 1781-1789
- The implementation of a dual dispatch system in out-of-hospital cardiac arrest is associated with improved short and long term survival.Eur Heart J Acute Cardiovasc Care. 2014; 3: 293-303
Statistics Sweden. http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0101__BE0101A/FolkmangdNov/?rxid=a06f8566-441b-4254-9d76-c09bc5052536 [Internet]. Population statistics. Available from: http://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0101__BE0101A/FolkmangdNov/?rxid=a06f8566-441b-4254-9d76-c09bc5052536 [cited 12.12.14].
- Public locations of cardiac arrest implications for public access defibrillation.Circulation. 1998; 97: 2106-2109
- Recommended guidelines for reviewing, reporting, and conducting research on post-resuscitation care: the Utstein style.Resuscitation. 2005; 66: 271-283
- Out of hospital cardiac arrest outside home in Sweden, change in characteristics, outcome and availability for public access defibrillation.Scand J Trauma Resusc Emerg Med. 2009; 17: 18
- Validity of reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden.Resuscitation. 2013; 84: 952-956
- Public use of automated external defibrillators.N Engl J Med. 2002; 347: 1242-1247
- Use and benefits of public access defibrillation in a nation-wide network.Resuscitation. 2013; 84: 430-434
- Trends in treated ventricular fibrillation out-of-hospital cardiac arrest: a 17-year population-based study.Heart Rhythm Off J Heart Rhythm Soc. 2004; 1: 255-259
Herlitz J. http://HLR-registret-årsrapport-2014-sammanfattning-.pdf [Internet]; 2014. Available from: http://hlr.nu/wp-content/uploads/HLR-registret-%C3%A5rsrapport-2014-sammanfattning-.pdf [cited 12.12.14].
- Mobile phone technology identifies and recruits trained citizens to perform CPR on out-of-hospital cardiac arrest victims prior to ambulance arrival.Resuscitation. 2011; 82: 1514-1518
- Home use of automated external defibrillators for sudden cardiac arrest.N Engl J Med. 2008; 358: 1793-1804
Article info
Publication history
Published online: March 11, 2015
Accepted:
February 25,
2015
Received in revised form:
February 10,
2015
Received:
October 9,
2014
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2015.02.032.
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
