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A goal to transform public access defibrillation to all access defibrillation

  • Brian Grunau
    Correspondence
    Corresponding author at: Department of Emergency Medicine, St. Paul’s Hospital, 1081 Burrard St., Vancouver BC V6Z 1Y6, Canada.
    Affiliations
    Department of Emergency Medicine and Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Canada

    British Columbia Emergency Health Services, Canada
    Search for articles by this author
  • Thomas Rea
    Affiliations
    Emergency Medical Services Division of Public Health - Seattle & King County, United States

    Department of Medicine, University of Washington, United States
    Search for articles by this author
      Out-of-hospital cardiac arrest (OHCA) carries a substantial health burden, with emergency medical services (EMS) attending to 111 cases per 100,000 population annually.
      • Virani S.S.
      • Alonso A.
      • Benjamin E.J.
      • et al.
      Heart disease and stroke statistics—2020 update: a report from the American Heart Association.
      Of EMS-treated cases, overall survival is approximately 10%.
      • Virani S.S.
      • Alonso A.
      • Benjamin E.J.
      • et al.
      Heart disease and stroke statistics—2020 update: a report from the American Heart Association.
      When OHCA is witnessed however, many present with an initial shockable rhythm for which prognosis can be substantially better, with the outcome being largely dependent on the interval from collapse to defibrillation.
      • Larsen M.P.
      • Eisenberg M.S.
      • Cummins R.O.
      • Hallstrom A.P.
      Predicting survival from out-of-hospital cardiac arrest: a graphic model.
      • Grunau B.
      • Guy A.
      • Kawano T.
      • et al.
      The association between no-flow interval and neurological outcomes in out-of-hospital cardiac arrest: implications for rescuer response, initiating resuscitation, and ECPR candidacy evaluation.
      • Adnet F.
      • Triba M.
      • Borron S.
      • et al.
      Cardiopulmonary resuscitation duration and survival in out-of-hospital cardiac arrest patients.
      Upwards of three quarters may survive if the initial defibrillation occurs within a few minutes of collapse. After the first few minutes, the chances of survival decline by approximately 5–10% per minute that defibrillation is delayed, depending in part on the provision of early CPR which can slow the ischemic insult of cardiovascular collapse.
      • Larsen M.P.
      • Eisenberg M.S.
      • Cummins R.O.
      • Hallstrom A.P.
      Predicting survival from out-of-hospital cardiac arrest: a graphic model.
      • Grunau B.
      • Guy A.
      • Kawano T.
      • et al.
      The association between no-flow interval and neurological outcomes in out-of-hospital cardiac arrest: implications for rescuer response, initiating resuscitation, and ECPR candidacy evaluation.
      • Adnet F.
      • Triba M.
      • Borron S.
      • et al.
      Cardiopulmonary resuscitation duration and survival in out-of-hospital cardiac arrest patients.
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