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Increasing automated external defibrillator (AED) survival rates
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Poster Presentations / Resuscitation 84S (2013) S8–S98 S19 AP029 Activation time while using stand-alone feedback devices during cardiopulmonary resuscitation: A randomised simulation study Florian Schachinger 1,∗ , Julian Voittl 1 , Paul Bsuchner 1 , Dominik Stumpf 2 , Bernhard Zapletal 3 , Robert Greif 4 , Franz-Josef Nierscher 5 , Sophie Frantal 6 , Henrik Fischer 5 1 Medical University Vienna, Vienna, Austria 2 Hospital of the Sisters of Charity Linz, Linz, Austria 3 Department of Anaesthesia, General Intensive Care and Pain Medicine, Medical University Vienna, Vienna, Austria 4 University Department of Anaesthesiology and Pain Medicine, Bern University Hospital and University of Bern, Bern, Switzerland 5 Department of Anaesthesia, General Intensive Care and Pain Medicine, Division of Cardiothoracic and Vascular Anaesthesia and Intensive Care, Vienna, Austria 6 Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria Purpose of the study: Basic Life Support (BLS) is an effective method to maintain minimal coronary blood flow after cardiac arrest, but it is often insufficient due to rescuers’ declining per- formance over time. Resuscitation quality reporting audio-visual feedback devices may prevent this decline and probably improve outcome. The study aimed to investigate the time needed to acti- vate the device during BLS and was part of a research project on feedback devices. Materials and methods: In this open, prospective RCT we compared three stand-alone CPR feedback devices (PocketCPR ® , CPRmeter ® , iPhone app PocketCPR ® ) with standard BLS without audio-visual feedback in a simulated single rescuer situation. Two hundred and forty BLS trained medical students were randomised into 4 groups and performed BLS on a manikin (Ambu ® ManC) for 8 min. The activation time until the first chest compression was recorded. Results: Study participants using PocketCPR ® needed 16 ± 14 s from device activation until first chest compression compared to 8 ± 8 with CPRmeter ® , 11 ± 13 with the iPhone app PocketCPR ® and 2 ± 3 performing standard BLS (PocketCPR ® vs. CPRMeter ® p < 0.001, PocketCPR ® vs. iPhone app p = 0.03, PocketCPR ® vs. standard BLS p < 0.001, CPRMeter ® vs. standard BLS p = 0.015, iPhone app vs. standard BLS p < 0.001, others not significant). Conclusion: Although the time users needed to activate the devices seems to be short, we have evidence that even a few seconds in the delay of proper treatment in a cardiac arrest situation signifi- cantly reduces the chances of survival. 1, 2 The significant differences in activation time indicate the possibility that device improvement could minimise a delay of potentially lifesaving therapy. References 1. Chan PS, Krumholz HM, Nichol G, Nallamothu BK. Delayed time to defibrillation after in-hospital cardiac arrest. N Engl J Med 2008;358:9–17. 2. Cheskes S, Schmicker RH, Christenson J, et al. Perishock pause: an independent predictor of survival from out-of-hospital shockable cardiac arrest. Circulation 2011;124:58–66. http://dx.doi.org/10.1016/j.resuscitation.2013.08.061 AP030 Increasing automated external defibrillator (AED) survival rates Caleb Brown David Lloyd Leisure, Hertfordshire, UK AEDs were introduced to the Health & Fitness chain in 1998; survival rates from out of hospital cardiac arrest (OHCA) to hospital discharge were good; ranging year-on-year from 56% to 72%. With a desire to increase survival rates a review of AED training was conducted in 2010. The review focused on the business AED policy, training and 21 AED usage events, which occurred in the previous two years. Dur- ing the review it was established that the AED incident response was excellent with the AED arriving on the scene of the majority of incidents within thirty seconds. Although achieving high sur- vival rates it was felt that the training programme lacked direct focus on the core survival outcome drivers. A high percentage of training time was spent on topics that, although informative, were not relied upon by rescuers in real events and did not influence potential survival outcomes. As a result of the review a new AED training programme was instigated purely based on the guidance expressed by the Resusci- tation Council UK and the European Resuscitation Council. A target of having the AED electrodes placed on the victim’s chest within 1 min of collapse was set. The programme was launched in January 2011 with 100 trainers and 1750 team members, all non medical lay rescuers, being trained and updated in the new programme. Following the instigation of the updated AED training pro- gramme survival rates from OHCA to hospital discharge increased substantially to over 80%; during this period lay rescuers responded to 21 incidents and saved 17 lives. Survival rates peaked at 88% in 2012 with 7 lives being saved. The programme demonstrates that lay rescuers can achieve very high OHCA survival rates by having a fixed AED policy in place and a clear and focused training programme. http://dx.doi.org/10.1016/j.resuscitation.2013.08.062 AP031 Training the public in basic life support—Are we making progress? Edward Caruana ∗ , Sarah Micallef, Michelle M. Boffa, Gillian Pace-Moore, Giuliana Torpiano, Gianluca Maresca, Janice Borg, Gregory Apap-Bologna University of Malta, Tal-Qroqq, Malta Purpose: Prompt and appropriate bystander intervention decreases morbidity and mortality in out of hospital cardiac arrest. This study assesses the relevant knowledge amongst the lay public in Malta, looking also at the impact of previous formal training. Methods: Volunteers, recruited according to a probability quota sample, submitted to a structured interview detailing demograph- ics and knowledge relevant to the care of the unresponsive patient. Individual chi-squared tests were performed to relate knowledge to expected influences. Results: 656 individuals (49% male) were interviewed; 35% (n = 229) of whom had previously received formal training in BLS: 13% within three years, and 22% more than three years prior. 9% (n = 58) and 27% (n = 179) would respectively assess for safety and responsiveness in their initial approach; with this being more com- monly reported by those trained within three years (19% and 48%
Transcript of Increasing automated external defibrillator (AED) survival rates
Poster Presentations / Resuscitation 84S (2013) S8–S98 S19
AP029
Activation time while using stand-alonefeedback devices during cardiopulmonaryresuscitation: A randomised simulation study
Florian Schachinger 1,∗, Julian Voittl 1, PaulBsuchner 1, Dominik Stumpf 2, BernhardZapletal 3, Robert Greif 4, Franz-Josef Nierscher 5,Sophie Frantal 6, Henrik Fischer 5
1 Medical University Vienna, Vienna, Austria2 Hospital of the Sisters of Charity Linz, Linz, Austria3 Department of Anaesthesia, General Intensive Careand Pain Medicine, Medical University Vienna,Vienna, Austria4 University Department of Anaesthesiology and PainMedicine, Bern University Hospital and University ofBern, Bern, Switzerland5 Department of Anaesthesia, General Intensive Careand Pain Medicine, Division of Cardiothoracic andVascular Anaesthesia and Intensive Care, Vienna,Austria6 Centre for Medical Statistics, Informatics andIntelligent Systems, Medical University Vienna,Vienna, Austria
Purpose of the study: Basic Life Support (BLS) is an effectivemethod to maintain minimal coronary blood flow after cardiacarrest, but it is often insufficient due to rescuers’ declining per-formance over time. Resuscitation quality reporting audio-visualfeedback devices may prevent this decline and probably improveoutcome. The study aimed to investigate the time needed to acti-vate the device during BLS and was part of a research project onfeedback devices.
Materials and methods: In this open, prospective RCT wecompared three stand-alone CPR feedback devices (PocketCPR®,CPRmeter®, iPhone app PocketCPR®) with standard BLS withoutaudio-visual feedback in a simulated single rescuer situation. Twohundred and forty BLS trained medical students were randomisedinto 4 groups and performed BLS on a manikin (Ambu®ManC) for8 min. The activation time until the first chest compression wasrecorded.
Results: Study participants using PocketCPR® needed 16 ± 14 sfrom device activation until first chest compression compared to8 ± 8 with CPRmeter®, 11 ± 13 with the iPhone app PocketCPR®
and 2 ± 3 performing standard BLS (PocketCPR® vs. CPRMeter®
p < 0.001, PocketCPR® vs. iPhone app p = 0.03, PocketCPR® vs.standard BLS p < 0.001, CPRMeter® vs. standard BLS p = 0.015,iPhone app vs. standard BLS p < 0.001, others not significant).
Conclusion: Although the time users needed to activate thedevices seems to be short, we have evidence that even a few secondsin the delay of proper treatment in a cardiac arrest situation signifi-cantly reduces the chances of survival.1,2 The significant differencesin activation time indicate the possibility that device improvementcould minimise a delay of potentially lifesaving therapy.
References
1. Chan PS, Krumholz HM, Nichol G, Nallamothu BK. Delayed time to defibrillationafter in-hospital cardiac arrest. N Engl J Med 2008;358:9–17.
2. Cheskes S, Schmicker RH, Christenson J, et al. Perishock pause: an independentpredictor of survival from out-of-hospital shockable cardiac arrest. Circulation2011;124:58–66.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.061
AP030
Increasing automated external defibrillator(AED) survival rates
Caleb Brown
David Lloyd Leisure, Hertfordshire, UK
AEDs were introduced to the Health & Fitness chain in 1998;survival rates from out of hospital cardiac arrest (OHCA) to hospitaldischarge were good; ranging year-on-year from 56% to 72%. Witha desire to increase survival rates a review of AED training wasconducted in 2010.
The review focused on the business AED policy, training and 21AED usage events, which occurred in the previous two years. Dur-ing the review it was established that the AED incident responsewas excellent with the AED arriving on the scene of the majorityof incidents within thirty seconds. Although achieving high sur-vival rates it was felt that the training programme lacked directfocus on the core survival outcome drivers. A high percentage oftraining time was spent on topics that, although informative, werenot relied upon by rescuers in real events and did not influencepotential survival outcomes.
As a result of the review a new AED training programme wasinstigated purely based on the guidance expressed by the Resusci-tation Council UK and the European Resuscitation Council. A targetof having the AED electrodes placed on the victim’s chest within1 min of collapse was set. The programme was launched in January2011 with 100 trainers and 1750 team members, all non medicallay rescuers, being trained and updated in the new programme.
Following the instigation of the updated AED training pro-gramme survival rates from OHCA to hospital discharge increasedsubstantially to over 80%; during this period lay rescuers respondedto 21 incidents and saved 17 lives. Survival rates peaked at 88% in2012 with 7 lives being saved.
The programme demonstrates that lay rescuers can achieve veryhigh OHCA survival rates by having a fixed AED policy in place anda clear and focused training programme.
http://dx.doi.org/10.1016/j.resuscitation.2013.08.062
AP031
Training the public in basic life support—Are wemaking progress?
Edward Caruana ∗, Sarah Micallef, Michelle M.Boffa, Gillian Pace-Moore, Giuliana Torpiano,Gianluca Maresca, Janice Borg, GregoryApap-Bologna
University of Malta, Tal-Qroqq, Malta
Purpose: Prompt and appropriate bystander interventiondecreases morbidity and mortality in out of hospital cardiac arrest.This study assesses the relevant knowledge amongst the lay publicin Malta, looking also at the impact of previous formal training.
Methods: Volunteers, recruited according to a probability quotasample, submitted to a structured interview detailing demograph-ics and knowledge relevant to the care of the unresponsive patient.Individual chi-squared tests were performed to relate knowledgeto expected influences.
Results: 656 individuals (49% male) were interviewed; 35%(n = 229) of whom had previously received formal training in BLS:13% within three years, and 22% more than three years prior. 9%(n = 58) and 27% (n = 179) would respectively assess for safety andresponsiveness in their initial approach; with this being more com-monly reported by those trained within three years (19% and 48%
