Automated External Defibrillator and Emergency Action Plan Preparedness Amongst Masters Athletes

Objectives: Sudden cardiac arrest/death (SCA/D) is the leading medical cause of death in athletes. Masters athletes (≥35 years old) are increasing in numbers and are responsible for the vast majority of sport-related SCDs. Automated external defibrillators (AEDs) and emergency action plans (EAPs) have been shown to unequivocally reduce SCD, however, their prevalence in masters athletics remains unknown. We sought to identify the perceived AED accessibility and EAP preparedness amongst a group of masters athletes.

Results: Sixty-eight percent of 735 athletes completed the survey. Ninety-seven percent and 99% of athletes believed CPR and AEDs were effective at saving lives, respectively.  Conclusions: These findings indicate that nearly all athletes believe CPR and AED are effective at saving lives, but only a minority are aware of an AED near their place of exercise. Master athletes underestimate their own risk for exercise-related cardiac events, affirming the importance of educating masters athletes on their increased cardiac risk.

https://pubmed.ncbi.nlm.nih.gov/35088628/

Proper Defibrillator Maintenance To Ensure Maximum Efficiency

Maintenance is essential: it is not enough to buy a defibrillator and place it in position to be sure that it is working properly when it needs to be used, especially years later with two standards that describe the obligation of defibrillator maintenance by purchasers.  An operator’s electronic check allows for specific and detailed testing of the AED including electrodes check

Derry-based cycle group given life-saving ‘rescue rucksack’ thanks to local business

A Derry-based community cycle group in Northern Ireland is now benefitting from a brand new ‘rescue rucksack’ defibrillator’ thanks to the generosity of a local business. The Bogside and Brandywell Health Forum’s (BBHF) cycle group, which runs every Saturday, was enabled to buy life-saving equipment through a grant funded by Power NI. 

The community-based health forum offers a holistic approach to health and wellbeing in the community, schools and in workplaces. “Our cycling sessions cater for all abilities and participants and are led by two facilitators at each outing. We wanted to secure a defibrillator that could be carried by a leader on his or her back during their cycle journeys”

https://www.belfastlive.co.uk/news/northern-ireland/derry-based-cycle-group-given-22811693

Survival Improving in Sports-Related Sudden Cardiac Arrest

The survival rate following a sports-related cardiac arrest (SrSCA) almost tripled over a recent 12-year period, due in large part to increased bystander use of automated external defibrillators (AEDs) and cardiopulmonary resuscitation (CPR), results of a new study from France suggest.

In an analysis of hospital data published in the Journal of the American College of Cardiology, researchers found that more frequent basic life support implementation by bystanders, including a threefold increase in the rate of bystander CPR and an 18-fold increase in the rate of automated external defibrillator use, account for the improved outcome, with a survival rate at hospital discharge reaching 67% during the last 2-year study period.

https://www.jacc.org/doi/10.1016/j.jacc.2021.11.012

Utilization and cost-effectiveness of school and community center AED deployment models in Canadian cities

The optimal locations and cost-effectiveness of placing automated external defibrillators(AEDs) for out-of-hospital cardiac arrest(OHCAs) in urban residential neighbourhoods are unclear. We used prospectively collected data from 2016 to 2018 from the British Columbia OHCA Registry to examine the utilization and cost-effectiveness of hypothetical AED deployment in municipalities with a population of over 100 000.  The estimated radius of effectiveness around each AED was 625 m for automobile and 240m for pedestrian retrieval.

With AEDs placed outside each school and community center, 2567(64%) and 605(15%) of OHCAs fell within the radii of effectiveness for automobile and pedestrian retrieval, respectively. For each AED, there was an average of 1.20-2.66 and 0.25-0.61 in-range OHCAs per year for automobile retrieval and pedestrian retrieval, respectively, depending on the deployment model. All of our proposed surpassed the cost-effectiveness threshold of 0.125 OHCA/AED/year provided >5.3-11.6% in-range AEDs were brought-to-scene.

Conclusions: The systematic deployment of AEDs at schools and community centers in urban neighbourhoods may result in increased application and be a cost-effective public health intervention.

https://pubmed.ncbi.nlm.nih.gov/35031391/

Improved ROSC rates in out-of-hospital cardiac arrest patients after introduction of a text message alert system for trained volunteers

Objective: To evaluate whether a text message (TM) alert system for trained volunteers contributed to early cardiopulmonary resuscitation, the use of automated external defibrillators (AEDs), return of spontaneous circulation (ROSC) and survival in out-of-hospital cardiac arrest (OHCA) patients in a region with above-average survival rates. Design: Data on all OHCA patients in 2012 (non-TM group) were compared with those of all OHCA patients in 2018 (TM group). The association of the presence of a TM alert system with ROSC and survival was assessed with multivariate regression analyses.

TM responders reached 42 OHCA patients (15.9%) earlier than the first responders or ambulance. They connected 31 of these 42 OHCA patients (73.8%) to an AED before the ambulance arrived, leading to a higher percentage of AEDs being attached in 2018 compared to the 2012 non-TM group (55% vs 46%, p = 0.03). 

ROSC was achieved more often in the TM group (61.0% vs 29.4%, p < 0.01).  Conclusion: A TM alert system seems to improve the chain of survival; because TM responders reached patients early, AEDs were attached more often and more OHCA patients achieved ROSC.

https://pubmed.ncbi.nlm.nih.gov/34993887/

 

Drone delivers life-saving defibrillator

An autonomous drone helped save the life of a man who suffered an out-of-hospital cardiac arrest in Sweden, it emerged this week. The 71 year-old man was shovelling snow in his driveway in the Swedish city of Trollhättan on the morning of December 9, 2021 when the incident happened. The time from when the alarm was raised until the defibrillator was safely delivered at the doorstep of the incident address was just over three minutes. The drone is a partnership between the Karolinska Institutet – Sweden’s largest medical university – together with the national emergency operator SOS Alarm, Region Vastra Gotaland and Everdrone. “This is an excellent real-world example of how Everdrone’s cutting-edge drone technology, fully integrated with emergency dispatch, can minimise the time for access to life-saving AED equipment”, said Mats Sällström, CEO of Everdrone.

https://www.euronews.com/next/2022/01/09/tech-this-week-drone-delivers-life-saving-defibrillator-and-bmw-unveils-colour-changing-ca

Responding to Cardiac Arrest in the Community in the Digital Age

Sudden cardiac arrest (SCA) is a common event, affecting almost 400,000 individuals annually in North America. Initiation of cardiopulmonary resuscitation (CPR) and early defibrillation using an automated external defibrillator (AED) are critical for survival, yet many bystanders are reluctant to intervene. Digital technologies, including mobile devices, social media and crowdsourcing may help play a role to improve survival from SCA. In this article we review the current digital tools and strategies available to increase rates of bystander recognition of SCA, prompt immediate activation of Emergency Medical Services (EMS), initiate high quality CPR and to locate, retrieve and operate AEDs.

Smartphones can help to both educate and connect bystanders with EMS dispatchers, through text messaging or video-calling, to encourage the initiation of CPR and retrieval of the closest AED. Wearable devices and household smartspeakers could play a future role in continuous vital signs monitoring in individuals at-risk of lethal arrhythmias and send an alert to either chosen contacts or EMS. Machine learning algorithms and mathematical modeling may aid EMS dispatchers with better recognition of SCA as well as policymakers with where to best place AEDs for optimal accessibility. There are challenges with the use of digital tech, including the need for government regulation and issues with data ownership, accessibility and interoperability.

Future research will include smart cities, e-linkages, new technologies and using social media for mass education. Together or in combination, these emerging digital technologies may represent the next leap forward in SCA survival.

https://pubmed.ncbi.nlm.nih.gov/34954009/

Gender and location disparities in prehospital bystander AED usage

With bystander AED usage being critical for prehospital cardiac arrest patient outcomes, it is important to analyze if the gender and location disparities found in bystander CPR rates also exist for bystander AED usage. Using the National Emergency Medical Services Information System (NEMSIS) database, 1,144,969 bystander AED cases were analyzed on the basis of gender and location and measured using relative risk (RR). Using female patients as a baseline, the RR for bystander AED usage for male patients was 1.34 (95% CI [1.3310, 1.3557], p < 0.001) indicating male patients are 34% more likely to receive bystander AED usage compared to female patients. Analyzing bystander AED showed  a sharp decline in the chance of bystander AED usage in rural and frontier areas.

Conclusions: Female patients are less likely to receive bystander AED usage compared to male patients and improvements in rural and frontier AED availability and training are necessary to increase bystander AED usage rates in those regions.

https://www.sciencedirect.com/science/article/abs/pii/S0300957220305566

Masters Age Football And Cardiovascular Risk (MAFACARI)

Background: Football (soccer) is popular among those of Masters age (≥35 years). Although regular exercise improves health, strenuous exercise causes a transient increase in cardiac risk. Aim: The aim of this survey of Masters Age Footballers was to gain insight into cardiac risk factors, symptoms, and knowledge, attitudes and beliefs about myocardial infarction (MI), and support for prevention.

Methods: A web-based survey using REDCap was completed by 153 amateur Masters footballers from A grade competition (n=24), B or lower grade (n=95) or social games (n=34) in Sydney, Australia.

Results: Participants were aged 49.3±7.5 years and primarily male (92.2%), Caucasian (88.9%) and university educated (75.2%). Risk factors included hypercholesterolaemia (37.3%), hypertension (19.6%), smoker (7.8%), overweight (40.5%) or obese (13.1%). One fifth (21.6%) reported ≥1 potential cardiac symptom during activity in the prior year, for which one quarter (24.2%) sought medical attention. Knowledge of typical MI symptoms was high (>80%) but lower (<40%) for less typical symptoms. Half (49.6%) were unconfident to recognise MI in themselves. Half (49.0%) would remain on the field for 5-10 minutes with chest pain. Only 39.9% were aware that warning signs may precede MI by days. They overestimated survival from cardiac arrest (43%). Participants supported training in automatic external defibrillators (AED) and CPR (84%), AEDs at games (85%) and cardiac education (>70%). 

Conclusions: Cardiac risk factors are common In Masters footballers, with one in five experiencing possible cardiac symptoms in the prior year. While gaps exist in knowledge and optimal responses, strong support exists for preventive measures.

https://pubmed.ncbi.nlm.nih.gov/34894042/