Category: News

Out-of-hospital sudden cardiac arrest (OHCA) is a major public health issue, with a survival rate at hospital discharge that remains below 10% in most cities, despite huge investments in this domain. Early basic life support (BLS) and early defibrillation using automated external defibrillators (AEDs) stand as key elements for improving OHCA survival rate. Nevertheless, the use of AEDs in OHCA remains low, for a variety of reasons, including the number, accessibility and ease of locating AEDs, as well as bystanders’ awareness of BLS maneuvers and of the need to use AEDs. Several measures have been proposed to improve the rate of AED use, including optimization of AED deployment strategies as well as the use of drones to bring the AEDs to the OHCA scene and of mobile applications to locate the nearest AED. If they are to be effective, these measures should be combined with large communication campaigns on OHCA, and wide-scale education of the public in BLS and AEDs, to reduce the burden of OHCA.

Full article;

Automated external defibrillator use in out-of-hospital cardiac arrest: Current limitations and solutions – PubMed

Maternal health includes health during pregnancy and childbirth. Each stage during pregnancy should be a positive experience, ensuring that women and their babies reach their full potential in health and well-being. However, this cannot always be achieved. According to UNFPA (United Nations Population Fund), approximately 800 women die every day from avoidable causes related to pregnancy and childbirth, so it is important to monitor mother and fetal health throughout the pregnancy. Many wearable sensors and devices have been developed to monitor both fetal and the mother’s health and physical activities and reduce risk during pregnancy. Some wearables monitor fetal ECG or heart rate and movement, while others focus on the mother’s health and physical activities. This study presents a systematic review of these analyses. Twelve scientific articles were reviewed to address three research questions oriented to (1) sensors and method of data acquisition; (2) processing methods of the acquired data; and (3) detection of the activities or movements of the fetus or the mother. Based on these findings, we discuss how sensors can help effectively monitor maternal and fetal health during pregnancy. We have observed that most of the wearable sensors were used in a controlled environment. These sensors need more testing in free-living conditions and to be employed for continuous monitoring before being recommended for mass implementation.

«Analysis of survival at cardiac arrest in events occurred in work environments in the territory served by an operations center of the 118 of Tuscany».

Background:: The global incidence of cardiac arrest is nearly one person in 1,000 per year, a rate which also applies to Italy; a great deal of these events is likely to strike people outside their homes. Objectives: To analyze a cohort of cardiac arrest events occurred in various public spaces and workplaces across an area under the responsibility of an Emergency Unit related to the national emergency number (118) and to assess the efficacy of first-aid intervention and the usage of a defibrillator while handling an acute cardiac event.

Methods:: We analyzed data of 32 sanitary interventions on cardiac arrest events occurred from January 2015 to June 2018 across USL Toscana Centro – Pistoia and Empoli’s jurisdiction. The survival rate to hospital admission has been analysed according to the following parameters: the availability of an AED at the place, the CPR maneuvers performed or not by personnel present at the site and the time of intervention of the sanitary rescuers.

Results:: Twenty-eight point two % of acute cardiac event occurred in a workplace setting, 18.7% during work activity. An AED was present for immediate cardiac arrest treatment in 15.6% of cases with a survival rate of 100% (n=5/5) (p=0.04); in 84.4% of cases the AED was available only after the arrival of national emergency rescuers and the survival rate was 40.74% (n=11/27). The survival rate appears to be higher (55.5% Vs 42.8%) when cardiopulmonary resuscitation was started by witnesses at the event.

Conclusions:: The results of this study suggest that early defibrillation provided by work-related First Aid Emergency Procedure may be a primary aid and a desirable standard to improve both workers’ and private citizens’ survival rate after cardiac arrest.

Cardiovascular diseases and cardiac arrest (CA) are the main causes of death worldwide. This review aims to identify publications on the learning outcomes for the use of an automated external defibrillator (AED) and/or cardiopulmonary resuscitation (CPR) to train laypeople (LP), the method of training used, the year of publication and their recommendations. We employed Miller’s assessment pyramid to describe learning outcomes as knowledge, skills, and confidence. The methods of training are face-to-face, online, and mixed. The evidence found in this study will be used to support the development and validation of a simulation-based training program to teach LP to operate AEDs delivered by drones in rural and remote (R&R) locations. This article is an integrative literature review with a quantitative and qualitative research design and is composed of seven steps: research question, inclusion and exclusion criteria, search and selection of studies, the role of a second reviewer of the findings, data analysis, interpretation and discussion of the results, and finally knowledge synthesis. The results of this review demonstrate that there are no significant differences in the learning outcomes of the different training methods. Since these findings suggest good results in all methods, the development of a training program based on face-to-face, online, and mixed, especially for places with few resources such as R&R places, indicates all methods can be used as good practices to develop training programs.

Sudden cardiac arrest (SCA) is the leading cause of exercise-related fatalities in athletes. A comprehensive emergency action plan (EAP) is critical to facilitate a rapid and effective response to a cardiac emergency. SCA should be suspected in any athlete that collapses suddenly and is unresponsive. All potential responders to a collapsed athlete should be trained in the recognition of SCA, cardiopulmonary resuscitation, and use of an automated external defibrillator (AED). AEDs should be accessible on-site at sporting venues with a target collapse to first shock interval of less than 3 min. Every school, club, and sporting organization that sponsors athletic activities should have a written EAP for SCA. An EAP coordinator should be designated to foster compliance with training, practice, and rehearsal of the EAP at least once annually. Some sports require special considerations for equipment removal or access to emergency services in geographically broad or water-based venues.

Children, adolescents, and young adults with conditions such as cardiomyopathies and channelopathies are at higher risk of sudden cardiac death caused by lethal arrhythmias, especially ventricular fibrillation. Timely defibrillation saves lives. Patients thought to be at significantly high risk of sudden death typically undergo placement of an implantable cardioverter-defibrillator. Patients thought to be at lower risk are typically followed medically but do not undergo implantable cardioverter-defibrillator placement. However, low risk does not equal no risk. Compared with the general population, many of these patients are at significantly higher risk for lethal arrhythmias. We make the case that such individuals and families will benefit from having an at-home automatic external defibrillator. Used in conjunction with conventional measures such as training on cardiopulmonary resuscitation, an at-home automatic external defibrillator could lead to significantly shortened time to defibrillation with better overall and neurological survival. We recommend that the cost of such home automatic external defibrillators should be covered by medical insurance.

Aim: To investigate out-of-hospital cardiac arrest (OHCA) trend, provided advanced life support (ALS) measures, automated external defibrillator (AEDs) utilization and bystanders’ involvement in cardiopulmonary resuscitation (CPR) during OHCA incidents.

Methods: This cross-sectional study encompassed data pertaining to all OHCA incidents attended to by the Emergency Medical Service of Canton Sarajevo, Bosnia and Herzegovina, covering the period from January 2018 to December 2022.

Results: Among a total of 1131 OHCA events, 236 (20.8 %) patients achieved return of spontaneous circulation (ROSC); there were 175 (74.1%) males and 61 (25.9%) females. The OHCA incidence was 54/100,000 inhabitants per year. After a 30-day period post-ROSC, 146 (61.9%) patients fully recovered, while 90 (38.1%) did not survive during this timeframe. Younger age (p<0.05), initial rhythm of ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT) (p<0.05), and faster emergency medical team (EMT) response time (p<0.05) were significantly associated with obtaining ROSC. Only 38 (3.3%) OHCA events were assisted by bystanders, who were mostly medical professionals, 25 (65.7%), followed by close family members, 13 (34.3%). There was no report of AED usage.

Conclusion: This follow-up study showed less ROSC achievement, similar bystanders’ involvement, similar factors associated with achieving ROSC (age, EMT response time), and a decline in OHCA events (especially in year 2021 and 2022) compared to our previous study (2015-2019). There was an extremely low rate of bystander engagement and no AEDs usage. Governments and health organizations must swiftly improve public awareness, promote better practice (basic life support), and actively encourage bystander participation.

Background: Out-of-hospital cardiac arrest is a public health crisis affecting about 356,000 adults and 23,000 children annually in the US with 90% fatality. Early bystander CPR and AED application improve survival. Less than 3% of the US population is CPR trained annually. Since 20% of the US population is at school daily, these represent ideal places to target CPR training. Having standardized state school CPR and AED laws will help with training.

Methods: We performed a systemic search of the state-specific laws for school AED and CPR requirements within the US. We used PubMed and Google search using keywords: school CPR mandates, US laws for CPR in schools, US state laws for AED implementation, and gaps in US school CPR and AED. We searched for mandates for schools in other countries for comparison.

Results: The state laws for CPR training for high school graduation and AED requirements in US. schools are highly variable, and funding for AEDs is inadequate, especially in schools in lower socio-economic zip codes. Recent AED legislative efforts focus mainly on athletic areas and don’t adequately address school size, number of buildings, non-athletic areas, and engagement of student-led advocacy efforts.

Conclusion: To improve OHCA survival, we identified potential solutions to consolidate efforts and overcome the barriers-standardize state laws, involve student bodies, increase funding, and allocate appropriate resources. The CPR/AED education needs to start earlier in schools and be part of the standard curriculum rather than implemented as a stopgap check-box mandate.