Category: News

Many nurses will be familiar with the defibrillator on a resuscitation trolley in hospitals but may be less confident to use one as part of a resuscitation attempt outside of the hospital setting. This article, the second in a four-part series on basic life support, describes how to use an automated external defibrillator. More than 30,000 people in Britain every year have a cardiac arrest in the community (British Heart Foundation, 2014) – 73% of out-of-hospital cardiac arrests happened in private locations (at home or in care homes) and 27% occurred in a public place.

This series provides an update on basic life support for out-of-hospital cardiac arrest and adheres to Resuscitation Council UK (RCUK) guidance by Perkins et al (2021). In the UK, there are no legal restrictions on using an AED. A rescuer, whether a trained first aider or an untrained member of the public, who has acted to the best of their ability to help a person in cardiac arrest, should not be sued when using an AED, no matter what the outcome.

In this study, research on pre-EMS services was reviewed.  Existing studies on AED locations often consider that these devices are placed at fixed locations using different modeling techniques, such as coverage models, and people have to find them and get them to the scene of emergencies. However, one promising way of using these devices for emergency response is mobile AEDs. In this setup, AEDs can be delivered to the emergency scene by different modes of transport (e.g., drones or taxis). The review recommends wider use of drones for pickup and delivery of all kinds of medical equipment to the scene of emergencies, especially to areas that have less stationary equipment or to mountainous regions that are harder to reach.

The benefits of using drones, potentially together with logistics and service design, is a research area widely open for further investigation.

https://link.springer.com/article/10.1007/s10100-021-00769-y

The aim of this study is to analyze the way and correctness of use of automated external defibrillators placed in public spaces in Polish cities. The data analyzed 120 cases of use of automated external defibrillators, placed in public spaces. The predominant location of AED use is in public transportation facilities, and the injured party is the traveler. AED use in non-hospital settings is more common in male victims aged 50–60 years. Findings: The documentation that forms the basis of the emergency medical services intervention needs to be refined. There is no mention of resuscitation performed by a witness of an event or of the use of an AED. In addition, Poland lacks the legal basis for maintaining a register of automated external defibrillators. There is a need to develop appropriate documents to determine the process of reporting by the owners of the use of AEDs in out-of-hospital conditions (OHCA).

https://www.mdpi.com/1660-4601/18/18/9892/htm

As a direct result of devastating statistics, the #DefibsSaveLives campaign has launched an education-based advocacy and campaign that serves areas all over the world. This critical work equips communities with the education, tools and resources necessary to implement the chain of survival during SCA in the public and private sectors.

 

https://www.heartrhythmalliance.org/aa/uk/defibs-save-lives

Video developed for public as part of the  #DefibsSaveLives. This critical work equips communities with the education, tools and resources necessary to implement the chain of survival during SCA in the public and private sectors.

A number of selected sports clubs were visited, and participants aged ≥16 were asked to complete a questionnaire relating to current awareness and attitudes toward AEDs, and their willingness to use the device. Each participant then attended a 2-hour small-group teaching session where they were educated on the role and use of an AED, with opportunity to practice AED use in a controlled environment. After receiving teaching, each individual again completed the questionnaire. 142 people participated in the study. Before teaching, the average level of knowledge regarding AED use was relatively low.

The most common reason identified for unwillingness to operate an AED was lack of knowledge on how to correctly use the device.  After teaching, 77.5%(n=110) of participants reported that they would definitely be willing to use an AED, compared with 20.4%(n=30) before teaching.

Conclusion: A structured educational programme can increase layperson awareness, confidence and willingness to operate an AED.

http://imj.ie/wp-content/uploads/2021/08/Assessment-of-Layperson-Knowledge-of-AED-use-in-Sports-Clubs.pdf

Researchers in Sweden are hoping they can be used to outrun ambulances as they respond to heart attacks.  In what they describe as the world’s first real-world feasibility study of drone-based defibrillator deliveries, first responders showed that going airborne helped shave off minutes where time matters most—by dropping the life-saving devices right on the doorsteps of homes in need. “When a drone arrived before the ambulance it was nearly two minutes quicker,” study author Sofia Schierbeck, of Stockholm’s Karolinska University Hospital, said in a statement.  The study was conducted within a certain radius of the airport near the city of Gothenburg, the second-largest city in Sweden, with a population of about 580,000. Three drone stations were set up, each with the ability to fly 5 kilometres, with automated flight programs overseen by trained drone pilots. After emergency dispatchers received a call for a cardiac arrest, they would send ambulances as well as the drones—which, after arriving at the scene, would hover at about 100 feet and lower an AED to the ground by a winch. Between June and September 2020, drones were dispatched to 12 cardiac arrests, successfully delivering AEDs near the patient in 11 cases, covering a median flight distance of 3.1 kilometres.  “Drone delivery of AEDs could be common practice in the coming years.”

https://www.fiercebiotech.com/medtech/drones-outpace-ambulances-by-airdropping-defibrillators-to-heart-attack-patients-real-world

Out-of-hospital cardiac arrest (OHCA) is a major healthcare problem, with approximately 200 weekly cases in the Netherlands. Its critical, time-dependent nature makes it a unique medical situation, of which outcomes strongly rely on infrastructural factors and on-scene care by emergency medical services (EMS). Survival to hospital discharge is poor, although it has substantially improved, to roughly 25% over the last years. Recognised key factors, such as bystander resuscitation and automated external defibrillator use at the scene, have been markedly optimised with the introduction of technological innovations. In an era with ubiquitous smartphone use, the Dutch digital text message alert platform HartslagNu increasingly contributes to timely care for OHCA victims. Optimisation of available prehospital technologies is crucial to further improve OHCA outcomes, with particular focus on more available trained volunteers in the first phase and additional research on advanced EMS care in the second phase.

https://link.springer.com/article/10.1007/s12471-021-01602-6

Describing AED’s  as the Ctrl-Alt-Del for the heart, the article explains what’s happening inside the AED which has two main functions. First, it needs to recognize the lethal haywire rhythm of ventricular fibrillation. Second, it needs to deliver a 100-kilowatt shock to the heart. This jolt allows the heart to restart its normal rhythm, sort of like a Ctrl-Alt-Del for the organ. If the shock is delivered in the first minute of ventricular fibrillation, in more than 90 percent of cases the heart will regain a normal sequence of electric signals, and the steady contractions will return. It took decades of careful engineering to develop a device that could perform those two functions reliably, have a long shelf life, and be both safe and easy to use.

https://spectrum.ieee.org/idiotproofing-the-defibrillator

Just published in Curr Sports Medicine Journal.  It highlights that given that most sudden cardiac arrests (SCAs) occur outside of a medical facility, often in association with exercise and sporting events, and given that early cardiopulmonary resuscitation (CPR) plus defibrillation is the strongest predictor of survival from SCA, this Call to Action from the American College of Sports Medicine recommends increasing the availability and effectiveness of early CPR plus defibrillation so that the time from collapse-to-first automated external defibrillator shock is less than 3 min.

https://pubmed.ncbi.nlm.nih.gov/34357888/