Category: News

Sudden cardiac arrest (SCA) remains one of the most prevalent cardiovascular emergencies in the world. The development of international protocols and the use of accessible devices such as automated external defibrillators (AEDs) allowed for the standardization and organization of medical care related to SCA. When defibrillation is performed within five minutes of starting ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT), the victim survival rate has increased considerably. 

Therefore, training healthcare professionals to use AEDs correctly is essential to improve patient outcomes and response time in the intervention. In this technical report, we advocate simulation-based education as a teaching methodology and an essential component of drone adaptation, novel technology, that can deliver AEDs to the site, as well as a training scenario to teach healthcare professionals how to operate the real-time communication components of drones and AEDs efficiently.

Studies have suggested that simulation can be an effective way to train healthcare professionals. Through teaching methodology using simulation, training these audiences has the potential to reduce the response time to intervention, consequently, increasing the patient’s chance of surviving.

https://pubmed.ncbi.nlm.nih.gov/35228952/

Fire and police first responders are often the first to arrive in medical emergencies and provide basic life support services until specialized personnel arrive. This study aims to evaluate rates of fire or police first responder-initiated cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, as well as their associated impact on out-of-hospital cardiac arrest (OHCA) outcomes.

Results: Our cohort included 25,067 OHCA incidents. We found fire or police first responders initiated CPR in 31.8% of OHCA events and AED use in 6.1% of OHCA events. Likelihood of sustained ROSC on ED arrival after CPR initiated by a fire/police first responder was not statistically different as compared to EMS initiated CPR (aOR 1.01, CI 0.93-1.11). However, fire/police first responder interventions were associated with significantly higher odds of survival to hospital discharge and survival with good neurologic outcome (aOR 1.25, 95% CI 1.08-1.45 and aOR 1.40, 95% CI 1.18-1.65, respectively). Similar associations were see when examining fire or police initiated AED use.

Conclusions: Fire or police first responders may be an underutilized, potentially powerful mechanism for improving OHCA survival. Future studies should investigate barriers and opportunities for increasing first responder interventions by these groups in OHCA.

https://pubmed.ncbi.nlm.nih.gov/35257834/

Bystander cardiopulmonary resuscitation (BCPR), early defibrillation and timely treatment by emergency medical services (EMS) can double the chance of survival from out-of-hospital sudden cardiac arrest (OHCA). We investigated the effect of the COVID-19 pandemic on the pre-hospital chain of survival. 

We searched five bibliographical databases for articles that compared prehospital OHCA care processes during and before the COVID-19 pandemic. Random effects meta-analyses were conducted, and meta-regression with mixed-effect models and subgroup analyses were conducted where appropriate. The search yielded 966 articles; 20 articles were included in our analysis. OHCA at home was more common during the pandemic (OR 1.38, 95% CI 1.11-1.71, p = 0.0069). BCPR did not differ during and before the COVID-19 pandemic (OR 0.94, 95% CI 0.80-1.11, p = 0.4631), although bystander defibrillation was significantly lower during the COVID-19 pandemic (OR 0.65, 95% CI 0.48-0.88, p = 0.0107).

EMS call-to-arrival time was significantly higher during the COVID-19 pandemic (SMD 0.27, 95% CI 0.13-0.40, p = 0.0006). Resuscitation duration did not differ significantly between pandemic and pre-pandemic timeframes. The COVID-19 pandemic significantly affected prehospital processes for OHCA. These findings may inform future interventions, particularly to consider interventions to increase BCPR and improve the pre-hospital chain of survival.

https://pubmed.ncbi.nlm.nih.gov/35039578/

Geographical setting is seldomly taken into account when investigating out-of-hospital cardiac arrest (OHCA). It is a common notion that living in rural areas means a lower chance of fast and effective help when suffering a time-critical event. This retrospective cohort study investigates this hypothesis and compares across healthcare-divided administrative regions. We investigated incidence, EMS response time and 30-day survival according to area type and subsidiarily by healthcare-divided administrative region in Denmark.

The majority (71%) of 8,579 OHCAs were residential, and 53.2% of all arrests occurred in the most densely populated cell group amongst residential arrests. This group had a median EMS response time of six minutes, whereas the most sparsely populated group had a median of 10 minutes. Public arrests also had a median response time of six minutes.

Conclusion: Our study demonstrates that while EMS response times in Denmark are longer in the rural areas, there is no statistically significant decrease in survival compared to the most densely populated areas.

https://pubmed.ncbi.nlm.nih.gov/35146464/

Automated external defibrillators (AEDs) use various shock protocols with different characteristics when deployed in pediatric mode. The aim of this study is to assess and compare the safety and efficacy of different AED pediatric protocols using novel experimental approaches.

Two defibrillation protocols (A and B) were assessed across two studies:

• Protocol A: escalating (50-75-90 J) defibrillation waveform with higher voltage, shorter duration and equal phase durations.
• Protocol B: non-escalating (50-50-50 J) defibrillation waveform with lower voltage, longer duration and unequal phase durations. Animals were randomized into two groups, receiving three shocks from Protocol A (50-75-90 J) or B (50-50-50 J).

Conclusions: There is no evidence that administration of clinically relevant shock sequences, without experimental confounders, result in significant myocardial damage in this model of pediatric resuscitation. Typical variations in AED pediatric mode settings do not affect defibrillation safety and efficacy.

https://pubmed.ncbi.nlm.nih.gov/35146463/

February is National Heart Month and the perfect time to take a course to learn what to do if someone is having a heart attack, how to perform CPR, use an automated external defibrillator (AED) and help save lives. Here are details of American Red Cross’ initiative but there will be an equivalent course near you if interested.

https://www.redcross.org/about-us/news-and-events/news/2021/national-heart-month-get-trained-and-help-save-lives.html

Currently, there are around 7.6 million people in the UK living with heart and circulatory diseases and 1 in 2 of us will experience a heart or circulatory condition during our lifetime. However, making small changes to your daily routine can make a big difference to your heart health, which in the long term could help reduce your risk of heart and circulatory related conditions such as diabetes, stroke, vascular dementia or heart disease. Here are some of the ways which you can improve your heart health and support us during Heart Month

https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2022/february/support-the-bhf-this-heart-month

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/

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

https://www.emergency-live.com/marketplace/proper-defibrillator-maintenance-to-ensure-maximum-efficiency/