Category: News

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

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

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