Document Detail


Increasing first responder CPR during resuscitation of out-of-hospital cardiac arrest using automated external defibrillators.
MedLine Citation:
PMID:  16942824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Evidence supports that increasing the balance of "hands-on" CPR may improve survival in ventricular fibrillation out-of-hospital cardiac arrest (OHCA). We assessed whether training and/or AED reconfiguration was associated with an increase in the proportion of time during which CPR was performed between first and second stacks of shocks. METHODS: The investigation was a cohort study of 291 persons who suffered ventricular fibrillation OHCA and were treated with at least two stacks of AED shocks by emergency medical services (EMS) first-tier responders. In January 2003, first-tier providers were retrained regarding the importance of CPR. In addition, a subset of AEDs was reconfigured to remove continuous fibrillation detection and its associated voice prompts as to be comparable with other AED models. The amount of time spent on CPR was assessed through review of AED electronic and audio recordings to compare the pre-intervention (n = 241) and post-intervention periods (n = 50). RESULTS: The proportion of time spent performing hands-on CPR between first and second stacks of shocks was 0.40 in the pre-intervention period compared to 0.51 in the post-intervention period (p = 0.001). The difference was greatest for AEDs where EMS was retrained and the AED reconfigured (0.33 versus 0.50, p = 0.01). No difference in survival was detected between the pre- and post-intervention periods (24.9% versus 28.0%, p = 0.65). CONCLUSIONS: An intervention consisting of retraining and AED reconfiguration was associated with an increase in the proportion of time spent performing CPR between first and second stacks of shocks by first-tier EMS. Whether this increase improves patient outcomes requires additional study.
Authors:
Sachita Shah; Michele Garcia; Thomas D Rea
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-08-30
Journal Detail:
Title:  Resuscitation     Volume:  71     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-12     Completed Date:  2007-01-11     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  29-33     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Brigham and Women's Hospital and Mass General, Harvard University, Neville House, Boston (SS), MA 02115, USA. SSHAH11@PARTNERS.ORG
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiopulmonary Resuscitation*
Cohort Studies
Defibrillators*
Emergency Medical Services*
Female
Heart Arrest / therapy*
Humans
Male
Resuscitation / instrumentation*
Treatment Outcome
Ventricular Fibrillation / therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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