Document Detail

Out-of-hospital cardiac arrest-review of demographics in South Australia to inform decisions about the provision of automatic external defibrillators within the community.
MedLine Citation:
PMID:  21181686     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Sudden, out-of-hospital cardiac arrest (OHCA) has an annual incidence of approximately 50 per 100,000 population. Public access defibrillation is seen as one of the key strategies in the chain-of-survival for OHCA. Positioning of these devices is important for the maximization of public health outcomes. The literature strongly advocates widespread public access to automated external defibrillatiors (AEDs). The most efficient placement of AEDs within individual communities remains unclear.
METHODS: A retrospective case review of OHCAs attended by the South Australia Ambulance Service in metropolitan and rural South Australia over a 30-month period was performed. Data were analyzed using Utstein-type indicators. Detailed demographics, summative data, and clinical data were recorded.
RESULTS: A total of 1,305 cases of cardiac arrest were reviewed. The annual rate of OHCA was 35 per 100,000 population. Of the cases, the mean value for the ages was 66.3 years, 517 (39.6%) were transported to hospital, 761 (58.3%) were judged by the paramedic to be cardiac, and 838 (64.2%) were witnessed. Bystander cardiopulmonary resuscitation (CPR) was performed in 495 (37.9%) of cases. The rhythm on arrival was ventricular fibrillation (VF) or ventricular tachycardia (VT) in 419 (32.1%) cases, and 315 (24.1%) of all arrests had return of spontaneous circulation (ROSC) before or on arrival at the hospital. For cardiac arrest cases that were witnessed by the ambulance service (n=121), the incidence of ROSC was 47.1%. During the 30-month period, there only was one location that recorded more than one cardiac arrest. No other location recorded recurrent episodes.
CONCLUSIONS: This study did not identify any specific location that would justify defibrillator placement over any other location without an existing defibrillator. The impact of bystander CPR and the relatively low rate of bystander CPR in this study points to an area of need. The relative potential impact of increasing bystander CPR rates versus investing in defibrillators in the community is worthy of further consideration.
Kathryn Zeitz; Hugh Grantham; Robert Elliot; Chris Zeitz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Prehospital and disaster medicine     Volume:  25     ISSN:  1049-023X     ISO Abbreviation:  Prehosp Disaster Med     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-03-08     Revised Date:  2011-12-15    
Medline Journal Info:
Nlm Unique ID:  8918173     Medline TA:  Prehosp Disaster Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  521-6     Citation Subset:  T    
St John Ambulance Aust SA Inc., Unley, SA, Australia.
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MeSH Terms
Emergency Medical Services*
Middle Aged
Out-of-Hospital Cardiac Arrest / therapy*
South Australia
Treatment Outcome

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