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Shock advisory system with minimal delay triggering after end of chest compressions: Accuracy and gained hands-off time.
MedLine Citation:
PMID:  22208180     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: Shortening hands-off intervals can improve benefits from defibrillation. This study presents the performance of a shock advisory system (SAS), which aims to decrease the pre-shock pauses by triggering fast rhythm analysis at minimal delay after end of chest compressions (CC). METHODS: The SAS is evaluated on a database of 1301 samples from 311 out-of-hospital cardiac arrests (OHCA) from automated external defibrillators (AEDs). The following rhythms are identified: 788 asystoles (ASYS), 20 normal sinus rhythms (NSR), 394 other non-shockable rythms (ONS), 81 ventricular fibrillations (VF), 18 rapid ventricular tachycardias (VThi). SAS is launched in two-stages: first stage for accurate detection of actual end of CC (ReEoCC); second stage for early "Shock"/"No-Shock" decision by using all available artifact-free ECG signals after REoCC during 3, 5, 7 s. RESULTS: Performance of the presented SAS versus AEDs is compared. The median hands-off time gained from earlier starting of ECG analysis is 5.8 s and for earlier shock advice is 12.5 s to 8.5 s when SAS rhythm analysis lasts 3 s to 7 s. The SAS accuracy at 3-7 s is: specificity 97.7-98.9% (ASYS), 100-100% (NSR), 98.5-99.2% (ONS); sensitivity 91.4-98.8% (VF), 88.9-96.7% (VThi). CONCLUSION: This study indicates that shortening the pre-shock hands-off pause by more efficient management of the SAS process in AEDs is possible. For analysis duration of 5 s (7 s), the delay between the end of chest compressions and the shock advice can be reduced by 10.5 s (8.5 s) median, while AHA requirements for rhythm detection accuracy are met. The use of this solution in AEDs could provide more reliable rhythm analysis than methods applying filtering techniques during CC.
Authors:
Jean-Philippe Didon; Vessela Krasteva; Sarah Ménétré; Todor Stoyanov; Irena Jekova
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Resuscitation     Volume:  82S2     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-1-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  S8-S15     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier B.V. All rights reserved.
Affiliation:
Schiller Médical SAS, 4 rue L. Pasteur, F-67160 Wissembourg, France.
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