1. Bystander Defibrillation for Out-of-Hospital Cardiac Arrest in Public vs Residential Locations
- Author
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Freddy Lippert, Shahzleen Rajan, Søren Pihlkjær Hjortshøj, Fredrik Folke, Carolina Malta Hansen, Linda Ejlskov, Steen Møller Hansen, Kristian Kragholm, Mads Wissenberg, Thomas A. Gerds, Christian Torp-Pedersen, Lars Køber, and Gunnar Gislason
- Subjects
Male ,medicine.medical_specialty ,Resuscitation ,Emergency Medical Services ,Defibrillation ,medicine.medical_treatment ,Denmark ,Electric Countershock ,030204 cardiovascular system & hematology ,Out-of-Hospital Cardiac Arrest/therapy ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Electric Countershock/statistics & numerical data ,Emergency medical services ,medicine ,Bystander effect ,Journal Article ,Humans ,Registries ,skin and connective tissue diseases ,Health Education ,Original Investigation ,Aged ,Aged, 80 and over ,business.industry ,030208 emergency & critical care medicine ,Middle Aged ,medicine.disease ,Cardiopulmonary Resuscitation ,Emergency medicine ,Emergency medical dispatch ,Defibrillators/supply & distribution ,Cardiopulmonary Resuscitation/statistics & numerical data ,Health education ,Female ,Medical emergency ,sense organs ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest ,Cohort study ,Defibrillators - Abstract
Importance: Bystander-delivered defibrillation (hereinafter referred to as bystander defibrillation) of patients with out-of-hospital cardiac arrests (OHCAs) remains limited despite the widespread dissemination of automated external defibrillators (AEDs).Objective: To examine calendar changes in bystander defibrillation and subsequent survival according to a public or a residential location of the cardiac arrest after nationwide initiatives in Denmark to facilitate bystander-mediated resuscitative efforts, including bystander defibrillation.Design, Setting, and Participants: This nationwide study identified 18 688 patients in Denmark with first-time OHCA from June 1, 2001, to December 31, 2012, using the Danish Cardiac Arrest Registry. Patients had a presumed cardiac cause of arrest that was not witnessed by emergency medical services personnel. Data were analyzed from April 1, 2015, to December 10, 2016.Exposures: Nationwide initiatives to facilitate bystander resuscitative efforts, including bystander defibrillation, consisted of resuscitation training of Danish citizens, dissemination of on-site AEDs, foundation of an AED registry linked to emergency medical dispatch centers, and dispatcher-assisted guidance of bystander resuscitation efforts.Main Outcomes and Measures: The proportion of patients who received bystander defibrillation according to the location of the cardiac arrest and their subsequent 30-day survival.Results: Of the 18 688 patients with OHCAs (67.8% men and 32.2% women; median [interquartile range] age, 72 [62-80] years), 4783 (25.6%) had a cardiac arrest in a public location and 13 905 (74.4%) in a residential location. The number of registered AEDs increased from 141 in 2007 to 7800 in 2012. The distribution of AED location was consistently skewed in favor of public locations. Bystander defibrillation increased in public locations from 3 of 245 (1.2%; 95% CI, 0.4%-3.5%) in 2001 to 78 of 510 (15.3%; 95% CI, 12.4%-18.7%) in 2012 (P Conclusions and Relevance: Initiatives to facilitate bystander defibrillation were associated with a marked increase in bystander defibrillation in public locations, whereas bystander defibrillation remained limited in residential locations. Concomitantly, survival increased after bystander defibrillation in residential and public locations.
- Published
- 2017