TY - JOUR
T1 - Alert system-supported lay defibrillation and basic life-support for cardiac arrest at home
AU - Stieglis, Remy
AU - Zijlstra, Jolande A.
AU - Riedijk, Frank
AU - Smeekes, Martin
AU - Van Der Worp, Wim E.
AU - Tijssen, Jan G.P.
AU - Zwinderman, Aeilko H.
AU - Blom, Marieke T.
AU - Koster, Rudolph W.
AU - Koster, Ruud W.
N1 - Publisher Copyright: © 2021 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2022/4/14
Y1 - 2022/4/14
N2 - Aims: Automated external defibrillators (AEDs) are placed in public, but the majority of out-of-hospital cardiac arrests (OHCA) occur at home. Methods and results: In residential areas, 785 AEDs were placed and 5735 volunteer responders were recruited. For suspected OHCA, dispatchers activated nearby volunteer responders with text messages, directing two-thirds to an AED first and one-third directly to the patient. We analysed survival (primary outcome) and neurologically favourable survival to discharge, time to first defibrillation shock, and cardiopulmonary resuscitation (CPR) before Emergency Medical Service (EMS) arrival of patients in residences found with ventricular fibrillation (VF), before and after introduction of this text-message alert system. Survival from OHCAs in residences increased from 26% to 39% {adjusted relative risk (RR) 1.5 [95% confidence interval (CI): 1.03-2.0]}. RR for neurologically favourable survival was 1.4 (95% CI: 0.99-2.0). No CPR before ambulance arrival decreased from 22% to 9% (RR: 0.5, 95% CI: 0.3-0.7). Text-message-responders with AED administered shocks to 16% of all patients in VF in residences, while defibrillation by EMS decreased from 73% to 39% in residences (P < 0.001). Defibrillation by first responders in residences increased from 22 to 40% (P < 0.001). Use of public AEDs in residences remained unchanged (6% and 5%) (P = 0.81). Time from emergency call to defibrillation decreased from median 11.7 to 9.3 min; mean difference -2.6 (95% CI: -3.5 to -1.6). Conclusion: Introducing volunteer responders directed to AEDs, dispatched by text-message was associated with significantly reduced time to first defibrillation, increased bystander CPR and increased overall survival for OHCA patients in residences found with VF.
AB - Aims: Automated external defibrillators (AEDs) are placed in public, but the majority of out-of-hospital cardiac arrests (OHCA) occur at home. Methods and results: In residential areas, 785 AEDs were placed and 5735 volunteer responders were recruited. For suspected OHCA, dispatchers activated nearby volunteer responders with text messages, directing two-thirds to an AED first and one-third directly to the patient. We analysed survival (primary outcome) and neurologically favourable survival to discharge, time to first defibrillation shock, and cardiopulmonary resuscitation (CPR) before Emergency Medical Service (EMS) arrival of patients in residences found with ventricular fibrillation (VF), before and after introduction of this text-message alert system. Survival from OHCAs in residences increased from 26% to 39% {adjusted relative risk (RR) 1.5 [95% confidence interval (CI): 1.03-2.0]}. RR for neurologically favourable survival was 1.4 (95% CI: 0.99-2.0). No CPR before ambulance arrival decreased from 22% to 9% (RR: 0.5, 95% CI: 0.3-0.7). Text-message-responders with AED administered shocks to 16% of all patients in VF in residences, while defibrillation by EMS decreased from 73% to 39% in residences (P < 0.001). Defibrillation by first responders in residences increased from 22 to 40% (P < 0.001). Use of public AEDs in residences remained unchanged (6% and 5%) (P = 0.81). Time from emergency call to defibrillation decreased from median 11.7 to 9.3 min; mean difference -2.6 (95% CI: -3.5 to -1.6). Conclusion: Introducing volunteer responders directed to AEDs, dispatched by text-message was associated with significantly reduced time to first defibrillation, increased bystander CPR and increased overall survival for OHCA patients in residences found with VF.
KW - Automated external defibrillator
KW - Cardiopulmonary resuscitation
KW - Defibrillation
KW - Dispatch
KW - Heart arrest
KW - Ventricular fibrillation
KW - Volunteer responder
UR - http://www.scopus.com/inward/record.url?scp=85128489279&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/eurheartj/ehab802
DO - https://doi.org/10.1093/eurheartj/ehab802
M3 - Article
C2 - 34791171
SN - 0195-668X
VL - 43
SP - 1465
EP - 1474
JO - European Heart journal
JF - European Heart journal
IS - 15
ER -