TY - JOUR
T1 - Bystander automated external defibrillator application in non-shockable out-of-hospital cardiac arrest
AU - Pollack, Ross A.
AU - Brown, Siobhan P.
AU - May, Susanne
AU - Rea, Tom
AU - Kudenchuk, Peter J.
AU - Weisfeldt, Myron L.
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/4
Y1 - 2019/4
N2 - Background: An increasing proportion of patients with OHCA present with non-shockable rhythms, among whom the benefit from AED application is not known. Methods: We performed a retrospective analysis of adults with non-traumatic, public, bystander-witnessed, non-shockable OHCA occurring between 2005–2015 at 9 locations participating in the Resuscitation Outcomes Consortium. Non-shockable arrest was defined as when no shock was administered by a bystander applied AED and confirmed by the initial rhythm on EMS arrival. Outcomes were compared between patients with non-shockable OHCA in whom a bystander AED was or was not applied. Results: Among 2809 patients with non-shockable public, witnessed OHCA, 8.4% had an AED applied. CPR was more often performed in the AED-applied group (99% vs. 51% of patients, p < 0.001). Among patients in whom an AED was not applied, 39.8% had any pre-hospital ROSC, 29.6% had a pulse at ED arrival and 11.1% survived to hospital discharge compared to 44.1%, 29.6% and 9.7%, respectively with AED application. After adjustment for the Utstein variables excluding bystander CPR, the OR for survival to hospital discharge for AED application was 0.90 (95% CI:0.57–1.42); when adjusted for the higher frequency of CPR in the AED group the OR was 0.92 (95% CI:0.57–1.47). Conclusions: The application of an AED in non-shockable public witnessed OHCA was associated with a higher frequency of bystander CPR. The probabilities of pre-hospital ROSC, pulse at ED arrival, and survival to hospital discharge were not altered by the application of an AED.
AB - Background: An increasing proportion of patients with OHCA present with non-shockable rhythms, among whom the benefit from AED application is not known. Methods: We performed a retrospective analysis of adults with non-traumatic, public, bystander-witnessed, non-shockable OHCA occurring between 2005–2015 at 9 locations participating in the Resuscitation Outcomes Consortium. Non-shockable arrest was defined as when no shock was administered by a bystander applied AED and confirmed by the initial rhythm on EMS arrival. Outcomes were compared between patients with non-shockable OHCA in whom a bystander AED was or was not applied. Results: Among 2809 patients with non-shockable public, witnessed OHCA, 8.4% had an AED applied. CPR was more often performed in the AED-applied group (99% vs. 51% of patients, p < 0.001). Among patients in whom an AED was not applied, 39.8% had any pre-hospital ROSC, 29.6% had a pulse at ED arrival and 11.1% survived to hospital discharge compared to 44.1%, 29.6% and 9.7%, respectively with AED application. After adjustment for the Utstein variables excluding bystander CPR, the OR for survival to hospital discharge for AED application was 0.90 (95% CI:0.57–1.42); when adjusted for the higher frequency of CPR in the AED group the OR was 0.92 (95% CI:0.57–1.47). Conclusions: The application of an AED in non-shockable public witnessed OHCA was associated with a higher frequency of bystander CPR. The probabilities of pre-hospital ROSC, pulse at ED arrival, and survival to hospital discharge were not altered by the application of an AED.
KW - Automated external defibrillator
KW - Cardiopulmonary resuscitation
KW - Out-of-hospital cardiac arrest
KW - Sudden cardiac arrest
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U2 - 10.1016/j.resuscitation.2019.02.007
DO - 10.1016/j.resuscitation.2019.02.007
M3 - Article
C2 - 30790694
AN - SCOPUS:85062372216
SN - 0300-9572
VL - 137
SP - 168
EP - 174
JO - Resuscitation
JF - Resuscitation
ER -