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Differences in Automated External Defibrillator Types in Out-of-Hospital Cardiac Arrest Treated by Police First Responders

Background: Police first responder systems also including automated external defibrillation (AED) has in the past shown considerable impact on favourable outcomes after out-of-hospital cardiac arrest (OHCA). While short hands-off times in chest compressions are known to be beneficial, various AED mo...

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Autores principales: Krammel, Mario, Eichelter, Jakob, Gatterer, Constantin, Lobmeyr, Elisabeth, Neymayer, Marco, Grassmann, Daniel, Holzer, Michael, Sulzgruber, Patrick, Schnaubelt, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219170/
https://www.ncbi.nlm.nih.gov/pubmed/37233163
http://dx.doi.org/10.3390/jcdd10050196
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author Krammel, Mario
Eichelter, Jakob
Gatterer, Constantin
Lobmeyr, Elisabeth
Neymayer, Marco
Grassmann, Daniel
Holzer, Michael
Sulzgruber, Patrick
Schnaubelt, Sebastian
author_facet Krammel, Mario
Eichelter, Jakob
Gatterer, Constantin
Lobmeyr, Elisabeth
Neymayer, Marco
Grassmann, Daniel
Holzer, Michael
Sulzgruber, Patrick
Schnaubelt, Sebastian
author_sort Krammel, Mario
collection PubMed
description Background: Police first responder systems also including automated external defibrillation (AED) has in the past shown considerable impact on favourable outcomes after out-of-hospital cardiac arrest (OHCA). While short hands-off times in chest compressions are known to be beneficial, various AED models use different algorithms, inducing longer or shorter durations of crucial timeframes along basic life support (BLS). Yet, data on details of these differences, and also of their potential impact on clinical outcomes are scarce. Methods: For this retrospective observational study, patients with OHCA of presumed cardiac origin and initially shockable rhythm treated by police first responders in Vienna, Austria, between 01/2013 and 12/2021 were included. Data from the Viennese Cardiac Arrest Registry and AED files were extracted, and exact timeframes were analyzed. Results: There were no significant differences in the 350 eligible cases in demographics, return of spontaneous circulation, 30-day survival, or favourable neurological outcome between the used AED types. However, the Philips HS1 and -FrX AEDs showed immediate rhythm analysis after electrode placement (0 [0–1] s) and almost no shock loading time (0 [0–1] s), as opposed to the LP CR Plus (3 [0–4] and 6 [6–6] s, respectively) and LP 1000 (3 [2–10] and 6 [5–7] s, respectively). On the other hand, the HS1 and -FrX had longer analysis times of 12 [12–16] and 12 [11–18] s than the LP CR Plus (5 [5–6] s) and LP 1000 (6 [5–8] s). The duration from when the AED was turned on until the first defibrillation were 45 [28–61] s (Philips FrX), 59 [28–81] s (LP 1000), 59 [50–97] s (HS1), and 69 [55–85] s (LP CR Plus). Conclusion: In a retrospective analysis of OHCA-cases treated by police first responders, we could not find significant differences in clinical patient outcomes concerning the respective used AED model. However, various differences in time durations (e.g., electrode placement to rhythm analysis, analysis duration, or AED turned on until first defibrillation) along the BLS algorithm were seen. This opens up the question of AED-adaptations and tailored training methods for professional first responders.
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spelling pubmed-102191702023-05-27 Differences in Automated External Defibrillator Types in Out-of-Hospital Cardiac Arrest Treated by Police First Responders Krammel, Mario Eichelter, Jakob Gatterer, Constantin Lobmeyr, Elisabeth Neymayer, Marco Grassmann, Daniel Holzer, Michael Sulzgruber, Patrick Schnaubelt, Sebastian J Cardiovasc Dev Dis Article Background: Police first responder systems also including automated external defibrillation (AED) has in the past shown considerable impact on favourable outcomes after out-of-hospital cardiac arrest (OHCA). While short hands-off times in chest compressions are known to be beneficial, various AED models use different algorithms, inducing longer or shorter durations of crucial timeframes along basic life support (BLS). Yet, data on details of these differences, and also of their potential impact on clinical outcomes are scarce. Methods: For this retrospective observational study, patients with OHCA of presumed cardiac origin and initially shockable rhythm treated by police first responders in Vienna, Austria, between 01/2013 and 12/2021 were included. Data from the Viennese Cardiac Arrest Registry and AED files were extracted, and exact timeframes were analyzed. Results: There were no significant differences in the 350 eligible cases in demographics, return of spontaneous circulation, 30-day survival, or favourable neurological outcome between the used AED types. However, the Philips HS1 and -FrX AEDs showed immediate rhythm analysis after electrode placement (0 [0–1] s) and almost no shock loading time (0 [0–1] s), as opposed to the LP CR Plus (3 [0–4] and 6 [6–6] s, respectively) and LP 1000 (3 [2–10] and 6 [5–7] s, respectively). On the other hand, the HS1 and -FrX had longer analysis times of 12 [12–16] and 12 [11–18] s than the LP CR Plus (5 [5–6] s) and LP 1000 (6 [5–8] s). The duration from when the AED was turned on until the first defibrillation were 45 [28–61] s (Philips FrX), 59 [28–81] s (LP 1000), 59 [50–97] s (HS1), and 69 [55–85] s (LP CR Plus). Conclusion: In a retrospective analysis of OHCA-cases treated by police first responders, we could not find significant differences in clinical patient outcomes concerning the respective used AED model. However, various differences in time durations (e.g., electrode placement to rhythm analysis, analysis duration, or AED turned on until first defibrillation) along the BLS algorithm were seen. This opens up the question of AED-adaptations and tailored training methods for professional first responders. MDPI 2023-04-27 /pmc/articles/PMC10219170/ /pubmed/37233163 http://dx.doi.org/10.3390/jcdd10050196 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Krammel, Mario
Eichelter, Jakob
Gatterer, Constantin
Lobmeyr, Elisabeth
Neymayer, Marco
Grassmann, Daniel
Holzer, Michael
Sulzgruber, Patrick
Schnaubelt, Sebastian
Differences in Automated External Defibrillator Types in Out-of-Hospital Cardiac Arrest Treated by Police First Responders
title Differences in Automated External Defibrillator Types in Out-of-Hospital Cardiac Arrest Treated by Police First Responders
title_full Differences in Automated External Defibrillator Types in Out-of-Hospital Cardiac Arrest Treated by Police First Responders
title_fullStr Differences in Automated External Defibrillator Types in Out-of-Hospital Cardiac Arrest Treated by Police First Responders
title_full_unstemmed Differences in Automated External Defibrillator Types in Out-of-Hospital Cardiac Arrest Treated by Police First Responders
title_short Differences in Automated External Defibrillator Types in Out-of-Hospital Cardiac Arrest Treated by Police First Responders
title_sort differences in automated external defibrillator types in out-of-hospital cardiac arrest treated by police first responders
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219170/
https://www.ncbi.nlm.nih.gov/pubmed/37233163
http://dx.doi.org/10.3390/jcdd10050196
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