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Defibrillation before EMS arrival in western Sweden
A Claesson1, J Herlitz2, L Svensson1
1Department of Medicine, Centre for Resuscitation Science, Karolinska Institute, SE-171 77 Stockholm, Sweden.
The American Journal of Emergency Medicine
|February 28, 2017
Summary
Public access defibrillation (PAD) by bystanders using automated external defibrillators (AEDs) before emergency medical services (EMS) arrive significantly improves survival for out-of-hospital cardiac arrest (OHCA) patients with ventricular fibrillation (VF). This trend is increasing over time.
Area of Science:
- Emergency Medicine
- Cardiology
- Public Health
Background:
- Bystanders are crucial for public access defibrillation (PAD) during out-of-hospital cardiac arrest (OHCA).
- Dual dispatch of first responders (FR) with emergency medical services (EMS) can reduce defibrillation times.
- This study examines automated external defibrillator (AED) use in OHCAs before EMS arrival.
Purpose of the Study:
- To describe the utilization of AEDs in OHCAs prior to EMS arrival.
- To compare bystander/FR defibrillation with EMS defibrillation.
- To assess the impact of early defibrillation on survival rates.
Main Methods:
- Analysis of OHCA cases with shockable rhythms receiving AED use before EMS arrival (2008-2015, western Sweden).
- Data sourced from the Swedish Register for Cardiopulmonary Resuscitation (SRCR).
- Comparison of on-site bystander/FR defibrillation versus EMS defibrillation.
Main Results:
- 162 of 6675 OHCA cases (24% with VF) received pre-EMS AED defibrillation (46% on-site).
- Pre-EMS AED use increased from 5% (2008) to 20% (2015).
- 30-day survival for VF patients rose from 22% to 28%, highest with on-site AED use (68%).
Conclusions:
- AED use before EMS arrival in OHCAs has increased.
- This rise in early defibrillation is linked to improved 30-day survival for VF patients.
- On-site AED application before EMS arrival yields the highest survival rates.
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