- Email: [email protected]
Witnessed cardiac arrest
Abstracts / Resuscitation 85S (2014) S15–S121
FRED Easy by Shiller, Baar, Switzerland; Lifeline AED by Defibtech, Guilford, CT, USA; Heartsave AD by Primedic, Rottweil, Germany). After turning on the machine AED paddles were attached on a manikin (ALS trainer by Laerdal Medical, Norway) and the performance both for shockable and non-shockable rhythms were tested. Results: Rhythm analysis times were identical when comparing shockable and non-shockable rhythms (10.4 ± 2.5 s,) and only in 3/8 (37.5%) AEDs was less than 10 s. The mean charging time was 7.4 ± 3.4 s and only in 1/8 (12.5%) AEDs was more than 10 s. A not recommended latency of 6.2 ± 2.2 s has been found between shock delivery and the indication to resume CPR with a resulting mean paddles to CPR time of 23.9 ± 5 s and in 0/8 AEDs was less than 10 s. While all the machines correctly identified sinus rhythm, ventricular fibrillation (VF) and asystole only 6/8 (75%) and 1/8 (12.5%) AEDs classified as shockable a fast ventricular tachycardia (VT) at 225 bpm and a slow VT at 125 bpm respectively. When the rhythm was changed during the charging phase only 3/8 (37.5%) AEDs recognized the changing and did not indicate the shock. Conclusion: AED performance may really affect the quality of CPR because of interruptions often longer than ten seconds in disagreement with international guidelines. Industry leaders should focus their research in that direction. http://dx.doi.org/10.1016/j.resuscitation.2014.03.138 AP090 Resuscitation by text-message responders in The Netherlands Wim van der Worp Ambulance Oost, Hengelo, The Netherlands Since 2008 there are projects in the Netherlands that provide civilians as lay-responders/volunteers to OHCA’s. One of these projects resulted in a system called HartslagNu (HeartbeatNow), which currently counts app. 60,000 volunteers and has approximately 7000 AED’s available spread over the larger part of The Netherlands. After the dispatch centre receives a 112-call for a resuscitation the dispatcher immediately sends out an ambulance and activates the system HartslagNu. Within a few seconds volunteers and AED’s are located in a circle of max 1000 m around the victims address. Volunteers receive a text message and max 10 of them are sent directly to the victims address to start CPR. Max. 20 volunteers are sent to an AED within the proximity, take it with them to the victim and use it if necessary. (pictures and slides of how the system works are available) All volunteers must be trained in CPR and use of AED. They subscribe to the system with name, address, phone number, email and training institute. 17 of the 24 dispatch centres are currently connected to the system. In 2013 the numbers were: Nr of activations of the system Nr of dispatched volunteers Nr of which sent directly to victim Nr of which sent to AED Nr of AED’s dispatched to
4176 74307 40906 33401 8282
Effectiveness is currently under study by Dr. R. W. Koster, Amsterdam Medical Centre and will be published later in 2014. This project is unique. There is no place in the world where there is a system with this number of available volunteers and AED’s, used
S55
on national scale. I’d like to show a presentation and tell the world about it! http://dx.doi.org/10.1016/j.resuscitation.2014.03.139 AP091 Witnessed cardiac arrest Amela Komilija ∗ , Amra Basic-Zivadinovic Emergency Medical Service Centre, Sarajevo, Bosnia and Herzegovina Purpose of the study: The aim is to show the most common cause of cardiac arrest during physical examination and emphasize the importance of defibrillation as the only treatment of ventricular fibrillation. Materials and methods: Retrospective study has been used in the five-year period to analyze experience of cardiac arrest in the Emergency Medical Service Centre of Sarajevo (EMSC). For the analysis we have used data from the protocols medical teams, emergency medicine ambulance and definitive diagnosis and condition of the patient discharge letters, Clinical Center University of Sarajevo. Results: During medical examination 76 patients experienced acute cardiac arrest. At the first site acute myocardial infarctionSTEMI was diagnosed in 82% of patients. Initial rhythm in 82% of patients was ventricular fibrillation. The male population was dominant, in 74% of cases. Commonly witnessed cardiac arrest was in the age group over 60 years, in 60% of cases. Significant percentage of working age population between 45 and 60 years was 38%. Analysis time events showed that in 40% of cases occurred in the period from 6.00 p.m. to midnight, and 22% from midnight till 6.00 a.m. In all patients in whom the initial rhythm at the time of cardiac arrest was ventricular fibrillation the DC shock was immediately delivered. After defibrillation 47% of patients were hospitalized at the Clinic for heart and rheumatism of Sarajevo, fully conscious with stable vital parameters. At the Heart (PCI) center of Sarajevo, 17% of all witnessed cardiac arrest patients PCI intervention was performed. Conclusion: EMSC is unique pre-hospital institution that operates 24 h a day/7 days a week. Thanks to adequate treatment, defibrillation, 76% of patients were hospitalized after the return of spontaneous circulation. Adequate treatment of witnessed cardiac arrest implies well-organized, highly sophisticated equipment and continuous education of emergency teams. http://dx.doi.org/10.1016/j.resuscitation.2014.03.140 AP092 The reliability of “hands on” defibrillation in patients with internal cardioverter defibrillator Sami Eksert 1 , Gokhan Ozkan 1 , Ender Sir 2,∗ , Mehmet Ozgur Ozhan 3 1 Gulhane Military Faculty of Medicine, Ankara, Turkey 2 Beytepe Military Hospital, Ankara, Turkey 3 TDV 29 Mayis Hospital, Ankara, Turkey
The advice regarding the potential dangers of practitioners contact with a patient during the firing of an internal cardioverter defibrillator (ICD) is rare. This case report presents an affected practitioner due to a shock obtained from an ICD during chest compression on a patient in cardiac arrest.
FRED Easy by Shiller, Baar, Switzerland; Lifeline AED by Defibtech, Guilford, CT, USA; Heartsave AD by Primedic, Rottweil, Germany). After turning on the machine AED paddles were attached on a manikin (ALS trainer by Laerdal Medical, Norway) and the performance both for shockable and non-shockable rhythms were tested. Results: Rhythm analysis times were identical when comparing shockable and non-shockable rhythms (10.4 ± 2.5 s,) and only in 3/8 (37.5%) AEDs was less than 10 s. The mean charging time was 7.4 ± 3.4 s and only in 1/8 (12.5%) AEDs was more than 10 s. A not recommended latency of 6.2 ± 2.2 s has been found between shock delivery and the indication to resume CPR with a resulting mean paddles to CPR time of 23.9 ± 5 s and in 0/8 AEDs was less than 10 s. While all the machines correctly identified sinus rhythm, ventricular fibrillation (VF) and asystole only 6/8 (75%) and 1/8 (12.5%) AEDs classified as shockable a fast ventricular tachycardia (VT) at 225 bpm and a slow VT at 125 bpm respectively. When the rhythm was changed during the charging phase only 3/8 (37.5%) AEDs recognized the changing and did not indicate the shock. Conclusion: AED performance may really affect the quality of CPR because of interruptions often longer than ten seconds in disagreement with international guidelines. Industry leaders should focus their research in that direction. http://dx.doi.org/10.1016/j.resuscitation.2014.03.138 AP090 Resuscitation by text-message responders in The Netherlands Wim van der Worp Ambulance Oost, Hengelo, The Netherlands Since 2008 there are projects in the Netherlands that provide civilians as lay-responders/volunteers to OHCA’s. One of these projects resulted in a system called HartslagNu (HeartbeatNow), which currently counts app. 60,000 volunteers and has approximately 7000 AED’s available spread over the larger part of The Netherlands. After the dispatch centre receives a 112-call for a resuscitation the dispatcher immediately sends out an ambulance and activates the system HartslagNu. Within a few seconds volunteers and AED’s are located in a circle of max 1000 m around the victims address. Volunteers receive a text message and max 10 of them are sent directly to the victims address to start CPR. Max. 20 volunteers are sent to an AED within the proximity, take it with them to the victim and use it if necessary. (pictures and slides of how the system works are available) All volunteers must be trained in CPR and use of AED. They subscribe to the system with name, address, phone number, email and training institute. 17 of the 24 dispatch centres are currently connected to the system. In 2013 the numbers were: Nr of activations of the system Nr of dispatched volunteers Nr of which sent directly to victim Nr of which sent to AED Nr of AED’s dispatched to
4176 74307 40906 33401 8282
Effectiveness is currently under study by Dr. R. W. Koster, Amsterdam Medical Centre and will be published later in 2014. This project is unique. There is no place in the world where there is a system with this number of available volunteers and AED’s, used
S55
on national scale. I’d like to show a presentation and tell the world about it! http://dx.doi.org/10.1016/j.resuscitation.2014.03.139 AP091 Witnessed cardiac arrest Amela Komilija ∗ , Amra Basic-Zivadinovic Emergency Medical Service Centre, Sarajevo, Bosnia and Herzegovina Purpose of the study: The aim is to show the most common cause of cardiac arrest during physical examination and emphasize the importance of defibrillation as the only treatment of ventricular fibrillation. Materials and methods: Retrospective study has been used in the five-year period to analyze experience of cardiac arrest in the Emergency Medical Service Centre of Sarajevo (EMSC). For the analysis we have used data from the protocols medical teams, emergency medicine ambulance and definitive diagnosis and condition of the patient discharge letters, Clinical Center University of Sarajevo. Results: During medical examination 76 patients experienced acute cardiac arrest. At the first site acute myocardial infarctionSTEMI was diagnosed in 82% of patients. Initial rhythm in 82% of patients was ventricular fibrillation. The male population was dominant, in 74% of cases. Commonly witnessed cardiac arrest was in the age group over 60 years, in 60% of cases. Significant percentage of working age population between 45 and 60 years was 38%. Analysis time events showed that in 40% of cases occurred in the period from 6.00 p.m. to midnight, and 22% from midnight till 6.00 a.m. In all patients in whom the initial rhythm at the time of cardiac arrest was ventricular fibrillation the DC shock was immediately delivered. After defibrillation 47% of patients were hospitalized at the Clinic for heart and rheumatism of Sarajevo, fully conscious with stable vital parameters. At the Heart (PCI) center of Sarajevo, 17% of all witnessed cardiac arrest patients PCI intervention was performed. Conclusion: EMSC is unique pre-hospital institution that operates 24 h a day/7 days a week. Thanks to adequate treatment, defibrillation, 76% of patients were hospitalized after the return of spontaneous circulation. Adequate treatment of witnessed cardiac arrest implies well-organized, highly sophisticated equipment and continuous education of emergency teams. http://dx.doi.org/10.1016/j.resuscitation.2014.03.140 AP092 The reliability of “hands on” defibrillation in patients with internal cardioverter defibrillator Sami Eksert 1 , Gokhan Ozkan 1 , Ender Sir 2,∗ , Mehmet Ozgur Ozhan 3 1 Gulhane Military Faculty of Medicine, Ankara, Turkey 2 Beytepe Military Hospital, Ankara, Turkey 3 TDV 29 Mayis Hospital, Ankara, Turkey
The advice regarding the potential dangers of practitioners contact with a patient during the firing of an internal cardioverter defibrillator (ICD) is rare. This case report presents an affected practitioner due to a shock obtained from an ICD during chest compression on a patient in cardiac arrest.