Bystander Use of AED Improves Survival in Public Cardiac Arrest

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As emergency medical services response time became longer for out-of-hospital cardiac arrest, the benefit of bystander shock increased.
As emergency medical services response time became longer for out-of-hospital cardiac arrest, the benefit of bystander shock increased.

HealthDay News — Bystander automated external defibrillator use in shockable observed public out-of-hospital cardiac arrest (OHCA) is associated with improved survival and functional outcomes, according to a study published in Circulation.

Ross A. Pollack, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues collected detailed information on all cardiac arrests at 9 regional centers to examine the correlation of bystander automated external defibrillator use with survival and functional outcomes. The correlation was examined in shockable observed OHCA.

The researchers found that 4115 observed public OHCAs were analyzed, out of 49,555 OHCAs; 60.8% of the observed public OHCAs were shockable.

In 18.8% of the shockable arrests, a bystander shock was applied. Compared with patients initially shocked by emergency medical services, patients who were shocked by a bystander were significantly more likely to survival to discharge (66.5% vs 43.0%) and to be discharged with favorable functional outcome (57.1% vs 32.7%). Bystander shock correlated with odds ratios of 2.62 and 2.73 for survival to hospital discharge and discharge with favorable functional outcome, respectively, after adjustment for known predictors of outcome. As emergency medical services response time became longer, the benefit of bystander shock increased progressively.

"Continued emphasis on public automated external defibrillator utilization programs may further improve outcomes of OHCA," the authors wrote.

Disclosures: One author disclosed financial ties to HeartSine.

Reference

Pollack RA, Brown SP, Rea T, et al. Impact of bystander automated external defibrillator use on survival and functional outcomes in shockable observed public cardiac arrests [published online February 26, 2018]. Circulation. doi: 10.1161/CIRCULATIONAHA.117.030700

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