Abstract 264: Out-of-Hospital Cardiac Arrest: The Cumulative Effect of Bystander Cardiopulmonary Resuscitation, Automated External Defibrillator and Automated Load Distributing Band Device Use on Return of Spontaneous Circulation
Introduction: Early bystander C.P.R., A.E.D. use and continuous chest compressions are essential elements of the a.h.a. “chain of survival”. Bystander C.P.R. and A.E.D. use in urban settings are becoming more prevalent. The use of an automated load distributing band (l.d.b.) device for O.H.C.A. management in a large metropolitan area by paramedics was implemented in the winter of 2007; in 9 municipalities, 582 paramedics were trained to use the l.d.b. device as part of a.l.s. measures. A retrospective paramedic “run-sheet” review was performed from 4/2008 - 8/2009 for all nontraumatic adult cardiac arrests. R.O.S.C. on arrival to the emergency departments (e.d.) was the endpoint.
Methods: 86 adult nontraumatic O.H.C.A. rehorts were found. each of the prehospital reports were reviewed. Utstein data elements were collected. bystander C.P.R. with “caller-aided” dispatch, A.E.D. use, paramedic use of standard a.h.a. resuscitation alogarthythms in addition to use of an automated l.d.b. device use (auto pulse® zoll) was recorded. Minitab 15 statistical software was used to evaluate the data. The cumulative effect of sequential “chain-of-survival” components was calculated.
Results: the mean age was 63 Y.O.; there were 58 males and 28 females. The initial rhythm was: v.fib, pulseless v.tach, P.E.A., or asystole. Chain of survival cumulative synergistic effect on R.O.S.C.
Conclusion: When bystander C.P.R., in addition to A.E.D. and autopulse were utilized synegistically, R.O.S.C. on e.d. arrival was 71%. When bystander C.P.R. and autopulse were used (without A.E.D. use) only 49% of patients had R.O.S.C. on e.d. arrival. Which is higher than previously reported: Hallstrom et al. (2006): 26% and Ong et al. (2006): 35%. When the l.d.b. device was used with a.l.s., R.O.S.C. was only 20%; which may be due to delayed care; since no efforts were made to resuscitate patients until the paramedics arrived. Our data reaffirms that early bystander C.P.R. and A.E.D. use are essential for achieving a high rate of R.O.S.C.
- © 2012 by American Heart Association, Inc.