Public-access AED pad application and outcomes for out-of-hospital cardiac arrests in Osaka, Japan
Public-access AED pad application and outcomes for out-of-hospital cardiac arrests in Osaka, Japan
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DOI：
10.1016/j.resuscitation.2016.06.025
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发表时间：
2016-09-01
期刊：
影响因子：
6.5
通讯作者：
Iwami, Taku
中科院分区：
文献类型：
--
作者：
Kiyohara, Kosuke;Kitamura, Tetsuhisa;Iwami, Taku
背景资料：实际应用的公共访问自动体外除颤器（AED）垫的患者与院外心脏骤停（OHCA）由public一直调查不足。方法：AED的应用，院前的特点，和一个月的结果发生在大坂府2011年至2012年从Utstein大坂项目注册。入选了在急诊就诊前发生非创伤性OHCA的患者。根据OHCA.Results的位置，对由公众应用于患者胸部的AED垫的比例和一个月的结果进行了分析：总的来说，在研究期间，3.5%的OHCA患者（351/9978）应用了公共获取的AED垫。在多变量分析中，发生在公共场所并接受旁观者启动的心肺复苏的OHCA与公共获取AED的应用显著增加相关。在使用公共通道AED垫的患者中，29.6%（104/351）接受了公共通道除颤。与未使用AED的患者相比，使用AED的患者的一个月生存率和良好的神经结局显著更高（19.4% vs. 3.0%; OR：2.76 [95% CI：1.92-3.97]）。在OHCA之后，公共接入AED的应用导致了有利的结果，但现有设备的利用仍然不足，并且根据OHCA事件的位置而变化很大。除了传播公共获取的AED，还需要采取进一步的战略方法在现场部署AED，以及为公众提供基本的生命支持培训，以提高OHCA后的存活率。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Background: Actual application of public-access automated external defibrillator (AED) pads to patients with an out-of-hospital cardiac arrest (OHCA) by the public has been poorly investigated.Methods: AED applications, prehospital characteristics, and one-month outcomes of OHCAs occurring in Osaka Prefecture from 2011 to 2012 were obtained from the Utstein Osaka Project registry. Patients with a non-traumatic OHCA occurring before emergency medical service attendance were enrolled. The proportion of AED pads that were applied to the patients' chests by the public and one-month outcomes were analysed according to the location of OHCA.Results: In total, public-access AED pads were applied to 3.5% of OHCA patients (351/9978) during the study period. In the multivariate analyses, OHCAs that occurred in public places and received bystander-initiated cardiopulmonary resuscitation were associated with significantly higher application of public-access AEDs. Among the patients for whom public-access AED pads were applied, 29.6% (104/351) received public-access defibrillation. One-month survival with a favourable neurological outcome was significantly higher among patients who had an AED applied compared to those who did not (19.4% vs. 3.0%; OR: 2.76 [95% CI: 1.92-3.97]).Conclusion: The application of public-access AEDs leads to favourable outcomes after an OHCA, but utilisation of available equipment remains insufficient, and varies considerably according to the location of the OHCA event. Alongside disseminating public-access AEDs, further strategic approaches for the deployment of AEDs at the scene, as well as basic life support training for the public are required to improve survival rates after OHCAs. (C) 2016 Elsevier Ireland Ltd. All rights reserved.