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Azevedo LSL, Ribeiro LG, Schmidt A, Pazin Filho A. Impact of training in Advanced Cardiac Life Support (ACLS) in the professional career and work environment. CIENCIA & SAUDE COLETIVA 2018. [PMID: 29538568 DOI: 10.1590/1413-81232018233.13762016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We sought to evaluate the impact of Advanced Cardiac Life Support (ACLS) training in the professional career and work environment of physicians who took the course in a single center certified by the American Heart Association (AHA). Of the 4631 students (since 1999 to 2009), 2776 were located, 657 letters were returned, with 388 excluded from the analysis for being returned lacking addressees. The final study population was composed of 269 participants allocated in 3 groups (< 3 years, 3-5 and > 5years). Longer training was associated with older age, male gender, having undergone residency training, private office, greater earnings and longer time since graduation and a lower chance to participate in providing care for a cardiac arrest. Regarding personal change, no modification was detected according to time since taking the course. The only change in the work environment was the purchase of an automated external defibrillator (AED) by those who had taken the course more than 5 years ago. In multivariable analysis, however, the implementation of an AED was not independently associated with this group, which showed a lower chance to take a new ACLS course. ACLS courses should emphasize also how physicians could reinforce the survival chain through environmental changes.
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Affiliation(s)
- Lunia Sofia Lima Azevedo
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP). Av. Bandeirantes 3900, Monte Alegre. 14049-900 Ribeirão Preto SP Brasil.
| | - Lucas Gaspar Ribeiro
- Fundação de Amparo ao Ensino, Pesquisa e Assistência (FAEPA), Hospital das Clínicas, FMRP, USP. Ribeirão Preto SP Brasil
| | - André Schmidt
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP). Av. Bandeirantes 3900, Monte Alegre. 14049-900 Ribeirão Preto SP Brasil.
| | - Antônio Pazin Filho
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP). Av. Bandeirantes 3900, Monte Alegre. 14049-900 Ribeirão Preto SP Brasil.
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Yoon CG, Jeong J, Kwon IH, Lee JH. Availability and use of public access defibrillators in Busan Metropolitan City, South Korea. SPRINGERPLUS 2016; 5:1524. [PMID: 27652097 PMCID: PMC5017999 DOI: 10.1186/s40064-016-3201-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 09/01/2016] [Indexed: 11/14/2022]
Abstract
Out-of-hospital cardiac arrest (OHCA) is considered an important health issue worldwide, and early defibrillation is a key element for a favourable prognosis. In South Korea, public access defibrillation (PAD) programmes were initiated in 2007. However, the impact of PAD programmes on OHCA survival rates remains unclear. This study evaluated the deployment and maintenance status of public automatic external defibrillators (AED), including how frequently they were used, in Busan Metropolitan City, South Korea. Managers of possible AED sites were first contacted by telephone and asked to confirm the possession of an AED. AED suppliers were contacted for AED sales records to identify missing AED sites. AEDs located in ambulances and medical institutions were not included. Investigators visited confirmed AED sites and completed a checklist on AED maintenance and use. In total, 206 AEDs were located, indicative of an AED density of 0.268 AED/km2 and a prevalence of 6.07 per 100,000 in Busan Metropolitan City. We found that public AEDs had been used for resuscitation only 15 times, an average rate of use of once every 26.3 years. Our results indicate that AEDs in Busan Metropolitan City are underused according to the guidelines, and several are in low-priority locations. We believe that AED deployment based on cardiac arrest statistics is important to optimise layperson AED training and utilisation.
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Affiliation(s)
- Chang Guk Yoon
- Department of Emergency Medicine, Dong-A University Hospital, Busan, 49201 Republic of Korea
| | - Jinwoo Jeong
- Department of Emergency Medicine, College of Medicine, Dong-A University, Busan, 49201 Republic of Korea
| | - In Ho Kwon
- Department of Emergency Medicine, College of Medicine, Dong-A University, Busan, 49201 Republic of Korea
| | - Jae Hoon Lee
- Department of Emergency Medicine, College of Medicine, Dong-A University, Busan, 49201 Republic of Korea
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Santos SV, Margarido MRRA, Caires IS, Santos RAN, Souza SG, Souza JMA, Martimiano RR, Dutra CSK, Palha P, Zanetti ACG, Pazin-Filho A. Basic life support knowledge of first-year university students from Brazil. ACTA ACUST UNITED AC 2015; 48:1151-5. [PMID: 26397971 PMCID: PMC4661033 DOI: 10.1590/1414-431x20154667] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 06/22/2015] [Indexed: 11/22/2022]
Abstract
We aimed to evaluate knowledge of first aid among new undergraduates and whether it
is affected by their chosen course. A questionnaire was developed to assess knowledge
of how to activate the Mobile Emergency Attendance Service - MEAS (Serviço de
Atendimento Móvel de Urgência; SAMU), recognize a pre-hospital emergency situation
and the first aid required for cardiac arrest. The students were also asked about
enrolling in a first aid course. Responses were received from 1038 of 1365 (76.04%)
new undergraduates. The questionnaires were completed in a 2-week period 1 month
after the beginning of classes. Of the 1038 respondents (59.5% studying biological
sciences, 11.6% physical sciences, and 28.6% humanities), 58.5% knew how to activate
the MEAS/SAMU (54.3% non-biological vs 61.4% biological, P=0.02),
with an odds ratio (OR)=1.39 (95%CI=1.07-1.81) regardless of age, sex, origin, having
a previous degree or having a relative with cardiac disease. The majority could
distinguish emergency from non-emergency situations. When faced with a possible
cardiac arrest, 17.7% of the students would perform chest compressions (15.5%
non-biological vs 19.1% biological first-year university students,
P=0.16) and 65.2% would enroll in a first aid course (51.1% non-biological
vs 74.7% biological, P<0.01), with an OR=2.61
(95%CI=1.98-3.44) adjusted for the same confounders. Even though a high percentage of
the students recognized emergency situations, a significant proportion did not know
the MEAS/SAMU number and only a minority had sufficient basic life support skills to
help with cardiac arrest. A significant proportion would not enroll in a first aid
course. Biological first-year university students were more prone to enroll in a
basic life support course.
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Affiliation(s)
- S V Santos
- Programa de Educação Tutorial, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - M R R A Margarido
- Programa de Educação Tutorial, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - I S Caires
- Programa de Educação Tutorial, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R A N Santos
- Programa de Educação Tutorial, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - S G Souza
- Programa de Educação Tutorial, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - J M A Souza
- Programa de Educação Tutorial, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R R Martimiano
- Programa de Educação Tutorial, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C S K Dutra
- Programa de Educação Tutorial, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - P Palha
- Programa de Educação Tutorial, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A C G Zanetti
- Programa de Educação Tutorial, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A Pazin-Filho
- Programa de Educação Tutorial, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Mobile Versus Fixed Deployment of Automated External Defibrillators in Rural EMS. Prehosp Disaster Med 2015; 30:152-4. [DOI: 10.1017/s1049023x1500014x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroductionThere is no consensus on where automated external defibrillators (AEDs) should be placed in rural communities to maximize impact on survival from cardiac arrest. In the community of Stokes County, North Carolina (USA) the Emergency Medical Services (EMS) system promotes cardiopulmonary resuscitation (CPR) public education and AED use with public access defibrillators (PADs) placed mainly in public schools, churches, and government buildings.Hypothesis/ProblemThis study tested the utilization of AEDs assigned to first responders (FRs) in their private-owned-vehicle (POV) compared to AEDs in fixed locations.MethodsThe authors performed a prospective, observational study measuring utilization of AEDs carried by FRs in their POV compared to utilization of AEDs in fixed locations. Automated external defibrillator utilization is activation with pads placed on the patient and analysis of heart rhythm to determine if shock/no-shock is indicated. The Institutional Review Board of Wake Forest University Baptist Health System approved the study and written informed consent was waived. The study began on December 01, 2012 at midnight and ended on December 01, 2013 at midnight.ResultsDuring the 12-month study period, 81 community AEDs were in place, 66 in fixed locations and 15 assigned to FRs in their POVs. No utilizations of the 66 fixed location AEDs were reported (0.0 utilizations/AED/year) while 19 utilizations occurred in the FR POV AED study group (1.27 utilizations/AED/year; P<.0001). Odds ratio of using a FR POV located AED was 172 times more likely than using a community fixed-location AED in this rural community.DiscussionPlacing AEDs in a rural community poses many challenges for optimal utilization in terms of cardiac arrest occurrences. Few studies exist to direct rural community efforts in placing AEDs where they can be most effective, and it has been postulated that placing them directly with FRs may be advantageous.ConclusionsIn this rural community, the authors found that placing AED devices with FRs in their POVs resulted in a statistically significant increase in utilizations over AED fixed locations.NelsonRD, BozemanW, CollinsG, BooeB, BakerT, AlsonR. Mobile versus fixed deployment of automated external defibrillators in rural EMS. Prehosp Disaster Med. 2015;30(2):1-3.
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Use of automated external defibrillators in US federal buildings: implementation of the Federal Occupational Health public access defibrillation program. J Occup Environ Med 2014; 56:86-91. [PMID: 24351893 DOI: 10.1097/jom.0000000000000042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Federal Occupational Health (FOH) administers a nationwide public access defibrillation program in US federal buildings. We describe the use of automated external defibrillators (AEDs) in federal buildings and evaluate survival after cardiac arrest. METHODS Using the FOH database, we examined reported events in which an AED was brought to a medical emergency in federal buildings over a 14-year period, from 1999 to 2012. RESULTS There were 132 events involving an AED, 96 (73%) of which were due to cardiac arrest of cardiac etiology. Of 54 people who were witnessed to experience a cardiac arrest and presented with ventricular fibrillation or ventricular tachycardia, 21 (39%) survived to hospital discharge. CONCLUSIONS Public access defibrillation, along with protocols to install, maintain, and deploy AEDs and train first responders, benefits survival after cardiac arrest in the workplace.
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The Importance of Automated External Defibrillation Implementation Programs. Resuscitation 2014. [DOI: 10.1007/978-88-470-5507-0_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nielsen AM, Isbye DL, Lippert FK, Rasmussen LS. Can mass education and a television campaign change the attitudes towards cardiopulmonary resuscitation in a rural community? Scand J Trauma Resusc Emerg Med 2013; 21:39. [PMID: 23675991 PMCID: PMC3666962 DOI: 10.1186/1757-7241-21-39] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 05/09/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Survival after out-of-hospital cardiac arrest (OHCA) is improved when bystanders provide Basic Life Support (BLS). However, bystander BLS does not occur frequently. The aim of this study was to assess the effects on attitudes regarding different aspects of resuscitation of a one-year targeted media campaign and widespread education in a rural Danish community. Specifically, we investigated if the proportion willing to provide BLS and deploy an automated external defibrillator (AED) increased. METHODS BLS and AED courses were offered and the local television station had broadcasts about resuscitation in this study community. A telephone enquiry assessed the attitudes towards different aspects of resuscitation among randomly selected citizens before (2008) and after the project (2009). RESULTS For responses from 2008 (n = 824) to 2009 (n = 815), there was a significant increase in the proportions who had participated in a BLS course within the past 5 years, from 34% to 49% (p = 0.0001), the number willing to use an AED on a stranger (p < 0.0001), confident at providing chest compressions (p = 0.03), and confident at providing mouth-to-mouth ventilations (MMV) (p = 0.048). There was no significant change in the proportions willing to provide chest compressions (p = 0.15), MMV (p = 0.23) or confident at recognizing a cardiac arrest (p = 0.09). The most frequently reported reason for not being willing to provide chest compressions, MMV and use an AED was insecurity about how to perform the task. CONCLUSION A targeted media campaign and widespread education can significantly increase the willingness to use an AED, and the confidence in providing chest compressions and MMV. The willingness to provide chest compressions and MMV may be less influenced by a targeted campaign.
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Affiliation(s)
- Anne Møller Nielsen
- Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Nielsen AM, Folke F, Lippert FK, Rasmussen LS. Use and benefits of public access defibrillation in a nation-wide network. Resuscitation 2013; 84:430-4. [DOI: 10.1016/j.resuscitation.2012.11.008] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 11/08/2012] [Accepted: 11/11/2012] [Indexed: 11/29/2022]
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The effect of the AED and AED programs on survival of individuals, groups and populations. Prehosp Disaster Med 2012; 27:419-24. [PMID: 22985768 DOI: 10.1017/s1049023x12001197] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The automated external defibrillator (AED) is a tool that contributes to survival with mixed outcomes. This review assesses the effectiveness of the AED, consistencies and variations among studies, and how varying outcomes can be resolved. METHODS A worksheet for the International Liaison Committee on Resuscitation (ILCOR) 2010 science review focused on hospital survival in AED programs was the foundation of the articles reviewed. Articles identified in the search covering a broader range of topics were added. All articles were read by at least two authors; consensus discussions resolved differences. RESULTS AED use developed sequentially. Use of AEDs by emergency medical technicians (EMTs) compared to manual defibrillators showed equal or superior survival. AED use was extended to trained responders likely to be near victims, such as fire/rescue, police, airline attendants, and casino security guards, with improvement in all venues but not all programs. Broad public access initiatives demonstrated increased survival despite low rates of AED use. Home AED programs have not improved survival; in-hospital trials have had mixed results. Successful programs have placed devices in high-risk sites, maintained the AEDs, recruited a team with a duty to respond, and conducted ongoing assessment of the program. CONCLUSION The AED can affect survival among patients with sudden ventricular fibrillation (VF). Components of AED programs that affect outcome include the operator, location, the emergency response system, ongoing maintenance and evaluation. Comparing outcomes is complicated by variations in definitions of populations and variables. The effect of AEDs on individuals can be dramatic, but the effect on populations is limited.
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Rea T, Blackwood J, Damon S, Phelps R, Eisenberg M. A link between emergency dispatch and public access AEDs: Potential implications for early defibrillation. Resuscitation 2011; 82:995-8. [DOI: 10.1016/j.resuscitation.2011.04.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Revised: 04/08/2011] [Accepted: 04/14/2011] [Indexed: 11/24/2022]
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Mochmann HC. Lebensbedrohliche Herzrhythmusstörungen. Notf Rett Med 2011. [DOI: 10.1007/s10049-010-1328-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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