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Heo JY, Oh YT, Kim JH, Ahn C, Yang MS, Kim CW, Kim SE. Association between bystander automated external defibrillator use and survival in witnessed out-of-hospital cardiac arrest: A nationwide observational study in South Korea. Resuscitation 2024; 203:110388. [PMID: 39242017 DOI: 10.1016/j.resuscitation.2024.110388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/26/2024] [Accepted: 08/30/2024] [Indexed: 09/09/2024]
Abstract
AIM Sudden cardiac arrest is a global health issue, with out-of-hospital cardiac arrest (OHCA) posing a major challenge. Bystander cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) improve survival and neurological outcomes. However, their actual usage involves numerous constraints. Therefore, to determine the association between bystander AED use and survival of patients with OHCA, we analyzed South Korea's national OHCA database. METHODS This retrospective study included cases from the Korea Disease Control and Prevention Agency's Out-of-Hospital Cardiac Arrest Surveillance database from January 2016 to December 2021. Adult OHCA cases treated with bystander intervention were categorized into two groups, CPR with AEDs and without AEDs. Propensity score matching was employed to control for confounders and analyze bystander AED use's impact on survival to discharge and neurological outcomes. RESULTS Of 182,508 OHCA cases, 35,840 met the inclusion criteria, with 234 (0.7%) receiving bystander CPR with AEDs. The survival rate to discharge in the AED and non-AED group was 46.6% and 23.0%, respectively. However, after adjusting for potential confounders, bystander AED use did not significantly affect survival to discharge (adjusted odds ratio [aOR] 1.01, 95% confidence interval [CI] 0.70-1.44) or favorable neurological outcomes (aOR 1.08, 95% CI 0.99-1.18). CONCLUSION Survival to discharge or favorable neurological outcomes of patients with OHCA managed using bystander-applied AEDs and those without showed no significant difference. Factors such as AED accessibility and bystander preparedness influence the impact of bystander AED use. Further research should optimize AED deployment and usage strategies to enhance patient survival rate.
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Affiliation(s)
- Jang Yeong Heo
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, South Korea
| | - Young Taeck Oh
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, South Korea.
| | - Jae Hwan Kim
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, South Korea.
| | - Chiwon Ahn
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, South Korea.
| | - Mi Suk Yang
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, South Korea
| | - Chan Woong Kim
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, South Korea
| | - Sung Eun Kim
- Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul 06974, South Korea
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Taverna-Llauradó E, Martínez-Torres S, Granado-Font E, Pallejà-Millán M, Del Pozo A, Roca-Biosca A, Martín-Luján F, Rey-Reñones C. Online platform for cardiopulmonary resuscitation and automated external defibrillator training in a rural area: a community clinical trial protocol. BMJ Open 2024; 14:e079467. [PMID: 38326271 PMCID: PMC10859986 DOI: 10.1136/bmjopen-2023-079467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION Sudden death resulting from cardiorespiratory arrest carries a high mortality rate and frequently occurs out of hospital. Immediate initiation of cardiopulmonary resuscitation (CPR) by witnesses, combined with automated external defibrillator (AED) use, has proven to double survival rates. Recognising the challenges of timely emergency services in rural areas, the implementation of basic CPR training programmes can improve survival outcomes. This study aims to evaluate the effectiveness of online CPR-AED training among residents in a rural area of Tarragona, Spain. METHODS Quasi-experimental design, comprising two phases. Phase 1 involves assessing the effectiveness of online CPR-AED training in terms of knowledge acquisition. Phase 2 focuses on evaluating participant proficiency in CPR-AED simulation manoeuvres at 1 and 6 months post training. The main variables include the score difference between pre-training and post-training test (phase 1) and the outcomes of the simulated test (pass/fail; phase 2). Continuous variables will be compared using Student's t-test or Mann-Whitney U test, depending on normality. Pearson's χ2 test will be applied for categorical variables. A multivariate analysis will be conducted to identify independent factors influencing the main variable. ETHICS AND DISSEMINATION This study adheres to the tenets outlined in the Declaration of Helsinki and of Good Clinical Practice. It operated within the Smartwatch project, approved by the Clinical Research Ethics Committee of the Primary Care Research Institute IDIAP Jordi Gol i Gurina Foundation, code 23/081-P. Data confidentiality aligns with Spanish and European Commission laws for the protection of personal data. The study's findings will be published in peer-reviewed journals and presented at scientific meetings. TRIAL REGISTRATION NUMBER NCT05747495.
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Affiliation(s)
- Elena Taverna-Llauradó
- Primary Care Unit Camp de Tarragona, Institut Català de la Salut, Reus, Catalunya, Spain
- ISAC Research Group, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut IDIAP Jordi Gol i Gurina, Barcelona, Spain
- Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina, Reus, Spain
| | - Sara Martínez-Torres
- ISAC Research Group, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut IDIAP Jordi Gol i Gurina, Barcelona, Spain
- Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina, Reus, Spain
- Universitat Oberta de Catalunya, Barcelona, Catalunya, Spain
| | - Ester Granado-Font
- Primary Care Unit Camp de Tarragona, Institut Català de la Salut, Reus, Catalunya, Spain
- ISAC Research Group, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut IDIAP Jordi Gol i Gurina, Barcelona, Spain
- Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina, Reus, Spain
| | - Meritxell Pallejà-Millán
- ISAC Research Group, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut IDIAP Jordi Gol i Gurina, Barcelona, Spain
- Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina, Reus, Spain
- School of Medicine and Health Sciences, Universitat Rovira I Virgili, Reus, Catalunya, Spain
| | - Albert Del Pozo
- Primary Care Unit Camp de Tarragona, Institut Català de la Salut, Reus, Catalunya, Spain
- ISAC Research Group, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut IDIAP Jordi Gol i Gurina, Barcelona, Spain
- Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina, Reus, Spain
| | - Alba Roca-Biosca
- Nursing Department, Universitat Rovira i Virgili, Tarragona, Tarragona, Spain
| | - Francisco Martín-Luján
- ISAC Research Group, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut IDIAP Jordi Gol i Gurina, Barcelona, Spain
- Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina, Reus, Spain
- School of Medicine and Health Sciences, Universitat Rovira I Virgili, Reus, Catalunya, Spain
| | - Cristina Rey-Reñones
- ISAC Research Group, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut IDIAP Jordi Gol i Gurina, Barcelona, Spain
- Primary Healthcare Research Support Unit Camp de Tarragona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina, Reus, Spain
- School of Medicine and Health Sciences, Universitat Rovira I Virgili, Reus, Catalunya, Spain
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Munot S, Rugel EJ, Bray J, Redfern J, Yang G, Ngo L, Bauman A, Dang QM, Rock Z, Marschner S, Coggins A, Semsarian C, Middleton PM, Jennings G, Angell B, Kumar S, Kovoor P, Chow CK. Examining training and attitudes to basic life support in multi-ethnic communities residing in New South Wales, Australia: A mixed-methods investigation. BMJ Open 2023; 13:e073481. [PMID: 37491098 PMCID: PMC10373670 DOI: 10.1136/bmjopen-2023-073481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Bystander response, including cardiopulmonary resuscitation (CPR), is critical to out-of-hospital cardiac arrest (OHCA) survival. Nearly 30% of Australian residents were born overseas, and little is known about their preparedness to perform CPR. In this mixed-methods study, we examined rates of training and willingness and barriers to performing CPR among immigrants in Australia. METHODS First, we surveyed residents in New South Wales, Australia, using purposeful sampling to enrich immigrant populations. Multivariate logistic regression was used to examine the association between place of birth and willingness to perform CPR. Next, we conducted focus-group discussions with members of the region's largest migrant groups to explore barriers and relevant societal or cultural factors. RESULTS Of the 1267 survey participants (average age 49.6 years, 52% female), 60% were born outside Australia, most in Asia and 73% had lived in Australia for more than 10 years. Higher rates of previous CPR training were reported among Australian-born participants compared with South Asian-born and East Asian-born (77%, 35%, 48%, respectively, p <0.001). In adjusted models, the odds of willingness to perform CPR on a stranger were significantly lower among migrants than Australian-born (adjusted OR: 0.64; 95% CI 0.49 to 0.83); however, this association was mediated by history of training. Themes emerging from the focus-group discussions included concerns about causing harm, fear of liability, and birthplace-specific social and cultural barriers. CONCLUSIONS Targeted awareness and training interventions, which address common and culture-specific barriers to response and improved access to training, may improve confidence and willingness to respond to OHCA in multi-ethnic communities.
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Affiliation(s)
- Sonali Munot
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Emily J Rugel
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Janet Bray
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Guoyan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Linh Ngo
- Greater Brisbane Clinical School, Faculty of Medicine, The University of Queensland, Chermside, Queensland, Australia
| | - Adrian Bauman
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Quan Minh Dang
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Zoe Rock
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Simone Marschner
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Andrew Coggins
- Department of Emergency Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology at the Centenary Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul M Middleton
- South Western Emergency Research Institute, Ingham Institute, Liverpool, New South Wales, Australia
| | - Garry Jennings
- Sydney Health Partners, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Blake Angell
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Kensington, New South Wales, Australia
| | - Saurabh Kumar
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Pramesh Kovoor
- Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Clara K Chow
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- Department of Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Hammoud S, Daher R, Damaj R, Booz GW, Kurdi M. Knowledge and attitude of the young population towards sudden cardiac arrest: A cross-sectional study. Am J Emerg Med 2023:S0735-6757(23)00369-8. [PMID: 37474352 DOI: 10.1016/j.ajem.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023] Open
Affiliation(s)
- Sabah Hammoud
- Laboratory of Experimental and Clinical Pharmacology, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, Hadat, Lebanon
| | - Racha Daher
- Laboratory of Experimental and Clinical Pharmacology, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, Hadat, Lebanon
| | - Raghida Damaj
- Laboratory of Experimental and Clinical Pharmacology, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, Hadat, Lebanon
| | - George W Booz
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Mazen Kurdi
- Laboratory of Experimental and Clinical Pharmacology, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, Hadat, Lebanon; Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS, USA.
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Yukun J, Yanmang S, Yan W, Bei W, Shurui F. Improved immune algorithm for sudden cardiac death first aid drones site selection. Int J Med Inform 2023; 173:105025. [PMID: 36898205 DOI: 10.1016/j.ijmedinf.2023.105025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
AIMS Out-of-hospital cardiac arrest (OHCA) requires a fast emergency response, while traditional emergency takes too long to meet the demand. Combining a drone with a defibrillator can provide rapid resuscitation of OHCA patients. The aims are to improve survival in OHCA and to minimize the total system cost. METHODS We developed an integer planning model for sudden cardiac death (SCD) first aid drone siting based on a set covering model with the stability of the siting system as the main constraint, considering the rescue time and total system cost. Using 300 points to simulate potential cardiac arrest locations in the main municipal district of Tianjin, China, the SCD first aid drone siting points are solved using an improved immune algorithm. RESULTS Based on the actual parameters set by the SCD first aid drone, 25 siting points were solved in the main municipal district of Tianjin, China. These 25 sites were able to cover 300 simulated potential demand points. The average rescue time was 127.18 s and the maximum rescue time was 296.99 s. The total system cost was 136,824.46 Yuan. Comparing the pre- and post-algorithm solutions, the system stability was improved by 42.22%, and the maximum number of siting points corresponding to demand points was reduced by 29.41% and the minimum number was increased by 16.86%, which is closer to the average. CONCLUSIONS We propose the SCD emergency system and use the improved immune algorithm for example solving. Comparing the solution results using the pre- and post-improvement algorithms, the cost solved by the post-improvement algorithm is less and the system is more stable.
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Affiliation(s)
- Jia Yukun
- Hebei University of Technology, Tianjin 300400, China.
| | - Su Yanmang
- Hebei University of Technology, Tianjin 300400, China.
| | - Wang Yan
- Tianjin Vocational Institute, Tianjin 300350, China
| | - Wang Bei
- Hebei University of Technology, Tianjin 300400, China
| | - Fan Shurui
- Hebei University of Technology, Tianjin 300400, China
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