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Baldi E, Grieco NB, Ristagno G, Alihodžić H, Canon V, Birkun A, Cresta R, Cimpoesu D, Clarens C, Ganter J, Markota A, Mols P, Nikolaidou O, Quinn M, Raffay V, Ortiz FR, Salo A, Stieglis R, Strömsöe A, Tjelmeland I, Trenkler S, Wnent J, Grasner JT, Böttiger BW, Savastano S. The Automated External Defibrillator: Heterogeneity of Legislation, Mapping and Use across Europe. New Insights from the ENSURE Study. J Clin Med 2021; 10:5018. [PMID: 34768537 PMCID: PMC8585055 DOI: 10.3390/jcm10215018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The rapid use of an automated external defibrillator (AED) is crucial for increased survival after an out-of-hospital cardiac arrest (OHCA). Many factors could play a role in limiting the chance of an AED use. We aimed to verify the situation regarding AED legislation, the AED mapping system and first responders (FRs) equipped with an AED across European countries. METHODS We performed a survey across Europe entitled "European Study about AED Use by Lay Rescuers" (ENSURE), asking the national coordinators of the European Registry of Cardiac Arrest (EuReCa) program to complete it. RESULTS Nineteen European countries replied to the survey request for a population covering 128,297,955 inhabitants. The results revealed that every citizen can use an AED in 15 countries whereas a training certificate was required in three countries. In one country, only EMS personnel were allowed to use an AED. An AED mapping system and FRs equipped with an AED were available in only 11 countries. The AED use rate was 12-59% where AED mapping and FR systems were implemented, which was considerably higher than in other countries (0-7.9%), reflecting the difference in OHCA survival. CONCLUSIONS Our survey highlighted a heterogeneity in AED legislation, AED mapping systems and AED use in Europe, which was reflected in different AED use and survival.
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Affiliation(s)
- Enrico Baldi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia, 27100 Pavia, Italy
- Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Italian Resuscitation Council, 40128 Bologna, Italy; (N.B.G.); (G.R.); (S.S.)
| | - Niccolò B. Grieco
- Italian Resuscitation Council, 40128 Bologna, Italy; (N.B.G.); (G.R.); (S.S.)
- Cardiology Department, Niguarda Hospital, 20162 Milan, Italy
| | - Giuseppe Ristagno
- Italian Resuscitation Council, 40128 Bologna, Italy; (N.B.G.); (G.R.); (S.S.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Hajriz Alihodžić
- Emergency Medical Service, Public Institution Health Centre ‘Dr. Mustafa Šehović’ and Faculty of Medicine, University of Tuzla, 75000 Tuzla, Bosnia and Herzegovina;
| | - Valentine Canon
- CHU Lille, ULR 2694-METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, F-59000 Lille, France;
- French National Out-of-Hospital Cardiac Arrest Registry-Registre Électronique des Arrêts Cardiaques, F-59000 Lille, France
| | - Alexei Birkun
- Medical Academy Named after S. I. Georgievsky of V. I. Vernadsky Crimean Federal University, 95000 Simferopol, Russia;
| | - Ruggero Cresta
- Quality and Research Division, Federazione Cantonale Ticinese Servizi Ambulanza (FCTSA), 6500 Bellinzona, Switzerland;
- Fondazione Ticino Cuore, 6900 Lugano, Switzerland
| | - Diana Cimpoesu
- Emergency Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Carlo Clarens
- Luxembourg Resuscitation Council, 2680 Luxembourg, Luxembourg;
| | - Julian Ganter
- Department of Cardiovascular Surgery, Faculty of Medicine, University Heart Center Freiburg, 79085 Freiburg, Germany;
| | - Andrej Markota
- Slovenian Resuscitation Council, Slovenian Society of Emergency Medicine, 1000 Ljubljana, Slovenia;
- Medical Intensive Care Unit, University Medical Centre Maribor, 2000 Maribor, Slovenia
| | - Pierre Mols
- Service des Urgences et du SMUR, CHU Saint-Pierre, Université Libre de Bruxelles, 1000 Bruxelles, Belgium;
| | | | - Martin Quinn
- Out-of-Hospital Cardiac Arrest Registry Steering Group, National University of Ireland, H91 CF50 Galway, Ireland;
| | - Violetta Raffay
- Department of Medicine, European University Cyprus, Nicosia 2404, Cyprus;
- Serbian Resuscitation Council, 21102 Novi Sad, Serbia
| | | | - Ari Salo
- Department of Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, 00530 Helsinki, Finland;
| | - Remy Stieglis
- Department of Cardiology, Amsterdam University Medical Center, Location AMC, 1105 Amsterdam, The Netherlands;
| | - Anneli Strömsöe
- School of Education, Health and Social Studies, Dalarna University, S-79188 Falun, Sweden;
- Centre for Clinical Research Dalarna, Uppsala University, S-79182 Falun, Sweden
- Department of Prehospital Care, Region of Dalarna, S-79129 Falun, Sweden
| | - Ingvild Tjelmeland
- Division of Prehospital Services, Oslo University Hospital, 0372 Oslo, Norway;
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0372 Oslo, Norway
- Institute for Emergency Medicine, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.W.); (J.-T.G.)
| | - Stefan Trenkler
- Department of Anaesthesiology and Intensive Medicine, Medical Faculty, P.J. Safarik University, 040 11 Kosice, Slovakia;
| | - Jan Wnent
- Institute for Emergency Medicine, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.W.); (J.-T.G.)
- Department of Anesthesiology, University Hopspital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
- School of Medicine, University of Namibia, Windhoek 10005, Namibia
| | - Jan-Thorsten Grasner
- Institute for Emergency Medicine, University Hospital Schleswig-Holstein, 24105 Kiel, Germany; (J.W.); (J.-T.G.)
- Department of Anesthesiology, University Hopspital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
| | - Bernd W. Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital and Medical Faculty of Cologne, 50931 Cologne, Germany;
- European Resuscitation Council (ERC), 2845 Niel, Belgium
| | - Simone Savastano
- Italian Resuscitation Council, 40128 Bologna, Italy; (N.B.G.); (G.R.); (S.S.)
- Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
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