Remy Stieglis1, Jolande A Zijlstra2, Frank Riedijk3, Martin Smeekes3, Wim E van der Worp4, Rudolph W Koster2. 1. Amsterdam UMC, University of Amsterdam, Department of Cardiology, Amsterdam, The Netherlands. Electronic address: r.stieglis@amsterdamumc.nl. 2. Amsterdam UMC, University of Amsterdam, Department of Cardiology, Amsterdam, The Netherlands. 3. Veiligheidsregio Noord-Holland Noord, Alkmaar, The Netherlands. 4. Ambulance Oost, Hengelo, The Netherlands.
Abstract
BACKGROUND: For out-of-hospital cardiac arrest (OHCA) in residential areas, a dispatcher driven alert-system using text messages (TM-system) directing local rescuers (TM-responders) to OHCA patients was implemented and the desired density of automated external defibrillators (AEDs) or TM-responders investigated. METHODS: We included OHCA cases with the TM-system activated in residential areas between 2010-2017. For each case, densities/km2 of activated AEDs and TM-responders within a 1000 m circle were calculated. Time intervals between 112-call and first defibrillation were calculated. RESULTS: In total, 813 patients (45%) had a shockable initial rhythm. In 17% a TM-system AED delivered the first shock. With increasing AED density, the median time to shock decreased from 10:59 to 08:17 min. (p < 0.001) and shocks <6 min increased from 6% to 12% (p = 0.024). Increasing density of TM-responders was associated with a decrease in median time to shock from 10:59 to 08:20 min. (p < 0.001) and increase of shocks <6 min from 6% to 13% (p = 0.005). Increasing density of AEDs and TM-responders resulted in a decline of ambulance first defibrillation by 19% (p = 0.016) and 22% (p = 0.001), respectively. First responder AED defibrillation did not change significantly. Densities of >2 AEDs/km2 did not result in further decrease of time to first shock but >10 TM-responders/km2 resulted in more defibrillations <6 min. CONCLUSION: With increasing AED and TM-responder density within a TM-system, time to defibrillation in residential areas decreased. AED and TM-responders only competed with ambulances, not with first responders. The recommended density of AEDs and TM-responders for earliest defibrillation is 2 AEDs/km2 and >10 TM-responders/km2.
BACKGROUND: For out-of-hospital cardiac arrest (OHCA) in residential areas, a dispatcher driven alert-system using text messages (TM-system) directing local rescuers (TM-responders) to OHCA patients was implemented and the desired density of automated external defibrillators (AEDs) or TM-responders investigated. METHODS: We included OHCA cases with the TM-system activated in residential areas between 2010-2017. For each case, densities/km2 of activated AEDs and TM-responders within a 1000 m circle were calculated. Time intervals between 112-call and first defibrillation were calculated. RESULTS: In total, 813 patients (45%) had a shockable initial rhythm. In 17% a TM-system AED delivered the first shock. With increasing AED density, the median time to shock decreased from 10:59 to 08:17 min. (p < 0.001) and shocks <6 min increased from 6% to 12% (p = 0.024). Increasing density of TM-responders was associated with a decrease in median time to shock from 10:59 to 08:20 min. (p < 0.001) and increase of shocks <6 min from 6% to 13% (p = 0.005). Increasing density of AEDs and TM-responders resulted in a decline of ambulance first defibrillation by 19% (p = 0.016) and 22% (p = 0.001), respectively. First responder AED defibrillation did not change significantly. Densities of >2 AEDs/km2 did not result in further decrease of time to first shock but >10 TM-responders/km2 resulted in more defibrillations <6 min. CONCLUSION: With increasing AED and TM-responder density within a TM-system, time to defibrillation in residential areas decreased. AED and TM-responders only competed with ambulances, not with first responders. The recommended density of AEDs and TM-responders for earliest defibrillation is 2 AEDs/km2 and >10 TM-responders/km2.
Authors: Victor Taramarcaz; Tara Herren; Eric Golay; Simon Regard; Sébastien Martin-Achard; Francois Mach; Nicolas Schnetzler; Gaëtan Ricci; Ido Zamberg; Robert Larribau; Marc Niquille; Mélanie Suppan; Eduardo Schiffer; Laurent Suppan Journal: J Med Internet Res Date: 2022-05-18 Impact factor: 7.076
Authors: Ingvild B M Tjelmeland; Siobhan Masterson; Johan Herlitz; Jan Wnent; Leo Bossaert; Fernando Rosell-Ortiz; Kristin Alm-Kruse; Berthold Bein; Gisela Lilja; Jan-Thorsten Gräsner Journal: Scand J Trauma Resusc Emerg Med Date: 2020-10-19 Impact factor: 2.953
Authors: Camilla Metelmann; Bibiana Metelmann; Dorothea Kohnen; Peter Brinkrolf; Linn Andelius; Bernd W Böttiger; Roman Burkart; Klaus Hahnenkamp; Mario Krammel; Tore Marks; Michael P Müller; Stefan Prasse; Remy Stieglis; Bernd Strickmann; Karl Christian Thies Journal: Scand J Trauma Resusc Emerg Med Date: 2021-02-01 Impact factor: 2.953
Authors: Christopher M Smith; Ranjit Lall; Rachael T Fothergill; Robert Spaight; Gavin D Perkins Journal: Eur Heart J Acute Cardiovasc Care Date: 2022-01-12
Authors: Remy Stieglis; Jolande A Zijlstra; Frank Riedijk; Martin Smeekes; Wim E van der Worp; Jan G P Tijssen; Aeilko H Zwinderman; Marieke T Blom; Rudolph W Koster Journal: Eur Heart J Date: 2022-04-14 Impact factor: 29.983
Authors: Ludovic Sturny; Simon Regard; Robert Larribau; Marc Niquille; Georges Louis Savoldelli; François Sarasin; Eduardo Schiffer; Laurent Suppan Journal: J Med Internet Res Date: 2021-02-23 Impact factor: 5.428