دورية أكاديمية
أعرض في EDS

Delaying a shock after takeover from the automated external defibrillator by paramedics is associated with decreased survival.

التفاصيل البيبلوغرافية
العنوان: Delaying a shock after takeover from the automated external defibrillator by paramedics is associated with decreased survival.
المؤلفون: Berdowski J; Department of Cardiology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. J.Berdowski@amc.uva.nl, Schulten RJ, Tijssen JG, van Alem AP, Koster RW
المصدر: Resuscitation [Resuscitation] 2010 Mar; Vol. 81 (3), pp. 287-92. Date of Electronic Publication: 2009 Dec 22.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier/north-Holland Biomedical Press Country of Publication: Ireland NLM ID: 0332173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1570 (Electronic) Linking ISSN: 03009572 NLM ISO Abbreviation: Resuscitation Subsets: MEDLINE
أسماء مطبوعة: Publication: Limerick : Elsevier/north-Holland Biomedical Press
Original Publication: London, Middlesex Pub. Co.
مواضيع طبية MeSH: Defibrillators* , Emergency Medical Technicians*, Electric Countershock/*instrumentation , Heart Arrest/*mortality , Heart Arrest/*therapy, Aged ; Cohort Studies ; Equipment Design ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Survival Rate ; Time Factors
مستخلص: Introduction: The purpose of this study was to investigate whether the takeover by Advanced Life Support [ALS] trained ambulance paramedics from rescuers using an automated external defibrillator [AED] delays shocks and if this delay is associated with decreased survival after out-of-hospital cardiac arrest [OHCA].
Methods: We analyzed continuous ECG recordings of LIFEPAK AEDs and associated manual defibrillator recordings of OHCA of presumed cardiac cause, prospectively collected from July 2005 to July 2009. The primary outcome measure was survival to discharge. Among 693 patients treated with AEDs, 110 had a shockable initial rhythm and a shockable rhythm during ALS takeover. We measured the time interval between the expected shock if the AED would remain attached to the patient and the first observed shock given by the manual defibrillator [shock timing].
Results: Survival was 62% (13/21) if the shock was given early (<-20s), 52% (11/21; odds ratio [OR]=0.68, ns) if given on time (-20 to 20s), 29% (10/34; OR=0.26, 95% confidence interval [CI]=0.08-0.81; P=0.02) if the shock was 20-150s delayed and 21% (7/34; OR=0.16, 95% CI=0.05-0.54; P=0.003) if the shock was delayed >150s. The OR for trend was 0.41, 95% CI=0.25-0.71; P=0.001. The association between shock timing and survival was significant for patients with more than 150s shock delay (OR=0.19; 95% CI=0.04-0.71; P=0.02) or for trend in shock timing (0.42, 95% CI=0.20-0.84; P=0.02) after multivariable adjustment for prognostic factors age and slope of ventricular fibrillation.
Conclusions: ALS takeover delays the next shock delivery in almost two-third of cases. This delay is associated with decreased survival.
(Copyright 2009 Elsevier Ireland Ltd. All rights reserved.)
تواريخ الأحداث: Date Created: 20091222 Date Completed: 20100504 Latest Revision: 20100217
رمز التحديث: 20221213
DOI: 10.1016/j.resuscitation.2009.11.013
PMID: 20022683
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-1570
DOI:10.1016/j.resuscitation.2009.11.013