Public access defibrillation-results from the Victorian Ambulance Cardiac Arrest Registry

Marijana Lijovic, Stephen Anthony Bernard, Ziad Nehme, Tony L J Walker, Karen Louise Smith

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim To assess the impact of automated external defibrillator (AED) use by bystanders in Victoria, Australia on survival of adults suffering an out-of-hospital cardiac arrest (OHCA) in a public place compared to those first defibrillated by emergency medical services (EMS). Methods We analysed data from the Victorian Ambulance Cardiac Arrest Registry for individuals aged >15 years who were defibrillated in a public place between 1 July 2002 and 30 June 2013, excluding events due to trauma or witnessed by EMS. Results Of 2270 OHCA cases who arrested in a public place, 2117 (93.4 ) were first defibrillated by EMS and 153 (6.7 ) were first defibrillated by a bystander using a public AED. Use of public AEDs increased almost 11-fold between 2002/2003 and 2012/2013, from 1.7 to 18.5 , respectively (p <0.001). First defibrillation occurred sooner in bystander defibrillation (5.2 versus 10.0 min, p <0.001). Unadjusted survival to hospital discharge for bystander defibrillated patients was significantly higher than for those first defibrillated by EMS (45 versus 31 , p <0.05). Multivariable logistic regression analysis showed that first defibrillation by a bystander using an AED was associated with a 62 increase in the odds of survival to hospital discharge (adjusted odds ratio 1.62, 95 CI: 1.12?2.34, p = 0.010) compared to first defibrillation by EMS. Conclusion Survival to hospital discharge is improved in patients first defibrillated using a public AED prior to EMS arrival in Victoria, Australia. Encouragingly, bystander AED use in Victoria has increased over time. More widespread availability of AEDs may further improve outcomes of OHCA in public places.
Original languageEnglish
Pages (from-to)1739 - 1744
Number of pages6
JournalResuscitation
Volume85
Issue number12
DOIs
Publication statusPublished - 2014

Cite this

@article{98f34104897b4f23b8caa05febeefe7a,
title = "Public access defibrillation-results from the Victorian Ambulance Cardiac Arrest Registry",
abstract = "Aim To assess the impact of automated external defibrillator (AED) use by bystanders in Victoria, Australia on survival of adults suffering an out-of-hospital cardiac arrest (OHCA) in a public place compared to those first defibrillated by emergency medical services (EMS). Methods We analysed data from the Victorian Ambulance Cardiac Arrest Registry for individuals aged >15 years who were defibrillated in a public place between 1 July 2002 and 30 June 2013, excluding events due to trauma or witnessed by EMS. Results Of 2270 OHCA cases who arrested in a public place, 2117 (93.4 ) were first defibrillated by EMS and 153 (6.7 ) were first defibrillated by a bystander using a public AED. Use of public AEDs increased almost 11-fold between 2002/2003 and 2012/2013, from 1.7 to 18.5 , respectively (p <0.001). First defibrillation occurred sooner in bystander defibrillation (5.2 versus 10.0 min, p <0.001). Unadjusted survival to hospital discharge for bystander defibrillated patients was significantly higher than for those first defibrillated by EMS (45 versus 31 , p <0.05). Multivariable logistic regression analysis showed that first defibrillation by a bystander using an AED was associated with a 62 increase in the odds of survival to hospital discharge (adjusted odds ratio 1.62, 95 CI: 1.12?2.34, p = 0.010) compared to first defibrillation by EMS. Conclusion Survival to hospital discharge is improved in patients first defibrillated using a public AED prior to EMS arrival in Victoria, Australia. Encouragingly, bystander AED use in Victoria has increased over time. More widespread availability of AEDs may further improve outcomes of OHCA in public places.",
author = "Marijana Lijovic and Bernard, {Stephen Anthony} and Ziad Nehme and Walker, {Tony L J} and Smith, {Karen Louise}",
year = "2014",
doi = "10.1016/j.resuscitation.2014.10.005",
language = "English",
volume = "85",
pages = "1739 -- 1744",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier",
number = "12",

}

Public access defibrillation-results from the Victorian Ambulance Cardiac Arrest Registry. / Lijovic, Marijana; Bernard, Stephen Anthony; Nehme, Ziad; Walker, Tony L J; Smith, Karen Louise.

In: Resuscitation, Vol. 85, No. 12, 2014, p. 1739 - 1744.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Public access defibrillation-results from the Victorian Ambulance Cardiac Arrest Registry

AU - Lijovic, Marijana

AU - Bernard, Stephen Anthony

AU - Nehme, Ziad

AU - Walker, Tony L J

AU - Smith, Karen Louise

PY - 2014

Y1 - 2014

N2 - Aim To assess the impact of automated external defibrillator (AED) use by bystanders in Victoria, Australia on survival of adults suffering an out-of-hospital cardiac arrest (OHCA) in a public place compared to those first defibrillated by emergency medical services (EMS). Methods We analysed data from the Victorian Ambulance Cardiac Arrest Registry for individuals aged >15 years who were defibrillated in a public place between 1 July 2002 and 30 June 2013, excluding events due to trauma or witnessed by EMS. Results Of 2270 OHCA cases who arrested in a public place, 2117 (93.4 ) were first defibrillated by EMS and 153 (6.7 ) were first defibrillated by a bystander using a public AED. Use of public AEDs increased almost 11-fold between 2002/2003 and 2012/2013, from 1.7 to 18.5 , respectively (p <0.001). First defibrillation occurred sooner in bystander defibrillation (5.2 versus 10.0 min, p <0.001). Unadjusted survival to hospital discharge for bystander defibrillated patients was significantly higher than for those first defibrillated by EMS (45 versus 31 , p <0.05). Multivariable logistic regression analysis showed that first defibrillation by a bystander using an AED was associated with a 62 increase in the odds of survival to hospital discharge (adjusted odds ratio 1.62, 95 CI: 1.12?2.34, p = 0.010) compared to first defibrillation by EMS. Conclusion Survival to hospital discharge is improved in patients first defibrillated using a public AED prior to EMS arrival in Victoria, Australia. Encouragingly, bystander AED use in Victoria has increased over time. More widespread availability of AEDs may further improve outcomes of OHCA in public places.

AB - Aim To assess the impact of automated external defibrillator (AED) use by bystanders in Victoria, Australia on survival of adults suffering an out-of-hospital cardiac arrest (OHCA) in a public place compared to those first defibrillated by emergency medical services (EMS). Methods We analysed data from the Victorian Ambulance Cardiac Arrest Registry for individuals aged >15 years who were defibrillated in a public place between 1 July 2002 and 30 June 2013, excluding events due to trauma or witnessed by EMS. Results Of 2270 OHCA cases who arrested in a public place, 2117 (93.4 ) were first defibrillated by EMS and 153 (6.7 ) were first defibrillated by a bystander using a public AED. Use of public AEDs increased almost 11-fold between 2002/2003 and 2012/2013, from 1.7 to 18.5 , respectively (p <0.001). First defibrillation occurred sooner in bystander defibrillation (5.2 versus 10.0 min, p <0.001). Unadjusted survival to hospital discharge for bystander defibrillated patients was significantly higher than for those first defibrillated by EMS (45 versus 31 , p <0.05). Multivariable logistic regression analysis showed that first defibrillation by a bystander using an AED was associated with a 62 increase in the odds of survival to hospital discharge (adjusted odds ratio 1.62, 95 CI: 1.12?2.34, p = 0.010) compared to first defibrillation by EMS. Conclusion Survival to hospital discharge is improved in patients first defibrillated using a public AED prior to EMS arrival in Victoria, Australia. Encouragingly, bystander AED use in Victoria has increased over time. More widespread availability of AEDs may further improve outcomes of OHCA in public places.

UR - http://www.sciencedirect.com.ezproxy.lib.monash.edu.au/science/article/pii/S0300957214007849

U2 - 10.1016/j.resuscitation.2014.10.005

DO - 10.1016/j.resuscitation.2014.10.005

M3 - Article

VL - 85

SP - 1739

EP - 1744

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

IS - 12

ER -