CPR and AED Unit Research | Articles, Studies & More
As a national leader in providing American Heart Association courses to large and small businesses alike, Annuvia finds it important to share the latest world-wide research in this important, life-saving industry.
CPR Training Research
The scientists and healthcare providers participating in a comprehensive evidence evaluation process analyzed the sequence and priorities of the steps of CPR in light of current scientific advances to identify factors with the greatest potential impact on survival. On the basis of the strength of the available evidence, they developed recommendations to support the interventions that showed the most promise. There was unanimous support for continued emphasis on high-quality CPR, with compressions of adequate rate and depth, allowing complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). Return to a prior quality of life and functional state of health is the ultimate goal of a resuscitation system of care.
The two papers are remarkably similar in design and results. One was conducted in Washington state — mostly the Seattle suburbs — and in London, England. The other study was done in Sweden. In both cases, patients whose hearts had stopped received either traditional CPR, or a version with chest-compressions only. The patients were divided randomly, with 911 dispatchers giving instructions to callers who performed the CPR.
In the Seattle-London experiment, patients receiving chest compressions without mouth-to-mouth were more likely to survive without brain damage. In both experiments, patients getting chest-compressions only were more likely to survive, period.
In both cases, the difference was small enough that it was not considered statistically significant. But the authors — and an accompanying editorial — all said the findings support the idea that bystanders should be encouraged to do steady chest compressions on victims of apparent cardiac arrest, without pausing to give breaths. Learn more here.
Learn why experts, aided by extensive studies worldwide, believe Hands-only CPR is as, or perhaps even MORE, effective than traditional CPR (where rescue breaths are included). The AHA hopes that Hands-only CPR will increase the odds victims receive bystander CPR. You can watch a brief video to learn hands only CPR here: www.heart.org/handsonlycpr
- Likelihood of CPR by Bystanders Depends on Location of Cardiac Arrest
Sasson and colleagues explain that more than 300 000 cases of out-of-hospital cardiac arrest occur in the US each year, and outcomes vary markedly, with survival rates ranging from 0.2% in Detroit to 16.0% in Seattle. The variation can be explained, in part, by different rates of bystander-initiated CPR. On average, bystanders administer CPR in less than one-third of all out-of-hospital cardiac arrests.
atients who receive BCPR are more often found in VT/VF and have an increased rate of live discharge, with controls for age and response and definitive care intervals. For VT/VF patients, BCPR is associated with an increased rate of live discharge.
AED Unit Research
Over a two-year period, 21 persons had non-traumatic cardiac arrest, 18 of whom had ventricular fibrillation. With two exceptions, defibrillator operators were good Samaritans, acting voluntarily. In the case of four patients with ventricular fibrillation, defibrillators were neither nearby nor used within five minutes, and none of these patients survived. Three others remained in fibrillation and eventually died, despite the rapid use of a defibrillator (within five minutes). Eleven patients with ventricular fibrillation were successfully resuscitated, including eight who regained consciousness before hospital admission. No shock was delivered in four cases of suspected cardiac arrest, and the device correctly indicated that the problem was not due to ventricular fibrillation. The rescuers of 6 of the 11 successfully resuscitated patients had no training or experience in the use of automated defibrillators, although 3 had medical degrees. Ten of the 18 patients with ventricular fibrillation were alive and neurologically intact at one year. Read more here. Caffrey, Sherry L., et al. “Public use of automated external defibrillators.” New England Journal of Medicine 347.16 (2002): 1242-1247.
In 1287 consecutive patients with out-of-hospital cardiac arrest, we assessed the results of initial treatment with this device by firefighters who arrived first at the scene, as compared with the results of standard defibrillation administered by paramedics who arrived slightly after the firefighters. Of 276 patients who were initially treated by firefighters using the automatic defibrillator, 84 (30 percent) survived to hospital discharge, as compared with 44 (19 percent) of 228 patients when fire-fighters delivered only basic cardiopulmonary resuscitation and the first defibrillation was performed after the arrival of the paramedic team.
These findings support the widespread use of the automatic external defibrillator as an important part of the treatment of out-of-hospital cardiac arrest, although the overall impact of the use of this device on community survival rates is still uncertain.
The chain of survival begins with early access, in which the patient is helped as quickly as possible. Early access includes the implied component of early recognition. The resuscitation chain is initiated when a medical emergency is recognized and the emergency medical system accessed and activated.1 The time required for access begins the moment an emergency is recognized, by either the person with symptoms or a witness to the emergency. With sudden cardiac arrest, access time begins at the moment of collapse, and includes recognition of the emergency, the decision to make the call, time spent locating a telephone and emergency number, interrogation of the caller by the emergency dispatcher, and the decision to send an emergency vehicle. Learn more here.
Training and equipping volunteers to attempt early defibrillation within a structured response system can increase the number of survivors to hospital discharge after out-of-hospital cardiac arrest in public locations. Trained laypersons can use AEDs safely and effectively.