AED use unchanged with smartphone-dispatched responders to out-of-hospital cardiac arrest - Healio

Smartphone dispatch of unpaid responders for out-of-hospital cardiac apprehension researchers conferred a tiny but not important summation successful automated outer defibrillator attachment, researchers reported.

“We bash not construe the deficiency of statistical differences betwixt attraction groups to bespeak the information that the unpaid responder strategy does not person an effect. Instead, we reason that the power radical grew beardown arsenic a effect of methodological issues,” Ellinor Berglund, RN, PhD, of the section of objective subject and education, Södersjukhuset, Centre for Resuscitation Science astatine the Karolinska Institutet successful Stockholm, and colleagues wrote. “Therefore, our wide decision is that the unpaid responder strategy contributes to an summation successful the overall usage of AEDs and bystander CPR and whitethorn correspond an important complement to the efforts of modular [emergency aesculapian services] and archetypal responders.”

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Design of the SAMBA trial

SAMBA was a signifier 1, community-based, randomized proceedings that was conducted successful the Swedish regions of Stockholm and Västra Götaland to trial Heartrunner, a smartphone app developed for map-aided dispatch of CPR-trained unpaid responders. The unpaid responder strategy was integrated with a nationalist registry of AEDs. A full of 3,123 AEDs and 24,493 unpaid responders were registered successful Stockholm and 3,195 devices and 19,117 volunteers were registered successful Västra Götaland.

When an out-of-hospital cardiac apprehension is suspected, the unpaid responder strategy locates a maximum of 30 unpaid responders wrong a 1.3 km radius of the suspected out-of-hospital cardiac apprehension and the volunteers are requested via smartphone app to judge oregon diminution the alert. Ambulances and on-duty archetypal responders were dispatched simultaneously.

The unpaid responders past received map-aided directions via the app to the determination of the suspected out-of-hospital cardiac arrest. Volunteers assigned to the involution limb of the SAMBA proceedings besides received accusation astir the nearest AEDs portion the power limb did not.

The superior result was wide bystander AED attachment, including those attached by the unpaid responders and volunteers not utilizing the smartphone app.

Results of smartphone activated unpaid responders

Between December 2018 and January 2020, unpaid responders were activated for 947 patients with out-of-hospital cardiac arrest. AED attachment occurred successful 13.2% of the involution limb compared with 9.5% of the power limb (difference, 3.8 percent points; 95% CI, –0.3 to 7.9; P = .08), the bulk of which were utilized by laic volunteers not utilizing the app. Volunteer responders attached 38% of each AEDs; provided 45% of each defibrillations; and provided 43% of each CPR, according to the study.

Researchers reported determination was nary important differences successful secondary outcomes including each bystander CPR and each bystander defibrillations betwixt volunteers assigned to the interventions compared with the power arm.

Among the volunteers who utilized app, crossover during effect to out-of-hospital cardiac apprehension was 11% and compliance to instructions from the app was 31%.

“The reasons for crossover could beryllium several, 1 being that an proprietor of an AED, oregon a unpaid responder adjacent to one, volition bring it, careless of the instructions they received,” the researchers wrote. “Low compliance to instructions could besides beryllium explained by longer distances to cod the nearest AED, arsenic reported successful a erstwhile study.”