Smartphone dispatch of volunteer responders may not increase bystander use of automated external defibrillator in out-of-hospital cardiac arrest – the SAMBA trial - 2 Minute Medicine

1. This randomized controlled proceedings evaluating the effect of Heartrunner, a smartphone application, demonstrated nary important summation successful bystander-attached automated outer defibrillator (AED) among unpaid responders who received instructions to cod adjacent AED compared to those instructed to study to the diligent and statesman cardiopulmonary resuscitation (CPR).

2. Future studies to measure the efficacy of this exertion should see larger illustration sizes and clinical-based outcomes, specified arsenic diligent morbidity and mortality rates.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Prompt cardiopulmonary resuscitation (CPR) and automated outer defibrillator (AED) usage are captious successful improving endurance for out-of-hospital cardiac apprehension (OHCA). A erstwhile proceedings demonstrated that a mobile telephone dispatch of unpaid responders accrued bystander CPR rates. Recently, a mobile telephone exertion called Heartrunner, was developed to punctual users to usage AEDs. The SAMBA randomized objective proceedings investigated if the Heartrunner exertion improved the usage of AEDs by bystanders during OHCA. This proceedings was conducted betwixt December 7, 2018, and January 31, 2020. Volunteer responders were randomized 1:1. During a suspected lawsuit of OHCA, unpaid responders wrong a 1.3 km radius received a petition via their smartphone exertion to judge oregon diminution the alert. The involution radical received instructions to cod the nearest AED available, whereas the power radical was instructed to spell straight to the diligent and statesman CPR. Emergency calls for OHCA betwixt 7:00 AM and 10:59 PM were eligible. The superior result was bystander-attached AED, which was the proportionality of patients that had AED attached by immoderate bystander (this included unpaid responders successful the survey and different laic volunteers not portion of the study). During the survey period, the effect complaint by unpaid responders was 72%. 13.2% of patients had bystander-attached AED successful the involution radical compared to 9.5% successful the power radical (difference: 3.8% [95% CI: -0.3 to 7.9], p = 0.08; hazard ratio [RR]: 1.40 [95% CI: 0.97-2.01]). Most bystanders that attached the AEDs were not unpaid responders successful the study. No important quality was observed betwixt groups among bystander CPR (RR: 0.96 [95% CI: 0.89-1.05]) and bystander defibrillation (RR: 0.94 [95% CI: 0.50-1.79]). Overall, this randomized objective proceedings demonstrated a non-significant 3.8% summation successful bystander-attached AED successful the involution radical compared to the control. However, this survey was constricted by the deficiency of objective outcomes, specified arsenic the effect connected diligent morbidity and mortality. Currently, the efficacy of this exertion successful improving OHCA is unclear and requires further evaluation.

Click to work the survey successful JAMA Cardiology

Click to work an accompanying editorial successful JAMA Cardiology

Relevant Reading: Mobile-phone dispatch of laypersons for CPR successful out-of-hospital cardiac arrest

Image: PD

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