Objective: The Internet of Things provide solutions for many societal challenges including the use of unmanned aerial vehicles to assist in emergency situations that are out of immediate reach for traditional emergency services. Out of hospital cardiac arrest (OHCA) can result in death with less than 50% of victims receiving the necessary emergency care on time. The aim of this study is to link real world heterogenous datasets to build a system to determine the difference in emergency response times when having aerial ambulance drones available compared to response times when depending solely on traditional ambulance services and lay rescuers who would use nearby publicly accessible defibrillators to treat OHCA victims. Method: The system uses the geolocations of public accessible defibrillators and ambulance services along with the times when people are likely to have a cardiac arrest to calculate response times. For comparison, a Genetic Algorithm has been developed to determine the strategic number and positions of drone bases to optimize OHCA emergency response times. Conclusion: Implementation of a nationwide aerial drone network may see significant improvements in overall emergency response times for OHCA incidents. However, the expense of implementation must be considered.
Objective: Many public access defibrillators (PAD) incorporate computer programs to provide audiovisual feedback to assist the user to deliver cardiopulmonary resuscitation (CPR) according to current international guidelines. This usability study assessed if a PAD integrated with a real-time audiovisual CPR feedback system can guide lay-users to optimum chest compression rates, and if it is detrimental to chest compression depth. Methods: Randomly selected volunteers (15+ years) were recruited for two experiments. Experiment 1 (n=156) assessed the time taken to achieve the "Good speed" audio prompt (i.e. perform compressions at a rate of 100-120 compressions per minute) and chest compression fraction (CCF). Experiment 2 (n=140) assessed the effect of rate-only CPR feedback on chest compression depth. Two devices of the same model were used, one with CPR rate feedback, and the other with CPR feedback disabled. The difference in compression depths and CCF were assessed. Results: Experiment 1: A total of 136 (87.2%) participants achieved "Good speed" within 45 seconds with a mean CCF of 90.3% recorded. Experiment 2: The device with feedback lead to a mean (SE) depth of 24.61mm (0.99) compared to 20.08mm (0.96) for the feedback disabled device. ANCOVA analysis provided a mean significant difference (Standard Error; SE) of 4.52mm (1.38mm; p-value=0.001) favouring the device with CPR rate feedback. Conclusions: CPR rate-only feedback was not detrimental to chest compression depth and suggests rate-only feedback may improve compression depth. Significance: The incorporation of clear, intuitive, audiovisual CPR feedback systems can assist lay-users to optimise compression rates and maintain a high CCF.
Sudden cardiac arrest (SCA) is a leading cause of death worldwide. It is treated with a defibrillating shock from an automated external defibrillator (AED) and cardiopulmonary resuscitation. AEDs are commonly used by minimally-trained rescuers to treat patients of SCA, and need to be designed to be intuitive to use. However, there are no guidelines or recommendations for the user interface design of these devices, and as such, there are obvious inconsistencies in the aesthetics and functionality, of AEDs currently on the market. This study was designed to assess the variability and determine the visual hierarchy of a range of public access AEDs. This was done by analysing the user's eye gaze behaviour in 400 AED sense-making sessions (10 AEDs * 40 subjects/users).
BackgroundPublic access defibrillators (PADs) represent unique life-saving medical devices as they may be used by untrained lay rescuers. Collecting representative clinical data on these devices can be challenging. Here, we present results from a retrospective observational cohort study, describing real-world PAD utilisation over a 5-year period.MethodsData were collected between October 2012 and October 2017. Responders voluntarily submitted electronic data downloaded from HeartSine PADs, and patient demographics and other details using a case report form in exchange for a replacement battery and electrode pack.ResultsData were collected for 977 patients (692 males, 70.8%; 255 females, 26.1%; 30 unknown, 3.1%). The mean age (SD) was 59 (18) years (range <1 year to 101 years). PAD usage occurred most commonly in homes (n=328, 33.6%), followed by public places (n=307, 31.4%) and medical facilities (n=128, 13.1%). Location was unknown in 40 (4.09%) events. Shocks were delivered to 354 patients. First shock success was 312 of 350 patients where it could be determined (89.1%, 95% CI 85.4% to 92.2%). Patients with reported response times ≤5 min were more likely to survive to hospital admission (89/296 (30.1%) vs 40/250 (16.0%), p<0.001). Response time was unknown for 431 events.ConclusionThis is the first study to report global PAD usage in voluntarily submitted, unselected real-world cases and demonstrates the real-world effectiveness of PADs, as confirmed by first shock success.
A twelve-animal porcine study dataset was retrospectively analyzed to assess associations between chest compression (CC) depth, systolic blood pressure (SBP) and end-tidal carbon dioxide (EtCO2). Manual CCs were applied for 7 two-minute episodes, at CC depths between 10mm-55mm. A rolling 15s analysis window was applied to the continuous signals. Mean peak values were calculated for each window. Correlation analysis was applied to assess strength of association. Optimal CC depth to achieve physiological targets was determined via cutoff analysis. A total of 672 observations for each variable were available for analysis. Pearson correlations (95% confidence interval; p-value) between CC depth and both SBP and ETCO2 were 0.84 (0.82, 0.86; p < 0.001) and 0.75 (0.71, 0.78; p < 0.001) respectively. Optimal CC depth cutoff (sensitivity, specificity) to achieve SBP ≥ 100mmHg and EtCO2 ≥ 10mmHg was 33 mm (98.29%, 88.94%) and 20 mm (95.08%, 78.30%) respectively. A reasonable relationship between CC depth and physiological response was observed. Optimal SBP and EtCO2 cutoffs were achieved significantly below guideline depths. Furthermore, cutoff analysis suggests a disparity between CC depth and physiological targets.
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