Defi 2005

Jost, Daniel; Degrange, H.; Verret, Catherine; Hersan, Olivier; Banville, Isabelle; Chapman, Fred W.; Lank, Paula; Petit, Jean-Luc; Fuilla, C.; Migliani, R.; Carpentier, J.-P.

doi:10.1161/circulationaha.109.878389

Cited by 91 publications

(44 citation statements)

References 35 publications

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“…This finding is consistent with other reports. In 845 OHCA patients randomized to 2 protocols, Jost et al 21 reported a substantial difference in preshock pause duration (9 versus 19 seconds) but no difference in VF termination between groups. In 223 OHCA patients, Kramer-Johansen et al 6 compared defibrillation using manual and AED mode and found a significant difference in preshock pause duration (15 versus 22 seconds) but no difference in VF termination rate (61% versus 60%), despite a higher rate of postshock pulse-generating rhythms in the manual defibrillation arm (7% versus 3%).…”

Section: Discussionmentioning

confidence: 99%

Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest

Brouwer

Walker²,

Chapman³

et al. 2015

Circulation

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Background-Minimizing pauses in chest compressions during cardiopulmonary resuscitation is a focus of current guidelines. Prior analyses found that prolonged pauses for defibrillation (perishock pauses) are associated with worse survival. We analyzed resuscitations to characterize the association between pauses for all reasons and both ventricular fibrillation termination and patient survival. Methods and Results-In 319 patients with ventricular tachycardia/fibrillation out-of-hospital cardiac arrest, we analyzed recordings from all defibrillators used during resuscitation and measured durations of all cardiopulmonary resuscitation pauses. Median durations were 32 seconds (25th and 75th percentile, 22 and 52 seconds) for the longest pause for any reason, 23 seconds (25th and 75th percentile, 14 and 34 seconds) for the longest perishock pause, and 24 seconds (25th and 75th percentile, 11 and 38 seconds) for the longest nonshock pause. Multivariable regression models showed lower odds for survival per 5-second increase in the longest overall pause (odds ratio, 0.89; 95% confidence interval, 0.83-0.95), longest perishock pause (odds ratio, 0.85; 95% confidence interval, 0.77-0.93), and longest nonshock pause (odds ratio, 0.83; 95% confidence interval, 0.75-0.91). In 36% of cases, the longest pause was a nonshock pause; this subgroup had lower survival than the group in whom the longest pause was a perishock pause (27% versus 44%, respectively; P<0.01) despite a higher chest compression fraction. Preshock pauses were 8 seconds (25th and 75th percentile, 4 and 17 seconds) for shocks that terminated ventricular fibrillation and 7 seconds (25th and 75th percentile, 4 and 13 seconds) for shocks that did not (P=0.18). Conclusions-Prolonged pauses have a negative association with survival not explained by chest compression fraction or decreased ventricular fibrillation termination rate. Ventricular fibrillation termination was not the mechanism linking pause duration and survival. Strategies shortening the longest pauses may improve outcome.

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Section: Discussionmentioning

confidence: 99%

Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest

Brouwer

Walker²,

Chapman³

et al. 2015

Circulation

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“…23 The Paris emergency medical system is a 2-tiered response system coordinated via a unique dispatcher center: a basic life support tier provided by firefighters of the Brigade de Sapeurs Pompiers de Paris, who can apply an AED, and an advanced cardiac life support function provided by ambulance teams with an emergency physician, a nurse, and a paramedic (Service d'Aide Médicale Urgente).…”

Section: Population Studymentioning

confidence: 99%

Population Movement and Sudden Cardiac Arrest Location

et al. 2015

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Public-access defibrillation programs have thus been developed to make automatic external defibrillators (AEDs) publicly available, allowing rapid early defibrillation. 11-17Although the benefits of AED are undeniable, public use rates remain very low, 4,15,18 and thus the effectiveness of such programs could be dramatically improved. One of the key issues is the disparity between the locations of AEDs and SCAs. In Paris, although AED deployment in the community, which started in 1993 with the progressive equipping of EMS ambulances, has been particularly active over the last decade, the choice of where to install AEDs in public places has been driven mainly by empirical considerations (local unguided initiatives). Recent studies have already pointed out the limitations of such an approach, calling for an evidence-based strategy.

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“…Recent evidence shows that there is no difference in VF recurrence or outcome in terms of survival between the two strategies. (15,16) As in the 2011 National Resuscitation Council guidelines, a single shock followed by CPR is favoured over the three-stacked shock strategy (17) for persistent VF. With biphasic machines, the termination rate of VF is very high.…”

Section: Management Of Persistent Vfmentioning

confidence: 99%

Singapore Defibrillation Guidelines 2016

Lee

Anantharaman

Lim

et al. 2017

smedj

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The most common initial rhythm in a sudden cardiac arrest is ventricular fi brillation or pulseless ventricular tachycardia. This is potentially treatable with defi brillation, especially if provided early. However, any delay in defi brillation will result in a decline in survival. Defi brillation requires coordination with the cardiopulmonary resuscitation component for effective resuscitation. These two components, which form the key links in the chain of survival, have to be brought to the cardiac victim in a timely fashion. An effective chain of survival is needed in both the institution and community settings.

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Defi 2005

Cited by 91 publications

References 35 publications

Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest

Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest

Population Movement and Sudden Cardiac Arrest Location

Singapore Defibrillation Guidelines 2016

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