Response times and outcomes for cardiac arrests in las vegas casinos

Karch, Steven B.; Graff, J.; Young, Sandra; Ho, Chih-Hsiang

doi:10.1016/s0735-6757(98)90094-8

Cited by 37 publications

(17 citation statements)

References 15 publications

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“…There is unequivocal evidence showing the inverse relation between time to first defibrillation and survival from VF, as in the airline 5 and the casino experiences. 6,18 These reports support the idea that defibrillators should be widely available and accessible. 19,20 The evidence of improved survival with early defibrillation coupled with important AED technological advances has led to international action to increase public access to early defibrillation.…”

Section: Why Public Access Defibrillation?mentioning

confidence: 53%

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Tripling Survival From Sudden Cardiac Arrest Via Early Defibrillation Without Traditional Education in Cardiopulmonary Resuscitation

Capucci¹,

Aschieri²,

Piepoli³

et al. 2002

Circulation

268

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Background— Early defibrillation is the most important intervention affecting survival from sudden cardiac arrest (SCA). To improve public access to early defibrillation, we established Piacenza Progetto Vita (PPV), the first system of out-of-hospital early defibrillation by first-responder volunteers. Methods and Results— The system serves a population of 173 114 residents in the Piacenza region of Italy. Equipment for the system comprises 39 semiautomatic external biphasic defibrillators (AEDs): 12 placed in high-risk locations, 12 in lay-staffed ambulances, and 15 in police cars; 1285 lay volunteers trained in use of the AED, without traditional education in cardiac pulmonary resuscitation, responded to all cases of suspected SCA, in coordination with the Emergency Medical System (EMS). During the first 22 months, 354 SCA occurred (72±12 years, 73% witnessed). The PPV volunteers treated 143 SCA cases (40.4%), with an EMS call-to-arrival time of 4.8±1.2 minutes (versus 6.2±2.3 minutes for EMS, P =0.05). Overall survival rate to hospital discharge was tripled from 3.3% (7 of 211) for EMS intervention to 10.5% (15 of 143) for PPV intervention ( P =0.006). The survival rate for witnessed SCA was tripled by PPV: 15.5% versus 4.3% in the EMS-treated group ( P =0.002). A “shockable” rhythm was present in 23.8% (34 of 143) of the PPV patients versus 15.6% (33 of 211) of the EMS patients ( P =0.055). The survival rate from shockable dysrhythmias was higher for PPV versus EMS: 44.1% (15 of 34) versus 21.2% (7 of 33), P =0.046. The neurologically intact survival rate was higher in PPV-treated versus EMS-treated patients: 8.4% (12 of 143) versus 2.4% (5 of 211), P =0.009. Conclusions— Broad dissemination of AEDs for use by nonmedical volunteers enabled early defibrillation and tripled the survival rate for out-of-hospital SCA.

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Section: Why Public Access Defibrillation?mentioning

confidence: 53%

“…17,18 Training courses for the lay volunteers include 4 hours of theoretical and practical lessons. Four instructors train 12 volunteers during each session.…”

Section: Trainingmentioning

confidence: 99%

Tripling Survival From Sudden Cardiac Arrest Via Early Defibrillation Without Traditional Education in Cardiopulmonary Resuscitation

Capucci¹,

Aschieri²,

Piepoli³

et al. 2002

Circulation

268

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“…181 Community strategies that improve the delivery of early defibrillation to out-of-hospital cardiac arrest victims include training and equipping first responders (fire and law enforcement), EMS personnel, and paramedics to defibrillate, as well as placing automated external defibrillators in highly populated locations such as airports, commercial aircraft, and gambling casinos ("public access defibrillation"). [182][183][184][185][186][187][188][189][190][191][192][193] The latter strategy has been shown to approximately double the number of neurologically intact out-of-hospital cardiac arrest survivors when laypersons are trained and equipped to provide early CPR and defibrillation with automated external defibrillators, compared with providing CPR alone while awaiting arrival of EMS personnel. 183 Two RCTs have reported improved rates of neurologically intact survival to hospital discharge when comatose patients with out-of-hospital VF or nonperfusing VT cardiac arrest were cooled to 32°C to 34°C for 12 or 24 hours beginning minutes to hours after the return of spontaneous circulation.…”

Section: Prehospital Fibrinolytic Therapymentioning

confidence: 99%

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction

O’Gara¹,

Kushner²,

Ascheim³

et al. 2013

Circulation

2,518

930

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“…This discussion covers the public health issues in the gambling field and concludes with implications for public health policy, practice, and research. Focus on the prevalence of mental disorders should not suggest that gambling is unrelated to other disorders of consequence, such as repetitive movement disorders, orthopedic distress, sexual dysfunction, gastrointestinal problems, and cardiovascular or other physical ailments (e.g., 39, 68,74,126,127). However, discussion is limited to the distribution and determinants of disordered gambling and associated mental disorders.…”

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confidence: 99%

Gambling and Related Mental Disorders: A Public Health Analysis

Shaffer

Korn

2002

Annu. Rev. Public Health

466

342

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This article reviews the prevalence of gambling and related mental disorders from a public health perspective. It traces the expansion of gambling in North America and the psychological, economic, and social consequences for the public's health, and then considers both the costs and benefits of gambling and the history of gambling prevalence research. A public health approach is applied to understanding the epidemiology of gambling-related problems. International prevalence rates are provided and the prevalence of mental disorders that often are comorbid with gambling problems is reviewed. Analysis includes an examination of groups vulnerable to gambling-related disorders and the methodological and conceptual matters that might influence epidemiological research and prevalence rates related to gambling. The major public health problems associated with gambling are considered and recommendations made for public health policy, practice, and research.The enduring value of a public health perspective is that it applies different 'lenses' for understanding gambling behaviour, analysing its benefits and costs, as well as identifying strategies for action. Harvey A. Skinner (160, p. 286)

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Response times and outcomes for cardiac arrests in las vegas casinos

Cited by 37 publications

References 15 publications

Tripling Survival From Sudden Cardiac Arrest Via Early Defibrillation Without Traditional Education in Cardiopulmonary Resuscitation

Tripling Survival From Sudden Cardiac Arrest Via Early Defibrillation Without Traditional Education in Cardiopulmonary Resuscitation

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction

Gambling and Related Mental Disorders: A Public Health Analysis

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