Use of the automatic external defibrillator-pacemaker by ambulance personnel: the Stockport experience.

Gray, Alasdair; Redmond, A D; Martin, M A

doi:10.1136/bmj.294.6580.1133

Cited by 53 publications

(12 citation statements)

References 10 publications

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“…Of the 1-year survivors, 86% were in the best Cerebral Performance Category Scale class, 1 and there were no cases of class 4 vegetative state or class 5 brain death (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Overall, survival to hospital discharge remains poor, with survival rates for all rhythms combined ranging from 1% to 20%. 1,2 Variation in survival rates among communities can be attributed to differences in the chain of survival concept, as described by the American Heart Association. 3,4 It is generally believed that the best survival can only be achieved if all 4 of the following links have been optimized: (1) rapid access, (2) early cardiopulmonary resuscitation, (3) early defibrillation, and (4) early advanced cardiac life support.…”

mentioning

confidence: 99%

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Health-Related Quality of Life Is Better for Cardiac Arrest Survivors Who Received Citizen Cardiopulmonary Resuscitation

et al. 2003

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Background-This study evaluated the prehospital factors associated with better health-related quality of life for survivors of out-of-hospital cardiac arrest. Methods and Results-This prospective, 20-community, cohort study involved consecutive, adult out-of-hospital cardiac arrest patients who survived to 1 year. Patients were contacted by telephone and evaluated for the Health Utilities Index Mark III (HUI3), which describes health as a utility score on a scale from 0 (dead) to 1.0 (perfect health). The 8091 cardiac arrest patients had overall survival rates of 5.2% to hospital discharge and 4.0% to 1 year. We successfully contacted and evaluated 268 of 316 (84.8%) of known 1-year survivors. The median HUI3 score was 0.80 (interquartile range, 0.50 to 0.97), which compares well with age-adjusted values for the general population (0.83). Logistic regression identified 2 factors independently associated with very good quality of life (HUI3 Ͼ0.90) and their odds ratios (95% CIs), as follows: age 80 years or older, 0.3 (0.1 to 0.84), and citizen-initiated cardiopulmonary resuscitation (CPR), 2.0 (1.2 to 3.4) (Hosmer-Lemeshow goodness-of-fit statistic, 0.74). Conclusions-This study is the largest ever conducted for out-of-hospital cardiac arrest survivors, clearly shows that these patients have good quality of life, and is the first to demonstrate that citizen-initiated CPR is strongly and independently associated with better quality of life. These results emphasize the importance of optimizing community citizen CPR readiness. Given the low rate of citizen-initiated CPR in many communities, we believe that local and national initiatives should vigorously promote the practice of bystander CPR.

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“…Of the 1-year survivors, 86% were in the best Cerebral Performance Category Scale class, 1 and there were no cases of class 4 vegetative state or class 5 brain death (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Health-Related Quality of Life Is Better for Cardiac Arrest Survivors Who Received Citizen Cardiopulmonary Resuscitation

et al. 2003

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“…EMTs and paramedics were the first to deploy AEDs in OHCA safely and effectively [54][55][56]. Documentation of improved survival following automated defibrillation by EMTs soon followed [57][58][59][60]. Two meta-analyses [61,62] demonstrated that defibrillation by basic life support providers reduced the relative risk for death for a person experiencing OHCA with ventricular fibrillation.…”

Section: Within the Traditional Health Care Systemmentioning

confidence: 95%

Future shock: automatic external defibrillators

Einav

Weissman²,

Kark³

et al. 2005

Current Opinion in Anaesthesiology

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“…Despite these early initiatives in Brighton there was little progress elsewhere in the UK with these devices during the 1980s. Chapman and Chamberlain (1987) reported that they were training aircraft cabin crew to use them and Gray, Redmond and Martin (1987) equipped ambulances in Stockport with them, but reported very poor results with regard to survival.…”

Section: 13mentioning

confidence: 99%

Training lay-people to use automatic external defibrillators: Are all of their needs being met?

2006

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This thesis draws upon data gathered during research undertaken with a grant from the Resuscitation Council (UK). It explores the use of Automatic External Defibrillators (AEDs) by laypeople, which is known as Public Access Defibrillation (PAD). Whilst an abundance of research has been undertaken about this phenomenon, it has predominately been conducted using quantitative methods; however the data I am using was collected using a qualitative approach. During the research, fifty-three semi-structured interviews were carried out. Most of these were with laypeople who had been trained to use AEDs, and nine involved those who delivered the training. These interviews were conducted at sites typical of those where these devices have been introduced, such as railway stations and airports. The geographical area of these locations covered the East and West Midlands, South and West Yorkshire, Lincolnshire and Essex. The aims of the research were quite broad and included exploring how to make training more realistic, how debriefing and support for those who had used an AED should be organised and how the interviewees perceived the technology inherent in the AED.This thesis reanalyses the data that was collected during that research and focuses on two themes. Firstly, some of the theories of technologies in transition are used to illustrate how AEDs were developed in a laboratory and progressed from that setting to become commonplace in public locations. The actor-network theory is adopted to argue that these technological devices exert an influence on the human actors in the networks that exist within society. Specifically, my analysis is informed by the work of Timmermans (1998; 1999; 1997) whose theories about external chest compressions I have developed and applied to AEDs. They suggest that these devices achieved universality, in part, through the influence of debates and medical protocols.One significant factor was that AEDs allowed for defibrillation to be redefined from a medical, to a first aid procedure. Eventually, using these devices was included in the protocols for first aid and this legitimised their use by laypeople. These theories are observable in the data through the interviewees" accounts of how they came to accept being trained to use AEDs. The experiences of those who had used an AED during a resuscitation attempt are provided and suggest that these are distressing and unpleasant events.Consequently, a key component of this thesis is a discussion of the necessity to provide psychological debriefing for those who have been involved in these incidents.The findings of this thesis suggest that laypeople who have used an AED usually have questions about the actions they took during the attempted resuscitation and need to address these with someone soon afterwards.

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Use of the automatic external defibrillator-pacemaker by ambulance personnel: the Stockport experience.

Cited by 53 publications

References 10 publications

Health-Related Quality of Life Is Better for Cardiac Arrest Survivors Who Received Citizen Cardiopulmonary Resuscitation

Health-Related Quality of Life Is Better for Cardiac Arrest Survivors Who Received Citizen Cardiopulmonary Resuscitation

Future shock: automatic external defibrillators

Training lay-people to use automatic external defibrillators: Are all of their needs being met?

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