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PLoS One 2021 20;16(5):e0250591. Epub 2021 May 20.

Emergency Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.

Introduction: In out-of-hospital cardiac arrests (OHCAs), the use of an automatic external defibrillator (AED) by a bystander remains low, as AEDs may be misplaced with respect to the locations of OHCAs. As the distribution of historical OHCAs is potentially predictive of future OHCA locations, the purpose of this study is to assess AED positioning with regard to past locations of OHCAs, in order to improve the efficiency of public access defibrillation programs.

Methods: This is a retrospective observational study from 2014 to 2018. Read More

Resuscitation 2021 May 22;162:259-265. Epub 2021 Mar 22.

Emergency Medical Department, Paris Fire Brigade, 1, Place Jules Renard, 75017 Paris, France.

Aim: To reduce the delay in defibrillation of out-of-hospital cardiac arrest (OHCA) patients, recent publications have shown that drones equipped with an automatic external defibrillator (AED) appear to be effective in sparsely populated areas. To study the effectiveness of AED-drones in high-density urban areas, we developed an algorithm based on emergency dispatch parameters for the rate and detection speed of cardiac arrests and technical and meteorological parameters.

Methods: We ran a numerical simulation to compare the actual time required by the Basic Life Support team (BLSt) for OHCA patients in Greater Paris in 2017 to the time required by an AED-drone. Read More

Prehosp Emerg Care 2021 Feb 17:1-10. Epub 2021 Feb 17.

Out-of-hospital cardiac arrests (OHCA) in schools and universities are uncommon. However, these institutions must plan and prepare for such events to ensure the best outcomes. To evaluate their preparedness we assessed baseline characteristics, survival outcomes and 12-year trends for OHCA in schools/universities compared to other public locations. Read More

Cost Eff Resour Alloc 2020 Nov 17;18(1):52. Epub 2020 Nov 17.

UGent, Sint-Pietersnieuwstraat 25, 9000, Gent, Belgium.

Background: EVapp (Emergency Volunteer Application) is a Belgian smartphone application that mobilizes volunteers to perform cardiopulmonary resuscitation (CPR) and defibrillation with publicly available automatic external defibrillators (AED) after an emergency call for suspected out of hospital cardiac arrest (OHCA). The aim is to bridge the time before the arrival of the emergency services.

Methods: An accessible model was developed, using literature data, to simulate survival and cost-effectiveness of nation-wide EVapp implementation. Read More

Artif Intell Med 2020 11 7;110:101963. Epub 2020 Oct 7.

Machine Learning and Data Analytics Lab, Department of Computer Science, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.

Objective: Optimizing timing of defibrillation by evaluating the likelihood of a successful outcome could significantly enhance resuscitation. Previous studies employed conventional machine learning approaches and hand-crafted features to address this issue, but none have achieved superior performance to be widely accepted. This study proposes a novel approach in which predictive features are automatically learned. Read More

Am J Case Rep 2020 Oct 15;21:e925602. Epub 2020 Oct 15.

Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

BACKGROUND Long QT syndrome (LQTS) is an arrhythmogenic heart condition that can be congenital or acquired. Prolonged ventricular repolarizations in individuals with the disorder can cause fatal arrhythmias. Abnormal functioning of cardiac ion channels leads to arrhythmias such as torsades de pointes (TdP) and may be triggered by stress or medications. Read More

Simul Healthc 2020 09 23. Epub 2020 Sep 23.

From the Pavia nel Cuore (E.B., E.C., M.P., C.B.), Pavia; Robbio nel Cuore (E.B., E.C., D.B.), Robbio; Department of Molecular Medicine (E.B.), Section of Cardiology, University of Pavia; Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology (E.B.), Fondazione IRCCS Policlinico San Matteo; AAT 118 Pavia (E.C.), AREU Lombardia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Swiss Resuscitation Council (R.B.), Bern, Switzerland; Fondazione Ticino Cuore (R.B.), Breganzona, Switzerland; Department of Public Health, Experimental and Forensic Medicine (P.B., O.E.F.), Unit of Biostatistics and Clinical Epidemiology, University of Pavia; Department of Clinical-Surgical, Pediatric and Diagnostic Sciences-Anesthesia, Intensive Care and Pain Therapy (M.P.), University of Pavia, Pavia; Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), Department of Anesthesia Intensive Care and Emergency (M.P., A.C.), Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy; Federazione Cantonale Ticinese Servizi Autoambulanze (C.T.), Lugano; Accademia di Medicina d'Urgenza Ticinese (AMUT) (C.T.), Breganzona, Switzerland; Emergency Training Center (D.L.), Cugy, Switzerland; Centro Studi e Formazione Gymnasium (S.B.), Pordenone, Italy; École Supérieure d'Ambulancier et Soins d'Urgence Romande (ES-ASUR) (S.D.), Lausanne; and Formamed Sàrl (M.T.), Cortaillod, Switzerland.

Background: Compression-only cardiopulmonary resuscitation (CPR) is a suggested technique for laypeople facing out-of-hospital cardiac arrest (OHCA). However, it is difficult performing high-quality CPR until emergency medical services arrival with this technique. We aimed to verify whether incorporating intentional interruptions of different frequency and duration increases laypeople's CPR quality during an 8-minute scenario compared with compression-only CPR. Read More

Cochrane Database Syst Rev 2019 07 19;7:CD012764. Epub 2019 Jul 19.

School of Medicine, University College Dublin, Dublin, Ireland.

Background: Mobilization of community first responders (CFRs) to the scene of an out-of-hospital cardiac arrest (OHCA) event has been proposed as a means of shortening the interval from occurrence of cardiac arrest to performance of cardiopulmonary resuscitation (CPR) and defibrillation, thereby increasing patient survival.

Objectives: To assess the effect of mobilizing community first responders (CFRs) to out-of-hospital cardiac arrest events in adults and children older than four weeks of age, in terms of survival and neurological function.

Search Methods: We searched the following databases for relevant trials in January 2019: CENTRAL, MEDLINE (Ovid SP), Embase (Ovid SP), and Web of Science. Read More

N C Med J 2019 Jul-Aug;80(4):204-212

assistant professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Despite evidence linking rapid defibrillation to out-of-hospital cardiac arrest (OHCA) survival, bystander use of automatic external defibrillators (AEDs) remains low, due in part to AED placement and accessibility. AED-equipped drones may improve time-to-defibrillation, yet the benefits and costs are unknown. We designed drone deployment networks for the state of North Carolina using mathematical optimization models to select drone stations from existing infrastructure by specifying the number of stations and the targeted AED arrival time. Read More

Health Soc Care Community 2019 09 21;27(5):e744-e751. Epub 2019 Jun 21.

Department of Emergency Medicine, Sejong General Hospital, Bucheon, Gyeonggi, Korea.

High-quality bystander cardiopulmonary resuscitation (CPR) and early defibrillation in the community are important for survival in out-of hospital-cardiac-arrest, but maintaining the quality of CPR in bystanders is difficult. We aimed to determine the effect of an automated external defibrillator (AED) with real-time feedback on the quality of bystander CPR in a community setting. A before-and-after simulation study was designed. Read More

Acute Med Surg 2019 Apr 10;6(2):117-122. Epub 2019 Jan 10.

Department of Emergency Medicine Kawasaki Municipal Hospital Kanagawa Japan.

Aim: To better understand the current status and barriers to making basic life support a common practice among the citizens of Kawasaki City, Japan.

Method: We extracted data according to the Utstein-style guidelines specifically regarding out-of-hospital cardiac arrests (OHCAs) of cardiac etiology. The items were as follows: (i) OHCA witnessed by a citizen, (ii) the victim received bystander cardiopulmonary resuscitation (CPR), (iii) an automatic external defibrillator was used by the witness. Read More

High Alt Med Biol 2019 Mar 25;20(1):71-77. Epub 2019 Feb 25.

3 Emeritus, Department of Cardiovascular Surgery, Geneva University, Geneva, Switzerland.

Background: Because of the limited evidence available, recommendations for defibrillation of hypothermic patients vary among published guidelines.

Aim: To report successful defibrillation of four severely hypothermic patients with witnessed cardiac arrest.

Results: During a four-year period from 2014 to 2017, four of five hypothermic patients admitted to our institution with a history of sudden, unexpected ventricular fibrillation (core temperature: 24°C-27°C) were successfully defibrillated. Read More

Emerg Med Int 2018 29;2018:1480726. Epub 2018 Nov 29.

Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Bucheon, Gyeonggi-do, Republic of Korea.

Background: In South Korea, the prehospital treatment of cardiac arrest is generally led by an emergency medical technician-paramedic (EMT-P), and defibrillation is delivered by the automatic external defibrillator (AED). This study aimed at examining the effects of direct medical guidance by an emergency physician through a video call that enabled prompt manual defibrillation.

Methods: Two-hundred eighty-eight paramedics based in Gyeonggi Province were studied for four months, from July to November 2015. Read More

Curr Cardiovasc Risk Rep 2018 Nov 3;12. Epub 2018 Sep 3.

Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Purpose Of Review: Out-of-hospital cardiac arrest (OHCA) remains a significant health problem in the USA and only 8.6% of victims survive with good neurological function, despite advances in emergency cardiac care. The likelihood of OHCA survival decreases by 10% for every minute without resuscitation. Read More

Resuscitation 2019 01 11;134:127-132. Epub 2018 Nov 11.

UIC and Health Sciences, C/ JosepTrueta s/n. 08195 St. Cugat del Vallès, Barcelona, Spain. Electronic address:

Background: The use of online teaching methodology for basic life support (BLS) courses is progressively increasing.

Objective: The objective of this study was to verify whether the blended-learning methodology (virtual course with a short face-to-face complement) was more efficient than a course that followed the classical or face-to-face methodology in our university.

Materials And Methods: A cost minimization analysis was performed for two BLS and automatic external defibrillation (AED) courses, one of which was conducted face-to-face (Control Group) and the second of which was conducted via blended-learning (Experimental Group). Read More

Aerosp Med Hum Perform 2018 Aug;89(8):754-759

Introduction: Although cardiac arrest during airline flights is relatively uncommon, the unusual setting, limited resources, and the variability of the skills in medical volunteers present unique challenges. Survival in patients who suffer a witnessed arrest with a shockable rhythm who are treated promptly has improved since the advent of widely available automated external defibrillators (AEDs). In general, the chances of survival from an out-of-hospital cardiac arrest (OHCA) are greater when ventricular fibrillation (VF) is seen as the initial rhythm or if there is return of spontaneous circulation (ROSC). Read More

G Ital Cardiol (Rome) 2018 Mar;19(3):178-186

Clinica di Cardiologia ed Aritmologia, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona.

Background: Despite the many recent improvements in basic life support (BLS) and the widespread training to a great number of lay rescuers, out-of-hospital cardiac arrest (OHCA) is still a major cause of death. Nowadays, BLS teaching protocols ask for many concepts to be learned and specific algorithms to be applied, without any available data on how much all these inputs are retained by the students. The present survey aims to evaluate how BLS is really retained by those rescuers (laypersons and nurses) who do not often put it into practice. Read More

Nurse Educ Today 2018 Jun 24;65:232-238. Epub 2018 Mar 24.

Universitat de Barcelona and Senior Consultant at the Department of Anesthesia and Intensive Care, Hospital Clínic de Barcelona, Spain. Electronic address:

Aim Of The Study: The objective of this study was to compare the immediate and 6-month efficacy of basic life support (BLS) and automatic external defibrillation (AED) training using standard or blended methods.

Methods: First-year students of medicine and nursing (n = 129) were randomly assigned to a control group (face-to-face training based on the European Resuscitation Council [ERC] Guidelines) or to an experimental group that trained with a self-training video, a new website, a Moodle platform, an intelligent manikin, and 45 min of instructor presence. Both groups were homogeneous and were evaluated identically. Read More

Emergencias 2018 02;30(1):28-34

Gerencia de Urgencias y Emergencias 061 de la Región de Murcia, España. Universidad Católica de Murcia (UCAM), España.

Objectives: To compare secondary students' learning of basic life support (BLS) theory and the use of an automatic external defibrillator (AED) through face-to-face classroom instruction versus educational video instruction.

Material And Methods: A total of 2225 secondary students from 15 schools were randomly assigned to one of the following 5 instructional groups: 1) face-to-face instruction with no audiovisual support, 2) face-to-face instruction with audiovisual support, 3) audiovisual instruction without face-to-face instruction, 4) audiovisual instruction with face-to-face instruction, and 5) a control group that received no instruction. The students took a test of BLS and AED theory before instruction, immediately after instruction, and 2 months later. Read More

Resuscitation 2018 04 4;125:83-89. Epub 2018 Feb 4.

Fondazione Ticino Cuore, Lugano, Switzerland; Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland; Center for Computational Medicine in Cardiology, Università della Svizzera Italiana, Lugano, Switzerland. Electronic address:

Background: Mathematical optimisation models have recently been applied to identify ideal Automatic External Defibrillator (AED) locations that maximise coverage of Out of Hospital Cardiac Arrest (OHCA). However, these fixed location models cannot relocate existing AEDs in a flexible way, and have nearly exclusively been applied to urban regions. We developed a flexible location model for AEDs, compared its performance to existing fixed location and population models, and explored how these perform across urban and rural regions. Read More

Wien Med Wochenschr 2018 Apr 31;168(5-6):99-107. Epub 2018 Jan 31.

Klinik III für Innere Medizin, Herzzentrum der Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland.

Background: Sudden cardiac arrest is still one of the most frequent causes of death. Teaching resuscitation in schools was already successfully implemented in Scandinavian countries. Following a recommendation of the conference of german stateministers of education in June 2014, additional tuition for resuscitation is to be implemented in german schools starting in seventh grade. Read More

Int J Technol Assess Health Care 2017 Jan 16;33(4):424-429. Epub 2017 Oct 16.

Health Information and Quality Authority,Dublin.

Objectives: The aim of this study was to illustrate the contribution of stakeholder engagement to the impact of health technology assessment (HTA) using an Irish HTA of a national public access defibrillation (PAD) program.

Background: In response to draft legislation that proposed a PAD program, the Minister for Health requested that Health Information and Quality Authority undertake an HTA to inform the design and implementation of a national PAD program and the necessary underpinning legislation. The draft legislation outlined a program requiring widespread installation and maintenance of automatic external defibrillators in specified premises. Read More

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Oct;29(10):946-949

Department of Emergency Medicine, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003, Henan, China (Hu YY); Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China (Xu J, Yu XZ). Corresponding author: Yu Xuezhong, Email:

It's necessary to interrupt cardiopulmonary resuscitation (CPR) for a reliable automatic external defibrillator (AED) rhythm analysis, because the mechanical activity from the chest compressions introduces artifacts in the electrocardiogram (ECG) that substantially lower the capacity of an AED to judge cardio-electric rhythm. However, repeated interruptions of compression will reduce the quality of CPR, which in turn affect the prognosis of patients with cardiac arrest (CA). In order to improve the quality of CPR, reduce the interruptions of chest compression and implement accurate defibrillation, people have made many efforts on identifying ECG rhythm in CPR. Read More

Rev Esp Cardiol (Engl Ed) 2018 02 22;71(2):64-66. Epub 2017 Sep 22.

Unitat de Crítics Cardiovasculars, Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Comput Assist Surg (Abingdon) 2017 12 25;22(sup1):86-92. Epub 2017 Sep 25.

e Department of Biomedical Engineering, School of Medicine , Kyungpook National University , Daegu , Korea.

The increase in mortality associated with arrhythmia is an inevitable problem of modern society such as westernized eating habits and an increase in stress due to industrialization, and the related social costs are increasing. In this regard, the supply of automatic external defibrillator (AED) used outside hospitals is increasing mainly in public institutions, and AED is a medical practice performed by non-medical personnel. Therefore, studies on arrhythmia detection algorithm to make accurate clinical judgment for proper use are increasing. Read More

J Am Coll Cardiol 2017 Sep;70(12):1496-1509

Department of Cardiology, University of Washington, Seattle, Washington.

Cardiac arrest is defined as the termination of cardiac activity associated with loss of consciousness, of spontaneous breathing, and of circulation. Sudden cardiac arrest and sudden cardiac death (SCD) are terms often used interchangeably. Most patients with out-of-hospital cardiac arrest have shown coronary artery disease or symptoms during the hour before the event. Read More

Pan Afr Med J 2017 30;27:157. Epub 2017 Jun 30.

UFR Sciences de la Santé, Université Gaston Berger de Saint Louis, Sénégal.

Poorly tolerated broad QRS complex tachycardia in a newborn poses problems with its diagnosis and emergency management. We report the case of a 35-day-old newborn with broad QRS complex tachycardia admitted because of cardiocirculatory distress. Doppler echocardiography showed morphologically normal heart. Read More

JAMA Cardiol 2017 10;2(10):1110-1118

University of Washington, Seattle.

Importance: We examined whether resuscitation care and outcomes vary by the racial composition of the neighborhood where out-of-hospital cardiac arrests (OHCAs) occur.

Objective: To evaluate the association between bystander treatments (cardiopulmonary resuscitation and automatic external defibrillation) and timing of emergency medical services personnel on OHCA outcomes according to the racial composition of the neighborhood where the OHCA event occurred.

Design, Setting, And Participants: This retrospective observational cohort study examined patients with OHCA from January 1, 2008, to December 31, 2011, using data from the Resuscitation Outcomes Consortium. Read More

Pediatr Emerg Care 2020 Jan;36(1):e18-e20

University of Pittsburgh, Children's Hospital of Pittsburgh, Pittsburgh, PA.

Lightning strike injuries, although less common than electrical injuries, have a higher morbidity rate because of critical alterations of the circulatory system, respiratory system, and central nervous system. Most lightning-related deaths occur immediately after injury because of arrhythmia or respiratory failure. We describe the case of a pediatric patient who experienced cardiorespiratory arrest secondary to a lightning strike, where the Advanced Cardiac Life Support and Basic Life Support chain of survival was well executed, leading to return of spontaneous circulation and intact neurological survival. Read More

Resuscitation 2017 09 24;118:27-34. Epub 2017 Jun 24.

Institute of Anaesthesiology, University and University Hospital Zurich, Zurich, Switzerland. Electronic address:

Introduction: Out of hospital cardiac arrest (OHCA) occurs frequently and the outcome is often dismal. Early defibrillation saves lives and brain function in OHCA. The Zurich city police (STAPO) forces were instructed and equipped to provide basic life support (BLS) and to use an AED in 2009. Read More