Experience with the use of automated external defibrillators in out of hospital cardiac arrest

• Published in: Resuscitation 1998-04, Vol.37 (1), p.3-7
• Main Authors: Herlitz, Johan, Bång, Angela, Axelsson, Åsa, Graves, Judy R, Lindqvist, Jonny
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Automated external defibrillators; Automation; Biological and medical sciences; Cardiac and Cardiovascular Systems; Cardiac arrest; Clinical Medicine; complications; Electric Countershock; Electric Countershock - instrumentation; Electric Countershock - statistics & numerical data; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; etiology; Female; Heart Arrest; Heart Arrest - etiology; Heart Arrest - therapy; Hospitalization; Humans; instrumentation; Intensive care medicine; Kardiologi; Klinisk medicin; Male; Medical sciences; statistics & numerical data; Tachycardia; Tachycardia, Ventricular - complications; therapy; Treatment Failure; Ventricular; Ventricular Fibrillation; Ventricular Fibrillation - complications
• ISSN: 0300-9572; 1873-1570; 1873-1570
• DOI: 10.1016/S0300-9572(98)00032-X

Aim: To describe the sequences of arrhythmias, number of shocks delivered and the number of failures in a consecutive series of patients with out-of-hospital cardiac arrest attended by our emergency medical service (EMS) and in whom cardio-pulmonary resuscitation (CPR) was initiated and in whom automated external defibrillators (AEDs) were used. Patients: All patients with out-of-hospital cardiac arrest attended by the EMS and in whom AEDs were used. Time for inclusion in the study: January 1st, 1987 to December 31st, 1992. Results: In all there were 1781 out of hospital cardiac arrests during the study period. Among them AEDs were used in 383 cases (22%). The total number of interpreted rhythms delivered in these patients was 2719. Among all rhythm sequences coarse ventricular fibrillation (VF) was found on 375 occasions (14%); fine VF on 107 occasions (4%) and ventricular tachycardia (VT) on 12 occasions (0.4%). In ten cases with coarse VF (nine patients) the AED did not advise a shock (2.7%). In five of those nine patients a human error was interpreted as the explanation and in four there was a possible technical error. In these four patients defibrillation was delayed by 33–43 s, respectively. Among the 2225 rhythm sequences not judged as VF/VT the AED advised a shock on one occasion (0.04%). Conclusion: Among patients with coarse VF AED gave inaccurate instructions in 2.7%. However, the majority of the failures were judged to be caused by human errors.