Abstract 149: The Impact of Bystander AED Usage on Out of Hospital Cardio-Pulmonary Arrest in the Highly Disseminated City; From the Experiences at Central Tokyo
Background: Out of hospital cardio-pulmonary arrest (OHCPA) is an important factor of all cause of death. Although survival rate improves dramatically according to the increasing usage of AED in patients with OHCPA especially with VF, the detail of characteristics of AED usage still remains unknown.
Methods: A total of 395 consecutive OHCPA patients was transferred to emergency department in our institution from Jan. 2010 to June 2012. Our institution is situated at central Tokyo where is known as one of the highest AED disseminated city in the world. Among those transferred to our institution, 65 patients who experienced documented VF were retrospectively reviewed.
Results: Underlying diseases of the patients were acute coronary syndrome (ACS, 52.3%), idiopathic VF (9.2%), cardiomyopathy (6.2%), bleeding (4.6%), hypothermia (4.6%), and others (21.5%). Survival rate and the rate of favorable neurological outcome (CPC 1-2) of overall VF patients were 56.9% and 46.1%. All of the patients were tried to be defibrillated by using AED before hospital arrival. 35 (53.8%) of 65 patients could receive AED by bystander personnel at OHCPA, and the rest of patients received by emergency medical personnel. The survival rate of the patients received AED by bystander was significantly higher than others (74.3% vs. 40.0%, p<0.005). The rate of the favorable neurological outcome (CPC 1-2) among patients survived was also higher (88.5% vs. 58.3%, p<0.05) in patients received AED by bystander.
Conclusion: According to the easiness of public access to AEDs, percentages of bystander AED usage were extremely high in central Tokyo. Patients who could not receive AED by bystander were poor prognosis even though the overall survival of OHCPA with VF was satisfactory high in this study. High prevalence of AEDs in this area might result in high survival rate of OHCPA with VF.
- © 2013 by American Heart Association, Inc.