Abstract 225: Early Defibrillation, Mainly by Bystanders and First Responders, Associated with Higher Survival in Statewide Data
Objective: Early defibrillation is strongly associated with increased survival after out-of-hospital cardiac arrest. Statewide efforts to increase early defibrillation by bystanders and first responders were initiated in 2010. The aim of this study was to examine time to defibrillation (according to who defibrillated patients) and survival during 2010-2013 in North Carolina.
Methods: Through the Cardiac Arrest Registry to Enhance Survival, we identified out-of-hospital cardiac arrests of presumed cardiac etiology and not witnessed by the Emergency Medical Services (EMS) during 2010-2013 in North Carolina. Only counties with complete data reporting were included in the analyses (n=12).
Results: A total of 5114 cardiac arrests were identified. The median age was 66 years; 61.8% were men, 2297 (44.9%) were witnessed and 1155 (22.6%) had initial ventricular fibrillation or pulseless ventricular tachycardia. Bystanders and first responders initiated CPR in 2353 (46.1%) and 2065 (40.4%) of the cases, respectively. A total of 1705 (33.3%) patients was defibrillated before arrival at the hospital, 116 (6.8%) by bystanders and 815 (47.8%) by first responders. A minority of patients (107 [5.7%]) was defibrillated within 5 minutes of cardiac arrest, mostly by bystanders and first responders. The majority (405 [21.6%)]) was defibrillated 5-10 minutes after cardiac arrest (Figure 1 ). Patients defibrillated within 2 and 5 minutes of cardiac arrest had 60% and 35% survival to hospital discharge, respectively.
Conclusion: Bystanders and first responders were largely responsible for defibrillating patients in the electrical phase of cardiac arrest (<5 minutes). Although only a minority of all patients were defibrillated within 2 minutes of cardiac arrest, those who did had a 60% survival to discharge. Further improvements in bystander and first responder defibrillation rates are warranted to increase survival after out-of-hospital cardiac arrest.
Author Disclosures: C. Malta Hansen: Research Grant; Significant; Laerdal. J.G. Jollis: Research Grant; Significant; Medtronic Foundation. M. Dupre: None. B. McNally: None. L. Monk: None. C. Tyson: None. D.A. Pearson: None. R. Nelson: None. B. Myers: None. C.B. Granger: Research Grant; Significant; Medtronic Foundation.
- © 2014 by American Heart Association, Inc.