Abstract 15429: Predictors of Resuscitation Success Prior to EMS Arrival in Out of Hospital Cardiac Arrest Patients Treated With a Public Access AED
Introduction: In some instances, out of hospital cardiac arrest (OHCA) patients receiving bystander CPR and/or defibrillation by a public access AED (PAD) are successfully resuscitated prior to EMS arrival. The purpose of this study was to describe the factors that predict restoration of spontaneous breathing prior to EMS arrival in OHCA patients treated with a PAD.
Methods: A retrospective analysis was performed on data collected through a web-based AED management system (PlusTracTM, En Pro Inc.) from US customers between 2008 and 2015. Following each AED use, customers completed an anonymous online survey to describe characteristics and estimate times of resuscitation efforts. Multivariate logistic regression was used to determine the independent predictors of restored spontaneous breathing prior to EMS arrival.
Results: Out of 576 reported AED uses, 217 patients (56 ± 15 yrs of age, 89% male) received at least one shock and were considered in confirmed OHCA. Of these, 153 (71%) suffered a witnessed arrest. Location of event was categorized as Retail (19%), Hotel/Resort (11%), Business/Corporation (25%), Government Organization (7%), Fitness Center (35%), or Nursing Home (4%). Bystander CPR was performed by a medical professional or AED-trained individual for 63% of patients. Time to AED retrieval was 2 min (IQR 1,5) and patients received 1 shock (IQR 1, 2). Spontaneous breathing was restored prior to EMS arrival for 80 patients (37%). Multivariate logistic regression revealed that witnessed arrest was a positive predictor of restoration of breathing whereas time to retrieve an AED, total number of shocks, and arrest in a hotel or nursing home were negative predictors (Table).
Conclusion: A significant proportion of OHCA patients that receive a shock from a PAD regain spontaneous breathing prior to EMS arrival. Time to AED retrieval, number of shocks delivered, witnessed arrest, and location of arrest are significant predictors of restored breathing.
Author Disclosures: H. Fukushima: None. A. Silver: Employment; Significant; Zoll Medical Corporation. J. Gould: Employment; Significant; Zoll Medical Corporation. K. Edgell: Employment; Significant; Zoll Medical Corporation. D. Appleby: Employment; Significant; Zoll Medical Corporation. T. Iwami: Other Research Support; Modest; Zoll Medical Corporations. M. Mullins: Other Research Support; Modest; Zoll Medical Corporation and Medtronic Foundation. R. McDannold: Other Research Support; Modest; Zoll Medical Corporation and Medtronic Foundation. B.J. Bobrow: Other Research Support; Modest; Zoll Medical Corporation and Medtronic Foundation.
- © 2016 by American Heart Association, Inc.