Abstract 15801: Assessing Quality of Bystander Chest Compression and Shock Delivery by Electrocardiogram Signals From Public Automated External Defibrillators in Taiwan
Assessing Quality of Bystander Chest Compression and Shock Delivery by Electrocardiogram Signals from Public Automated External Defibrillators in Taiwan
Background: Bystander-initiated cardiopulmonary resuscitation (B-CPR) is pivotal in the community chain of survival, but the quality of B-CPR in the community is scarcely reported. Since 2013, certain public locations have been required by law to install public automated external defibrillators (AED) in Taiwan, with a compulsory registry of devices. Incident reports along with uploeded electrocardiogram records were also required once public AED was used.
Method: We analyzed AED records operated by bystanders for cardiac-arrest patients in public locations. Initial rhythms, timeliness of device operation, shock success, and minute-by-minute assessment of quality of chest compressions up to 5 minutes were reviewed. Chest compressions were registered by reviewing deflections on electrocardiogram signals.
Results: From Sep. 1, 2013 to Mar. 31, 2015, a total of 70 AED records were reviewed, and 20 (28.6%) presented with shockable rhythm initially. Among shockable cases, first shock was delivered 7 (±3) seconds after device voice prompt. All were successfully defibrillated with the first attempt. Bystander chest compressions were observed in 51 (72.9%) cases. In the first 5 minutes, the average ratio of hands-off-time was 39.7% (±21.8%), the average number of compression per minute were 74(±15.9), and the average rate of compression was 127(±37.4). Quality of chest compression deteriorated after the third minute, with ratio of hands-off time increased from 33.0% to 43.0%.
Conclusions: Bystanders delivered a first shock in a timely manner following device prompt, but quality of chest compressions were suboptimal and deteriorated rapidly over time. Measures should be taken to assess and to improve B-CPR quality.
Author Disclosures: H. Lin: None. H. Wang: None. H. Chu: None. S. Hsu: None. W. Chen: None. N. Cheng: None. E.P. Huang: None. M.H. Ma: None. J. Sun: None. W. Chong: None. M. Hsieh: None. C. Yang: None. K. Chong: None. C. Lin: None. S. Hsu: None. C. Kuo: None.
- © 2016 by American Heart Association, Inc.