| 1. |
- Fredman, D., et al.
(author)
-
Expanding the first link in the chain of survival – Experiences from dispatcher referral of callers to AED locations
- 2016
-
In: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 107, s. 129-134
-
Journal article (peer-reviewed)abstract
- Introduction Early use of automated external defibrillators (AED) increases survival in cases of out-of-hospital cardiac arrest (OHCA). Dispatchers play important roles in identifying OHCA, dispatching ambulances and providing callers with telephone-assisted cardiopulmonary resuscitation. Guidelines recommend that AED registries be linked to dispatch centres as tools to refer callers to nearby AED. Aim The aim of this study was to investigate to what extent dispatchers, when provided with a tool to display AED locations and accessibility, referred callers to nearby AED. Methods An application providing real-time visualization of AED locations and accessibility was implemented at four dispatch centres in Sweden. Dispatchers were instructed to refer callers to nearby AED when OHCA was suspected. Such cases were prospectively collected, and geographic information systems were used to identify those located ≤100 m from an AED. Audio recordings of emergency calls were assessed to evaluate the AED referral rate. Results Between February and August 2014, 3009 suspected OHCA calls were received. In 6.6% of those calls (200/3009), an AED was ≤100 m from the suspected OHCA. The AED was accessible and the caller was not alone on scene in 24% (47/200) of these cases. In two of those 47 cases (4.3%), the dispatcher referred the caller to the AED. Conclusion Despite a tool for dispatchers to refer callers to a nearby AED, referral was rare. Only a minority of the suspected OHCA cases occurred ≤100 m from an AED. We identified AED accessibility and callers being alone on scene as obstacles for AED referral.
|
|
| 2. |
- Claesson, A., et al.
(author)
-
Unmanned aerial vehicles (drones) in out-of-hospital-cardiac-arrest
- 2016
-
In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central (BMC). - 1757-7241. ; 24:1
-
Journal article (peer-reviewed)abstract
- Background: The use of an automated external defibrillator (AED) prior to EMS arrival can increase 30-day survival in out-of-hospital cardiac arrest (OHCA) significantly. Drones or unmanned aerial vehicles (UAV) can fly with high velocity and potentially transport devices such as AEDs to the site of OHCAs. The aim of this explorative study was to investigate the feasibility of a drone system in decreasing response time and delivering an AED. Methods: Data of Global Positioning System (GPS) coordinates from historical OHCA in Stockholm County was used in a model using a Geographic Information System (GIS) to find suitable placements and visualize response times for the use of an AED equipped drone. Two different geographical models, urban and rural, were calculated using a multi-criteria evaluation (MCE) model. Test-flights with an AED were performed on these locations in rural areas. Results: In total, based on 3,165 retrospective OHCAs in Stockholm County between 2006-2013, twenty locations were identified for the potential placement of a drone. In a GIS-simulated model of urban OHCA, the drone arrived before EMS in 32 % of cases, and the mean amount of time saved was 1.5 min. In rural OHCA the drone arrived before EMS in 93 % of cases with a mean amount of time saved of 19 min. In these rural locations during (n = 13) test flights, latch-release of the AED from low altitude (3-4 m) or landing the drone on flat ground were the safest ways to deliver an AED to the bystander and were superior to parachute release. Discussion: The difference in response time for EMS between urban and rural areas is substantial, as is the possible amount of time saved using this UAV-system. However, yet another technical device needs to fit into the chain of survival. We know nothing of how productive or even counterproductive this system might be in clinical reality. Conclusions: To use drones in rural areas to deliver an AED in OHCA may be safe and feasible. Suitable placement of drone systems can be designed by using GIS models. The use of an AED equipped drone may have the potential to reduce time to defibrillation in OHCA.
|
|
| 3. |
- Rosenqvist, Tage, et al.
(author)
-
Inoculation with adapted bacterial communities promotes development of full scale slow sand filters for drinking water production
- 2024
-
In: Water Research. - 1879-2448. ; 253
-
Journal article (peer-reviewed)abstract
- Gravity-driven filtration through slow sand filters (SSFs) is one of the oldest methods for producing drinking water. As water passes through a sand bed, undesired microorganisms and chemicals are removed by interactions with SSF biofilm and its resident microbes. Despite their importance, the processes through which these microbial communities form are largely unknown, as are the factors affecting these processes. In this study, two SSFs constructed using different sand sources were compared to an established filter and observed throughout their maturation process. One SSF was inoculated through addition of sand scraped from established filters, while the other was not inoculated. The operational and developing microbial communities of SSFs, as well as their influents and effluents, were studied by sequencing of 16S ribosomal rRNA genes. A functional microbial community resembling that of the established SSF was achieved in the inoculated SSF, but not in the non-inoculated SSF. Notably, the non-inoculated SSF had significantly (p < 0.01) higher abundances of classes Armatimonadia, Elusimicrobia, Fimbriimonadia, OM190 (phylum Planctomycetota), Parcubacteria, Vampirivibrionia and Verrucomicrobiae. Conversely, it had lower abundances of classes Anaerolineae, Bacilli, bacteriap25 (phylum Myxococcota), Blastocatellia, Entotheonellia, Gemmatimonadetes, lineage 11b (phylum Elusimicrobiota), Nitrospiria, Phycisphaerae, subgroup 22 (phylum Acidobacteriota) and subgroup 11 (phylum Acidobacteriota). Poor performance of neutral models showed that the assembly and dispersal of SSF microbial communities was mainly driven by selection. The temporal turnover of microbial species, as estimated through the scaling exponent of the species-time relationship, was twice as high in the non-inoculated filter (0.946 ± 0.164) compared to the inoculated filter (0.422 ± 0.0431). This study shows that the addition of an inoculum changed the assembly processes within SSFs. Specifically, the rate at which new microorganisms were observed in the biofilm was reduced. The reduced temporal turnover may be driven by inoculating taxa inhibiting growth, potentially via secondary metabolite production. This in turn would allow the inoculation community to persist and contribute to SSF function.
|
|
