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Dual dispatch early defibrillation in out-of-hospital cardiac arrest: the SALSA-pilot

Hollenberg, Jacob (författare)
Karolinska Institutet
Riva, Gabriel (författare)
Department of Cardiology, Karolinska Institute, South Hospital, SE-118 83 Stockholm, Sweden
Bohm, Katarina (författare)
Karolinska Institutet
visa fler...
Nordberg, Per (författare)
Karolinska Institutet
Larsen, Robert (författare)
Department of Cardiology, Karolinska Institute, South Hospital, SE-118 83 Stockholm, Sweden
Herlitz, Johan, 1949 (författare)
Högskolan i Borås,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Cardiology, University of Göteborg, Sahlgrenska Hospital, Göteborg, Sweden,[external],Institutionen för Vårdvetenskap
Pettersson, Hans (författare)
Karolinska Institutet
Rosenqvist, Mårten (författare)
Karolinska Institutet
Svensson, Leif (författare)
Karolinska Institutet
visa färre...
 (creator_code:org_t)
Oxford University Press, 2009
2009
Engelska.
Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 30:14, s. 1781-9
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • AIMS: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. The objective of this study is to explore the effects of a dual dispatch early defibrillation programme. METHODS AND RESULTS: In this pilot study, automated external defibrillators (AEDs) were provided to all 43 fire stations in Stockholm during 2005. Fire-fighters were dispatched in parallel with traditional emergency medical responders (EMS) to all suspected cases of OHCA. Additionally, 65 larger public venues were equipped with AEDs. All 863 OHCA from December 2005 to December 2006 were included during the intervention, whereas all 657 OHCA from 2004 served as historical controls. Among dual dispatches, fire-fighters assisted with cardiopulmonary resuscitation (CPR) in 94% of the cases and arrived first on scene in 36%. The median time from call to arrival of first responder decreased from 7.5 min during the control period to 7.1 min during the intervention (P = 0.004). The proportion of patients in shockable rhythm remained unchanged. The proportion of patients alive 1 month after OHCA rose from 4.4 to 6.8% [adjusted odds ratio (OR): 1.6; 95% confidence interval (CI): 0.9-2.9]. One-month survival in witnessed cases rose from 5.7 to 9.7% (adjusted OR: 2.0; 95% CI: 1.1-3.7). Survival after OHCA in the rest of Sweden (Stockholm excluded) declined from 8.3 to 6.6% during the corresponding time period (unadjusted OR: 0.8; 95% CI: 0.6-1.0). Only three OHCA occurred at public venues equipped with AEDs. CONCLUSION: An introduction of a dual dispatch early defibrillation programme in Stockholm has shortened response times and is likely to have improved survival in patients with OHCA, especially in the group of witnessed cardiac arrests. The increase in survival is believed to be associated with improved CPR and shortened time intervals.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)

Nyckelord

Aged
Cardiopulmonary Resuscitation/*methods/mortality
Defibrillators/statistics & numerical data
*Emergency Medical Services/methods
Female
Heart Arrest/mortality/*therapy
Humans
Male
Pilot Projects
Survival Rate
Sweden/epidemiology
Time Factors

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