Comparing audio- and video-delivered instructions in dispatcher-assisted cardiopulmonary resuscitation with drone-delivered automatic external defibrillator: a mixed methods simulation study

This study compared first responders’ cardiopulmonary resuscitation (CPR) performance when a dispatcher provides audio instructions only and when both audio and video instructions are given. In the simulation, an automatic external defibrillator (AED) was delivered via drone in response to a cardiac arrest occurring outside a hospital setting. Participants’ qualitative experiences were also explored.An exploratory sequential mixed methods design was used. AEDs were delivered to college students via drone with one group receiving both audio and video instructions and the other receiving audio-only instruction, and differences in CPR performance and accuracy were compared. After completion, focus group interview data were collected and analyzed. Video-based instruction was found to be more effective in the number of chest compressions (p < 0.01), chest compression rate (p < 0.01), and chest compression interruptions (p < 0.01). The accuracy of the video group for the chest compression region was high (p = 0.05). Participants’ experiences were divided into three categories: “unfamiliar but beneficial experience,” “met helper during a desperate and embarrassing situation,” and “diverse views on drone use.” Our results lay the groundwork for a development plan for providing emergency medical services using drones, as well as the preparation of guidelines for dispatchers on the provision of video instructions.

How to improve automated external defibrillator placement for out-of-hospital cardiac arrests: A case study

Introduction In out-of-hospital cardiac arrests (OHCAs), the use of an automatic external defibrillator (AED) by a bystander remains low, as AEDs may be misplaced with respect to the locations of OHCAs. As the distribution of historical OHCAs is potentially predictive of future OHCA locations, the purpose of this study is to assess AED positioning with regard to past locations of OHCAs, in order to improve the efficiency of public access defibrillation programs. Methods This is a retrospective observational study from 2014 to 2018. The locations of historical OHCAs and AEDs were loaded into a geodata processing tool. Median distances between AEDs were collected, as well as the number and rates of OHCAs covered (distance of <100 meters from the nearest AED). Areas with high densities of uncovered OHCAs (hotspots) were identified in order to propose the placement of additional AEDs. Areas over-covered by AEDs (overlays) were also identified in order to propose the relocation of overlapping AEDs. Results There were 2,971 OHCA, 79.3% of which occurred at home, and 633 AEDs included in the study. The global coverage rate was 7.5%. OHCAs occurring at home had a coverage rate of 4.5%. Forty hotspots were identified, requiring the same number of additional AEDs. The addition of these would increase the coverage from 7.5% to 17.6%. Regarding AED overlays, 17 AEDs were found to be relocatable without reducing the AED coverage of historical OHCAs. Discussion This study confirms that geodata tools can assess AED locations and increase the efficiency of their placement. Historical hotspots and AED overlays should be considered, with the aim of efficiently relocating or adding AEDs. At-home OHCAs should become a priority target for future public access defibrillation programs as they represent the majority of OHCAs but have the lowest AED coverage rates.

Comprehensive Analysis, Discussion and Suggestion on the Current Situation of Cardiopulmonary Resuscitation and Automatic External Defibrillator in General Public in China

The number of sudden cardiac death (SCD) has increased year by year, which has become one of the main causes of death in China. Timely cardiopulmonary resuscitation (CPR) and timely and accurate use of automatic external defibrillator (AED) can greatly improve the survival rate of patients with sudden cardiac death. Because the large probability of sudden cardiac death occurs outside the hospital, it is very important for the general public to master first aid skills. This paper will mine all kinds of data from multi-dimensional and multi-angle, analyze the mastery of public first aid skills in China, and provide practical suggestions and ideas for popularizing first aid skills in the future.

TANGGAP DARURAT MEDIS (CODE BLUE) STUDI KASUS PADA RUMAH SAKIT UMUM DAERAH ABDUL WAHAB SJAHRANIE DI SAMARINDA

Code blue digunakan untuk menandakan adanya pasien yang sedang mengalami henti nafas, henti jantung di Rumah Sakit. Tim code blue melakukan Cardiopulmonary Resuscitation (CPR) yaitu tindakan pertolongan pertama pada orang yang mengalami henti napas, kemudian melakukan defibrilasi yaitu menganalisis irama jantung secara otomatis dan memberikan kejutan listrik untuk mengembalikan irama jantung dengan alat medis Automatic External Defibrillator (AED) (standar waktu tanggap petugas terhadap keadaan darurat code blue yaitu 3 – 5 menit menurut American Heart Association). Menurut data Rumah Sakit Umum Daerah Abdul Wahab Sjahranie Samarinda (Mei 2019), kejadian darurat code blue terjadi 12 kali dalam 3 tahun terakhir dengan diagnosa gagal jantung kongestif (decompensate cordis). Tujuan penelitian yaitu untuk mengetahui tanggap darurat medis (code blue) studi kasus pada Rumah Sakit Umum Daerah Abdul Wahab Sjahranie di Samarinda. Penelitian ini dilakukan dengan cara observasi langsung dan simulasi serta wawancara mendalam terkait waktu tanggap petugas terhadap kejadian darurat code blue. Berdasarkan hasil simulasi code blue pada Tanggal 04 Juli 2019, bahwa waktu tanggap petugas terhadap keadaan darurat code blue, pasien mendapatkan CPR dan AED pada waktu 4 menit 31 detik setelah alarm berbunyi. Berdasarkan hasil observasi langsung dan wawancara mendalam, sistem tanggap darurat blue code di Rumah Sakit Umum Daerah Abdul Wahab Sjahranie sudah terdiri dari sistem alarm, sarana dan prasarana pendukung tanggap darurat, pengetahuan pekerja, sistem organisasi dan sistem prosedur. Perbaikan-perbaikan yang diperlukan terdiri dari standar operasional prosedur kejadian henti jantung, standar operasional prosedur penggunaan alat defibrilasi (AED) karena petugas berpotensi mengalami beberapa bahaya saat melakukan tanggap darurat seperti shock dari alat defibrilasi otomatis, kemudian dokumentasi dan pelaporan.