Search

Background Laypersons’ efforts to initiate basic life support (BLS) in witnessed Out-of-Hospital Cardiac Arrest (OHCA) remain comparably low within western society. Therefore, in order to shorten no-flow times in cardiac arrest, several police-based first responder systems equipped with automated external defibrillators (Pol-AED) were established in urban areas, which subsequently allow early BLS and AED administration by police officers. However, data on the quality of BLS and AED use in such a system and its impact on patient outcome remain scarce and inconclusive. Methods A total of 85 Pol-AED cases were randomly assigned to a gender, age and first rhythm matched non-Pol-AED control group (n = 170) in a 1:2 ratio. Data on quality of BLS were extracted via trans-thoracic impedance tracings of used AED devices. Results Comparing Pol-AED cases and the control group, we observed a similar compression rate per minute (p = 0.677) and compression ratio (p = 0.651), mirroring an overall high quality of BLS administered by police officers. Time to the first shock was significantly shorter in Pol-AED cases (6 minutes [IQR: 2–10] vs. 12 minutes [IQR: 8–17]; p

Background: Sudden cardiac arrest (SCA) is one of the most common causes of death in western, industrialized countries. The hospital discharge rate after Out-of-Hospital Cardiac Arrests (OHCA with cardiac etiology and first monitored rhythm shockable) was 2011 24.7% in Vienna (Austria). The overall bystander CPR rate was 42% and in only 4% of the cases an AED was used by laypeople. Therefore, we wanted to assess whether a police first responder program with immediately initiated resuscitation measures (chest compression and use of an AED within the first three minutes) may increase survival rates after SCA in the Austrian capital. Methods: The police forces in Vienna were provided with 112 AEDs (52 in police cars / 60 at police stations) and CPR plus AED training. Emergency dispatching was organized such as AED-equipped police (P-AED) and conventional emergency medical service (EMS) responders were simultaneously dispatched to patients with assumed cardiac arrest. One month survival states of cardiac arrest victims provided with P-AED were compared to patient outcomes when EMS was the sole responder. Results: From August 2013 to April 2014, a 50% hospital discharge rate was observed for victims with initial ventricular fibrillation (VF) in the P-AED group, compared to 26% for standard EMS treatment. However, the overall survival benefit was diluted by the fact - that 75% of the initial rhythms were non-shockable, reducing the absolute survival to 10%. There have been 701 OHCA in this time, but due to lack of information, only 654 were included in the study. Figure 1 shows the outcome in detail. Conclusion: Use of AEDs by police first responders significantly increases survival and hospital discharge in VF patients. There was no benefit for victims with non-shockable rhythms yet. Further campaigning will be necessary, to increase the number of police first responder commitments and to implement an Austria wide P-AED system.