Intrahospital Dissemination of Automatic External Defibrillators Decrease Time to Defibrillation of In-Hospital Cardiac Arrests

D. Fredman, Leif Svensson, M. Jonsson, J. Beltzikoff, M. Ringh, P. Nordberg, J. Hollenberg, M. Rosenqvist

Department of Cardiology, Center of Resuscitation and Science, Karolinska Institutet, S?dersjukhuset, Sweden.
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Section of Anaestethiology, Department of Clinical Science and Education, Karolinska Institutet, S?dersjukhuset, Sweden.

DOI: 10.4236/ijcm.2014.52015                

Abstract

Background: Survival rates for in-hospital cardiac (IHCA) arrest are low. Early defibrillation is vital and international guidelines, which requests defibrillation within three minutes. Can dissemination of automatic external defibrillators (AED) at hospital wards shorten time to defibrillation compared to standard care, calling for medical emergency team (MET)? Material & Methods: Forty-eight (48) units at S?dersjukhuset, Sweden, were included in the study. They were divided into the intervention group (24 units equipped with AEDs) and the standard care group (24 units with no AEDs). Intervention group staff were trained in CPR to use AEDs and standard care group staff were trained in just CPR. Data were gathered from patient records, AEDs and the Swedish National Registry of Cardiopulmonary Resuscitation (NRCR). Results: 126 IHCA patients were included, 47 in the standard care group, 79 in the intervention group. AEDs in the intervention group were connected to a defibrillator and it was ready to shock before arrival of MET in 83.5% of all cases. AEDs were ready to be used on average 96 seconds (14-427 s) before arrival of MET. Seven (15%) patients were defibrillated in the control group and Twenty (25%) in the intervention group. Defibrillation within three minutes occurred in 67% in the intervention group (11/17), compared with none (0/7) in the control group (p = 0.02). Conclusion: A systematic implementation of AEDs in hospital wards decrease time to defibrillation compared to a standard MET response system. Larger studies are needed to evaluate the impact on the outcome.

Keywords

Cardiac Arrest; In-Hospital Cardiac Arrest; Defibrillator; AED

Conflicts of Interest

The authors declare no conflicts of interest.

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