Background: Patients with cardiac arrest have lower survival rates, when resuscitation performance is low. In\nIn-hospital settings the first responders on scene are usually nursing staff without rhythm analysing skills. In such\ncases Automated External Defibrillators (AED) might help guiding resuscitation performance. At the Wuerzburg\nUniversity Hospital (Germany) an AED-program was initiated in 2007.\nAim of the presented study was to monitor the impact of Automated External Defibrillators on the management of\nin-hospital cardiac arrest events.\nMethods: The data acquisition was part of a continuous quality improvement process of the Wuerzburg University\nHospital. For analysing the CPR performance, the chest compression rate (CCR), compression depth (CCD), the no\nflow fraction (NFF), time interval from AED-activation to the first compression (TtC), the time interval from AED activation\nto the first shock (TtS) and the post schock pause (TtCS) were determined by AED captured data. A\nquestionnaire was completed by the first responders.\nResults: From 2010 to 2012 there were 359 emergency calls. From these 53 were cardiac arrests with an AEDapplication.\nComplete data were available in 46 cases. The TtC was 34 (32ââ?¬â??52) seconds (median and IQR).The TtS\nwas 30 (28ââ?¬â??32) seconds (median and IQR) . The TtCS was 4 (3ââ?¬â??6) seconds (median and IQR)\n. The CCD was 5.5 Ã?± 1 cm while the CCR was 107 Ã?± 11/min. The NFF was calculated as 41 %.\nROSC was achieved in 21 patients (45 %), 8 patients (17 %) died on scene and 17 patients (37 %) were transferred\nunder ongoing CPR to an Intensive Care Unit (ICU).\nConclusion: The TtS and TtC indicate that there is an AED-user dependent time loss. These time intervals can be\nmarkedly reduced, when the user is trained to interrupt the AEDââ?¬â?¢s ââ?¬Å?chain of advicesââ?¬Â by placing the electrodepaddles\nimmediately on the patientââ?¬â?¢s thorax. At this time the AED switches directly to the analysing mode.\nIntensive training and adaption of the training contents is needed to optimize the handling of the AED in order to\nmaximize its advantages and to minimize its disadvantages.
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