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Use of automated external defibrillators for in-hospital cardiac arrest : Any time, any place?

Use of automated external defibrillators for in-hospital cardiac arrest : Any time, any place?
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Wutzler A, Kloppe C, Bilgard AK, Mügge A, Hanefeld C,


Wutzler A, Kloppe C, Bilgard AK, Mügge A, Hanefeld C, (click to view)

Wutzler A, Kloppe C, Bilgard AK, Mügge A, Hanefeld C,

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Medizinische Klinik, Intensivmedizin und Notfallmedizin 2017 11 07() doi 10.1007/s00063-017-0377-7
Abstract
BACKGROUND
Acute treatment of in-hospital cardiac arrest (IHCA) is challenging and overall survival rates are low. However, data on the use of public-access automated external defibrillators (AEDs) for IHCA remain controversial. The aim of our study was to evaluate characteristics of patients experiencing IHCA and feasibility of public-access AED use for resuscitation in a university hospital.

METHODS
IHCA events outside the intensive care unit were analysed over a period of 21 months. Patients’ characteristics, AED performance, return of spontaneous circulation (ROSC) and 24 h survival were evaluated. Outcomes following adequate and inadequate AED use were compared.

RESULTS
During the study period, 59 IHCAs occurred. AED was used in 28 (47.5%) of the cases. However, AED was adequately used in only 42.8% of total AED cases. AED use was not associated with an increased survival rate (12.9 vs. 10.7%, p = 0.8) compared to non-AED use. However, adequate AED use was associated with a higher survival rate (25 vs. 0%, p = 0.034) compared to inadequate AED use. Time from emergency call to application of AED >3 min was the most important factor of inadequate AED use. Adequate AED use was more often observed between 7:30 and 13:30 and in the internal medicine department.

CONCLUSION
AEDs were applied in less than 50% of the IHCA events. Furthermore, AED use was inadequate in the majority of the cases. Since adequate AED use is associated with improved survival, AEDs should be available in hospital areas with patients at high risk of shockable rhythm.

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