Resuscitation Council (UK)

Research

National database of AED use

The Resuscitation Council (UK) co-ordinated a national survey of the use of AEDs in the community by first responders and other lay persons.

Overview

The Resuscitation Council (UK) has been collecting AED use data since  1999 and published initial results in 'Resuscitation 2008 78 275-280' and a further report covering the latest analysis of almost 3500 reports.

The Resuscitation Council (UK) no longer supplies or collects the AED event form that has been in use. Out-of-hospital cardiac arrest remains an important priority for the Resuscitation Council (UK) and it has established a national out-of-hospital database with the British Heart Foundation and Association of Ambulance Medical Directors in partnership with the University of Warwick. This audit also captures the events where a public access AED has been used before the arrival of the ambulance crew via a reusable and easily accessible new online event form.

Abstract

A national scheme for public access defibrillation in England and Wales: Early results

The following is reproduced with permission of Elsevier Ireland Ltd., from the paper of the same title published in Resuscitation Volume 78, Issue 3 (September 2008), pages 275-280.
Summary:

Background    
Automated external defibrillators (AEDs) operated by lay persons are used in the UK in a National Defibrillator Programme promoting public access defibrillation (PAD).

Methods   
Two strategies are used: (1) Static AEDs installed permanently in busy public places operated by those working nearby. (2) Mobile AEDs operated by community first responders (CFRs) who travel to the casualty.

Results
One thousand five hundred and thirty resuscitation attempts. With static AEDs, return of spontaneous circulation (ROSC) was achieved in 170/437 (39%) patients, hospital discharge in 113/437 (26%). With mobile AEDs, ROSC was achieved in 110/1093 (10%), hospital discharge in 32 (2.9%) (P < 0.001 for both variables). More shocks were administered with static AEDs 347/437 (79%) than mobile AEDs 388/1093 (35.5%) P < 0.001. Highly significant advantages existed for witnessed arrests, administration of shocks, bystander CPR before arrival of AED and short delays to start CPR and attach AED. These factors were more common with static AEDs. For CFRs, patients at home did less well than those at other locations for ROSC (P < 0.001) and survival (P = .006). Patients at home were older, more arrests were unwitnessed, fewer shocks were given, delays to start CPR and attach electrodes were longer.

Conclusions
PAD is a highly effective strategy for patients with sudden cardiac arrest due to ventricular fibrillation who arrest in public places where AEDs are installed. Community responders who travel with an AED are less effective, but offer some prospect of resuscitation for many patients who would otherwise receive no treatment. Both strategies merit continuing development.

September 2008


Abstract:

Public access defibrillation: Designing a universal report form and database for a national programme

The following is reproduced with permission of Elsevier Science Ireland Ltd., from the paper of the same title published in Resuscitation Volume 61, No.1 (April 2004), pages 49-54.
 

We describe the design of a universal report form for use by lay-responders using an automated external defibrillator (AED) as part of a national programme for public access defibrillation (PAD).

The form was designed initially because the Department of Health in England required detailed audit data about the national programme for public access defibrillation they initiated. At that time (1999) there was very little reported experience of public access defibrillation and none from the UK.

The form evolved pragmatically as experience showed the wide range of situations under which lay-persons might use an AED, and also the information likely to be available that could be collected reliably. This report may help others who wish to audit schemes for PAD and facilitate the evolution of an internationally acceptable template for data collection.

November 2004

 

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