Singapore Defibrillation Guidelines 2016

The most common initial rhythm in a sudden cardiac arrest is ventricular fibrillation or pulseless ventricular tachycardia. This is potentially treatable with defibrillation, especially if provided early. However, any delay in defibrillation will result in a decline in survival. Defibrillation requires coordination with the cardiopulmonary resuscitation component for effective resuscitation. These two components, which form the key links in the chain of survival, have to be brought to the cardiac victim in a timely fashion. An effective chain of survival is needed in both the institution and community settings.

The role of dispatch in resuscitation

The role of the dispatch centre has increasingly become a focus of attention in cardiac arrest resuscitation. The dispatch centre is part of the first link in the chain of survival because without the initiation of early access, the rest of the chain is irrelevant. The influence of dispatch can also extend to the initiation of bystander cardiopulmonary resuscitation, early defibrillation and the rapid dispatch of emergency ambulances. The new International Liaison Committee on Resuscitation, the American Heart Association and, especially, the European Resuscitation Council 2015 guidelines have been increasing their emphasis on dispatch as the key to improving out-of-hospital cardiac arrest survival.

"Push Hard and Fast" Voice Prompt from AED Can Improve Quality of Chest Compression Performed by Untrained Lay People

PURPOSE: We conducted this study in order to evaluate the question of whether a simple voice prompt, "push hard and fast", could improve the quality of chest compression performed by lay people. METHODS: Non-medical college students with no experience of cardiopulmonary resuscitation (CPR) education participated in this study. They were randomly divided into two groups-metronome prompt automated external defibrillator (AED) (M) group and metronome with intermittent "push hard and fast" voice prompt AED (V) group and performed two cycles of chest compression-only CPR. "Push hard and fast" voice was prompted every 10 seconds. The rate of metronome was fixed to 100/min in two groups. We measured compression depth, compression rate, and total compression frequency using ResusciAnne(R)SkillReporter(TM) (Laerdal, Korea). RESULTS: A total of 208 volunteers were enrolled. There were 120 (57.7%) females, and mean age was 21+/-2 years old. The compression depth was deeper in the V group (40.0+/-12 mm) than in the M group (35.9+/-13 mm) (p=0.02). The mean rate of chest compression was faster in the V group (98+/-20 cpm) than in the M group (88+/-31 cpm) (p=0.07) (*cpm: compressions per minute). Total frequency of chest compression during 2-cycle CPR was also higher in the V group (392+/-80) than in the M group (341+/-117) (p<0.001). CONCLUSION: A simple voice prompt, "push hard and fast", can improve the quality of chest compression performed by untrained lay people.

Resultados iniciales de la implementación de programas de acceso público a la desfibrilación en Uruguay

Objetivo: comunicar las características de presentación y la sobrevida de un grupo de pacientes que sufrieron una MS y fueron asistidos con RCB y DEA antes de la llegada de una EMM. Material y método: se realizó un estudio descriptivo-analítico, retrospectivo, de todos los PCEH asistidos con DEA entre el 1° de enero de 2005 y el 1° de setiembre de 2011 en todo el país. Se evaluaron las características de los pacientes, de los PC y la evolución posterior. Resultados: los DEA instalados en lugares públicos y con personal entrenado fueron utilizados efectivamente en 24 eventos. El 62,5% logró RCE y el 45,8% sobrevivió y retornó a la vida activa. De los 16 PC en FV, 75% logró RCE y 56,3% sobrevivió y se reintegró a sus tareas habituales. Las personas que participaron de la resucitación y habían recibido entrenamiento previo en RCB y uso de DEA actuaron con celeridad y eficacia. Conclusiones: los DEA instalados en lugares públicos funcionaron adecuadamente. Los resucitadores no médicos probaron su idoneidad en la realización de las maniobras de resucitación El índice de RCE y de sobrevida al ingreso y al alta hospitalaria de nuestros pacientes fue adecuado y comparable a la casuística internacional.

Objective: to communicate the characteristics of presentation and survival in a group of patients who suffered Sudden Death and were assisted with Basic Cardiac Resuscitation and AED before the arrival of a Mobile Medical Emergency. Materials and methods: This was a descriptive-analytic study, retrospective, of all AED-assisted OHCA between January 1st, 2005 and September 1, 2011 throughout the country. Evaluated the characteristics of the patients and the cardiac arrest, and subsequent developments. Results: AEDs installed in public places with trained personnel were used effectively in 24 events. 62.5% achieved ROSC and 45.8% survived and returned to active life. Of the 16 Ventricular Fibrilation Cardiac Arrest, 75% achieved ROSC and 56.3% survived and returned to normal activities. People who participated in the resuscitation and had received previous training in cardiac resuscitation and AED use acted quickly and effectively. Conclusions: AEDs installed in public places worked properly. Nonmedical resuscitators probed their suitability in performing resuscitation. The rate of return of spontaneous circulation and survival to admission and discharge to the hospital of our patients was adequate and comparable to international reports.