ESC: Bystander Defibrillation Improves Out-of-Hospital Cardiac Arrest Survival

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Effect was significant even for EMS response times as short as two to four minutes

By Lori Solomon HealthDay Reporter

FRIDAY, Aug. 25, 2023 (HealthDay News) — Regardless of emergency medical service (EMS) response time (<20 minutes), bystander defibrillation increases 30-day survival for out-of-hospital cardiac arrest (OHCA), according to a study presented at the European Society of Cardiology Congress 2023, held Aug. 25 to 28 in Amsterdam.

Mathias Hindborg, from Nordsjaellands Hospital in Denmark, and colleagues used the Danish Cardiac Arrest Registry (2016 through 2020) to identify 7,471 adult cases of OHCA that were witnessed by a bystander, received bystander cardiopulmonary resuscitation, and had EMS response time of ≤25 minutes.

The researchers found that 14.7 percent of cases received bystander defibrillation before arrival of EMS. When bystander defibrillation was performed, 44.5 percent of individuals survived to 30 days versus 18.8 percent when no bystander defibrillation was performed. Thirty-day survival was consistently higher for each minute of EMS response time in the group receiving bystander defibrillation for the first 20 minutes after which the survival was similar for the two groups. In an adjusted analysis, 30-day survival was significantly higher for patients receiving bystander defibrillation versus patients not receiving bystander defibrillation for all intervals of EMS response time, except for response times of zero to two minutes (two to four minutes: relative risk [RR], 1.37; four to six minutes: RR, 1.55; six to eight minutes: RR, 2.23; eight to 10 minutes: RR, 1.99; 10 to 12 minutes: RR, 1.89; 12 to 15 minutes: RR, 1.86; >15 minutes: RR, 1.98).

“The findings indicate that when resources are limited, defibrillators should be located in areas where ambulance response times are likely to be more than six minutes,” Hindborg said in a statement.

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