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    CSMUIR > Medical College > School of Medicine > Journal paper >  Item 310902500/18169
    Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/18169


    Title: Use of automated external defibrillators in patients with traumatic out-of-hospital cardiac arrest
    Authors: Lin, C.-H.;Chiang, W.-C.;Ma, Ma M.H.M.;Wu, S.-Y.;Tsai, M.-C.;Chi, Chi C.-H.
    Keywords: Automated external defibrillator;Cardiopulmonary resuscitation;Emergency medical service;Out-of-hospital cardiac arrest;Trauma
    Date: 2013
    Issue Date: 2017-08-08T08:35:34Z (UTC)
    ISSN: 3009572
    Abstract: Background: Because out-of-hospital cardiac arrests (OHCAs) due to a major trauma rarely present with shockable rhythms, the potential benefits of using automated external defibrillators (AEDs) at the scene of traumatic OHCAs have not been examined. Methods: We conducted an observational, retrospective cohort study using an Utstein-style analysis in Tainan city, Taiwan. The enrollees were adult patients with traumatic OHCAs accessed by emergency medical technicians (EMTs) from January 1, 2004 to December 31, 2010. The exposure was the use or non-use of AEDs at the scene, as determined by the clinical judgment of the EMTs. The primary outcome evaluated was a sustained (?2. h) return of spontaneous circulation (ROSC), and the secondary outcomes were prehospital ROSC, overall ROSC, survival to hospital admission, survival at one month and favorable neurologic status at one month. Results: A total of 424 patients (313 males) were enrolled, of whom 280 had AEDs applied, and 144 did not. Only 25 (5.9%) patients had received bystander cardiopulmonary resuscitation (CPR), and merely 21 (7.5%) patients in the AED group presented with shockable rhythms. Compared to the non-AED group, the primary and secondary outcomes of the AED group were not significantly different, except for a significantly lower prehospital ROSC rate (1.1% vs 4.9%, p< 0.05). Multivariate analysis showed no significant interactions between the use of AEDs and other key variables. Use of the AED was not associated with sustained ROSC (OR 1.33; 95% CI 0.75-2.38, p= 0.33). Conclusions: In a community with a low prevalence of shockable rhythms and administration of bystander CPR in patients with traumatic OHCA, we found no significant differences in the sustained ROSC between the AED and the non-AED groups. Considering scene safety and the possible interruption of CPR, we do not encourage the routine use of AEDs at the scene of traumatic OHCAs. ? 2012 Elsevier Ireland Ltd.
    URI: http://dx.doi.org/10.1016/j.resuscitation.2012.09.028
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-84876710345&doi=10.1016%2fj.resuscitation.2012.09.028&partnerID=40&md5=1aea78deb3ffd92128175fa8a7d80d2e
    https://ir.csmu.edu.tw:8080/ir/handle/310902500/18169
    Relation: Resuscitation 84(5) ,586-591
    Appears in Collections:[School of Medicine] Journal paper

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