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Should we use automated external defibrillators in hospital wards?

Melissa De Regge UGent, Koenraad Monsieurs UGent, Koenraad Vandewoude UGent and Paul Calle UGent (2012) ACTA CLINICA BELGICA. 67(4). p.241-245
abstract
Automated external defibrillators (AEDs) have shown to improve survival after cardiopulmonary arrest (CPA) in many, but not all clinical settings. A recent study reported that the use of AEDs in-hospital did not improve survival. The current retrospective study reports the results of an in-hospital AED programme in a university hospital, and focuses on the quality of AED use. At Ghent University Hospital 30 AEDs were placed in non-monitored hospital wards and outpatient clinics treating patients with non-cardiac problems. Nurses were trained to use these devices. From November 2006 until March 2011, the AEDs were used in 23 of 39 CPA cases. in only one patient the presenting heart rhythm was ventricular fibrillation and this patient survived. Pulseless electrical activity was present in 14 patients (four survived) and asystole in eight patients (one survived). AEDs were attached to eight patients without CPA, and in 16 patients with CPA AED was not used. The quality of AED use was often suboptimal as illustrated by external artifacts during the first rhythm analysis by the AED in 30% (7/23) and more than 20 seconds delay before restart of chest compressions after the AED rhythm analysis in 50% (9/18). The literature data, supported by our results, indicate that in-hospital AED programmes are unlikely to improve survival after CPA. Moreover, their use is often suboptimal. Therefore, if AEDs are introduced in a hospital, initial training, frequent retraining and close follow-up are essential.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
cardiac arrest, CARDIOPULMONARY-RESUSCITATION, SURVIVAL, SECTION 2, SUDDEN CARDIAC-ARREST, RESUSCITATION-COUNCIL GUIDELINES, BASIC LIFE-SUPPORT, OUTCOMES, QUALITY, TRIAL, TIME, (MeSH): Automated External Defibrillator (AED), cardiopulmonary resuscitation (CPR), survival, nurses
journal title
ACTA CLINICA BELGICA
Acta Clin. Belg.
volume
67
issue
4
pages
241 - 245
Web of Science type
Article
Web of Science id
000312513500003
JCR category
MEDICINE, GENERAL & INTERNAL
JCR impact factor
0.589 (2012)
JCR rank
107/149 (2012)
JCR quartile
3 (2012)
ISSN
0001-5512
DOI
10.2143/ACB.67.4.2062666
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2972709
handle
http://hdl.handle.net/1854/LU-2972709
date created
2012-08-17 11:26:06
date last changed
2015-06-17 10:12:45
@article{2972709,
  abstract     = {Automated external defibrillators (AEDs) have shown to improve survival after cardiopulmonary arrest (CPA) in many, but not all clinical settings. A recent study reported that the use of AEDs in-hospital did not improve survival. The current retrospective study reports the results of an in-hospital AED programme in a university hospital, and focuses on the quality of AED use. At Ghent University Hospital 30 AEDs were placed in non-monitored hospital wards and outpatient clinics treating patients with non-cardiac problems. Nurses were trained to use these devices. From November 2006 until March 2011, the AEDs were used in 23 of 39 CPA cases. in only one patient the presenting heart rhythm was ventricular fibrillation and this patient survived. Pulseless electrical activity was present in 14 patients (four survived) and asystole in eight patients (one survived). AEDs were attached to eight patients without CPA, and in 16 patients with CPA AED was not used. The quality of AED use was often suboptimal as illustrated by external artifacts during the first rhythm analysis by the AED in 30\% (7/23) and more than 20 seconds delay before restart of chest compressions after the AED rhythm analysis in 50\% (9/18). The literature data, supported by our results, indicate that in-hospital AED programmes are unlikely to improve survival after CPA. Moreover, their use is often suboptimal. Therefore, if AEDs are introduced in a hospital, initial training, frequent retraining and close follow-up are essential.},
  author       = {De Regge, Melissa and Monsieurs, Koenraad and Vandewoude, Koenraad and Calle, Paul},
  issn         = {0001-5512},
  journal      = {ACTA CLINICA BELGICA},
  keyword      = {cardiac arrest,CARDIOPULMONARY-RESUSCITATION,SURVIVAL,SECTION 2,SUDDEN CARDIAC-ARREST,RESUSCITATION-COUNCIL GUIDELINES,BASIC LIFE-SUPPORT,OUTCOMES,QUALITY,TRIAL,TIME,(MeSH): Automated External Defibrillator (AED),cardiopulmonary resuscitation (CPR),survival,nurses},
  language     = {eng},
  number       = {4},
  pages        = {241--245},
  title        = {Should we use automated external defibrillators in hospital wards?},
  url          = {http://dx.doi.org/10.2143/ACB.67.4.2062666},
  volume       = {67},
  year         = {2012},
}

Chicago
De Regge, Melissa, Koenraad Monsieurs, Koenraad Vandewoude, and Paul Calle. 2012. “Should We Use Automated External Defibrillators in Hospital Wards?” Acta Clinica Belgica 67 (4): 241–245.
APA
De Regge, M., Monsieurs, K., Vandewoude, K., & Calle, P. (2012). Should we use automated external defibrillators in hospital wards? ACTA CLINICA BELGICA, 67(4), 241–245.
Vancouver
1.
De Regge M, Monsieurs K, Vandewoude K, Calle P. Should we use automated external defibrillators in hospital wards? ACTA CLINICA BELGICA. 2012;67(4):241–5.
MLA
De Regge, Melissa, Koenraad Monsieurs, Koenraad Vandewoude, et al. “Should We Use Automated External Defibrillators in Hospital Wards?” ACTA CLINICA BELGICA 67.4 (2012): 241–245. Print.