Unidad de Investigación en Emergencia y Desastre. Universidad de Oviedo, España. SAMU-Asturias, España.
Unidad de Investigación en Emergencia y Desastre. Universidad de Oviedo, España. Hospital Universitario Central de Asturias, Oviedo, España.
Emergencias. 2018;30(6):415-418.
On-site bystander use of automated external defibrillators (AEDs) was analized in Asturias, Spain, between January 2012 and December 2014. Hospital management and neurologic state on discharge were also studied. Our retrospective observational population-based design had 3 phases comrpising: 1) a telephone survey of facilities with onsite public-access AEDsc, 2) analysis of relevant case records held by the Asturian emergency medical service, and 3) analysis of relevant hospital case records. Thirteen cases of AED use by bystanders were found. Eleven patients (84.5%) had initial shockable rhythms. Three patients (23%) died before reaching the hospital, 1 (7.6%) died in hospital, and 9 (69.2%) survived. All of the survivors had a shockable rhythm and all had a score of 1 on the Cerebral Performance Category scale on discharge. Eight of the 10 patients who were alive on arrival at the hospital were treated with primary angioplasty; therapeutic hypothermia was applied in 3 cases. The mean (SD) hospital stay of survivors was 9.4 (4.88) days. We conclude that bystander use of an AED notably improves survival in out-of-hospital sudden cardiac arrest, probably related to shortening the delay in starting defibrillation.
2012 年 1 月至 2014 年 12 月期间，在西班牙阿斯图里亚斯对现场旁观者使用自动体外除颤器（AED）的情况进行了分析。还研究了医院的管理和出院时的神经状态。我们的回顾性观察性基于人群的设计有 3 个阶段：1）对有现场公共访问 AED 的设施进行电话调查，2）分析阿斯图里亚斯紧急医疗服务保存的相关病例记录，3）分析相关医院病例记录。发现了 13 例旁观者使用 AED 的案例。11 名患者（84.5%）初始存在可电击节律。3 名患者（23%）在到达医院前死亡，1 名（7.6%）在医院死亡，9 名（69.2%）存活。所有幸存者均存在可电击节律，且所有幸存者出院时的大脑功能分类量表评分均为 1。在抵达医院时存活的 10 名患者中有 8 名接受了经皮冠状动脉介入治疗；3 例应用了亚低温治疗。幸存者的平均（SD）住院时间为 9.4（4.88）天。我们得出结论，旁观者使用 AED 显著提高了院外心搏骤停患者的生存率，这可能与缩短除颤开始的延迟有关。
