St Marys Hospital, Imperial College NHS Trust, Praed Street, Paddington, London W2 1NY, UK; Imperial College London, Exhibition Rd, South Kensington, London SW7 2BX, UK.
Royal Hampshire County Hospital, Hampshire Hospitals NHS Foundation Trust, Romsey Rd, Winchester SO22 5DG, UK.
Curr Probl Cardiol. 2024 May;49(5):102484. doi: 10.1016/j.cpcardiol.2024.102484. Epub 2024 Feb 23.
Out of hospital cardiac arrest (OHCA) outcomes can be improved by strengthening the chain of survival, namely prompt cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED). However, provision of bystander CPR and AED use remains low due to individual patient factors ranging from lack of education to socioeconomic barriers and due to lack of resources such as limited availability of AEDs in the community. Although the impact of health inequalities on survival from OHCA is documented, it is imperative that we identify and implement strategies to improve public health and outcomes from OHCA overall but with a simultaneous emphasis on making care more equitable. Disparities in CPR delivery and AED use in OHCA exist based on factors including sex, education level, socioeconomic status, race and ethnicity, all of which we discuss in this review. Most importantly, we discuss the barriers to AED use, and strategies on how these may be overcome.
院外心搏骤停 (OHCA) 的结局可以通过加强生存链来改善,即及时进行心肺复苏 (CPR) 和自动体外除颤器 (AED)。然而,由于个体患者因素,如缺乏教育、社会经济障碍以及资源有限,如社区中 AED 的可用性有限,旁观者 CPR 和 AED 的使用仍然很低。尽管已经记录了健康不平等对 OHCA 生存率的影响,但我们必须确定并实施策略,以改善整体 OHCA 的公共卫生和结局,但同时要强调使护理更加公平。基于性别、教育水平、社会经济地位、种族和民族等因素,OHCA 中的 CPR 实施和 AED 使用存在差异,我们在本综述中对此进行了讨论。最重要的是,我们讨论了使用 AED 的障碍,以及如何克服这些障碍的策略。