Hayashi Meiso, Iwasaki Yu-Ki
Humanities and Social Sciences 2 College of Arts and Sciences, The University of Tokyo Tokyo Japan.
Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan.
J Arrhythm. 2024 Jul 4;40(4):753-766. doi: 10.1002/joa3.13103. eCollection 2024 Aug.
Out-of-hospital cardiac arrest (OHCA) is a global public health problem, with survival rates remaining low at around 10% or less despite widespread cardiopulmonary resuscitation (CPR) training and availability of automated external defibrillators (AEDs). This is partly due to the challenges of knowing when and where a sudden OHCA occurs and where the nearest AED is located. In response, countries around the world have begun to use network technology-based smartphone applications. These applications are activated by emergency medical service dispatchers and alert preregistered volunteer first responders (VFRs) to nearby OHCAs using Global Positioning System localization. Accumulating evidence, although mostly from observational studies, shows their effectiveness in increasing the rate of bystander CPR, defibrillation, and patient survival. Current guidelines recommend the use of these VFR alerting systems, and the results of ongoing randomized trials are awaited for further dissemination. This article also proposed the concept of a life-saving mobile network (LMN), which uses opportunistic network and wireless sensor network technologies to create a dynamic mesh network of potential victims, rescuers, and defibrillators. The LMN works by detecting a fatal arrhythmia with a wearable sensor device, localizing the victim and the nearest AED with nearby smartphones, and notifying VFRs through peer-to-peer communication. While there are challenges and limitations to implementing the LMN in society, this innovative network technology would reduce the tragedy of sudden cardiac death from OHCA.
院外心脏骤停（OHCA）是一个全球性的公共卫生问题，尽管进行了广泛的心肺复苏（CPR）培训且配备了自动体外除颤器（AED），但其生存率仍维持在10%左右或更低的低水平。这部分是由于难以知晓突发院外心脏骤停的时间和地点以及最近的自动体外除颤器的位置。作为应对措施，世界各国已开始使用基于网络技术的智能手机应用程序。这些应用程序由紧急医疗服务调度员激活，并利用全球定位系统定位功能，向预先登记的志愿急救人员（VFR）发出附近院外心脏骤停事件的警报。越来越多的证据（尽管大多来自观察性研究）表明，这些应用程序在提高旁观者心肺复苏、除颤率以及患者生存率方面具有有效性。当前指南推荐使用这些志愿急救人员警报系统，正在进行的随机试验结果有待进一步公布。本文还提出了救生移动网络（LMN）的概念，该网络利用机会网络和无线传感器网络技术，创建一个由潜在受害者、救援人员和除颤器组成的动态网状网络。救生移动网络的工作原理是通过可穿戴传感器设备检测致命心律失常，利用附近的智能手机定位受害者和最近的自动体外除颤器，并通过对等通信通知志愿急救人员。虽然在社会中实施救生移动网络存在挑战和限制，但这种创新的网络技术将减少院外心脏骤停导致的心源性猝死悲剧。
