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丹麦志愿者响应者招募、自动体外除颤器的自愿部署及院外心脏骤停的覆盖情况

Volunteer Responder Recruitment, Voluntary Deployment of Automated External Defibrillators, and Coverage of Out-of-Hospital Cardiac Arrest in Denmark.

作者信息

Bo Nanna, Juul Grabmayr Anne, Folke Fredrik, Jakobsen Louise Kollander, Kjølbye Julie Samsøe, Sødergren Shaun Theodor Florentz, Bundgaard Ringgren Kristian, Andelius Linn, Torp-Pedersen Christian, Tofte Gregers Mads C, Malta Hansen Carolina

机构信息

Faculty of Health and Medical Sciences University of Copenhagen Denmark.

Copenhagen Emergency Medical Services University of Copenhagen Denmark.

出版信息

J Am Heart Assoc. 2025 Mar 18;14(6):e036363. doi: 10.1161/JAHA.124.036363. Epub 2025 Mar 13.

Abstract

BACKGROUND

A volunteer responder program to out-of-hospital cardiac arrest (OHCA) was implemented stepwise in Denmark (2017-2020). This study assessed automated external defibrillator (AED) and volunteer responder coverage of historical OHCAs in Denmark.

METHODS

Non-emergency medical services witnessed OHCAs (2016-2020) from the Danish Cardiac Arrest Registry with known location and AEDs from the Danish AED network were included. Volunteer responders with an exact location were identified using the volunteer responder server. A historical OHCA was defined as covered when ≥4 volunteer responders and ≥1 AED were <500 m range. Coverage was examined according to location (public or home), time of day (noon or midnight), and volunteer responder background (lay people or health care professionals).

RESULTS

A total of 22 330 OHCAs and 22 418 AEDs (387 AEDs/100 000 inhabitants) were included. At noon, 34 180 volunteer responders (589 volunteer responders/100 000 inhabitants) were identified as available. During daytime, OHCA coverage was 56% (95% CI, 55.9-57.2, n=12 625) decreasing to 30% (95% CI, 29.8-31.0, n=6793) when including only volunteer responders with a health care background. There was no significant difference in coverage according to time of day or location of arrest. OHCA coverage was 85% (95% CI, 84.2-86.0, n=6153) 4 years after implementation (first area included).

CONCLUSION

Regardless of time of day, more than half of all OHCAs were covered by volunteer responders and AEDs in Denmark. Excluding lay volunteers would almost halve the coverage. Our results indicate successful recruitment of volunteer responders and deployment of AEDs with great potential for improving bystander defibrillation.

摘要

背景

丹麦逐步实施了一项针对院外心脏骤停(OHCA)的志愿者响应计划(2017 - 2020年)。本研究评估了丹麦历史上院外心脏骤停事件中自动体外除颤器(AED)和志愿者响应者的覆盖情况。

方法

纳入丹麦心脏骤停登记处记录的非紧急医疗服务人员目击的院外心脏骤停事件(2016 - 2020年),这些事件的位置已知,同时纳入丹麦AED网络中的AED。使用志愿者响应者服务器确定位置确切的志愿者响应者。当≥4名志愿者响应者和≥1台AED在<500米范围内时,定义一次历史院外心脏骤停事件被覆盖。根据位置(公共场所或家中)、一天中的时间(中午或午夜)以及志愿者响应者背景(非专业人员或医疗保健专业人员)对覆盖情况进行检查。

结果

共纳入22330次院外心脏骤停事件和22418台AED(每10万居民387台AED)。中午时分,确定有34180名志愿者响应者(每10万居民589名志愿者响应者)可供使用。在白天,院外心脏骤停事件的覆盖率为56%(95%置信区间,55.9 - 57.2,n = 12625),当仅纳入具有医疗保健背景的志愿者响应者时,覆盖率降至30%(95%置信区间,29.8 - 31.0,n = 6793)。根据一天中的时间或心脏骤停发生的位置,覆盖情况无显著差异。在实施该计划4年后(第一个纳入的区域),院外心脏骤停事件的覆盖率为85%(95%置信区间,84.2 - 86.0,n = 6153)。

结论

在丹麦,无论一天中的什么时间,超过一半的院外心脏骤停事件都有志愿者响应者和AED覆盖。排除非专业志愿者将使覆盖率几乎减半。我们的结果表明志愿者响应者的招募和AED的部署取得了成功,在改善旁观者除颤方面具有巨大潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3411/12132656/347e1ad65359/JAH3-14-e036363-g003.jpg

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