Chain of survival

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The importance of AED in the chain of survival

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Chain of survival

  1. 1. Kenneth Tran, B.Pharm, M.D October 2008
  2. 2. Chain of survival
  3. 3. Resuscitation success vs Time
  4. 4. Incremental benefits by 4 links
  5. 5. <ul><li>> 70% of sudden cardiac arrest cases occur out of hospital </li></ul><ul><li>training and equipping lay volunteers to use an AED in community settings doubled the number of survivors after an out-of-hospital cardiac arrest compared with training in cardiopulmonary resuscitation (CPR) alone, from 15% to 30% survival to hospital discharge </li></ul><ul><ul><li>Hallstrom AP et al. The Public Access Defibrillation (PAD) trial. N Engl J Med . 2004;351:637-646. </li></ul></ul><ul><li>People who survive sudden cardiac arrest have an excellent prognosis: </li></ul><ul><ul><li>83% survive for at least one year, and </li></ul></ul><ul><ul><li>57% survive for five years or longer. </li></ul></ul>Why AED is important
  6. 6. Sudden death and survival rate Why AED is important VF 62% VT 7% Brady/asystole/PEA 31%
  7. 7. Why AED is important Repartition of patients who died during Holter monitoring <ul><li>Ref.: </li></ul><ul><li>Bayes de Luna, Ambulatory sudden cardiac death: mechanisms of production of fatal arrhythmia on the basis of data from 157 cases . Am Heart J. 1989; 117: 151–159 </li></ul><ul><li>Olshausen KV et al. Sudden cardiac death while wearing a Holter monitor. Am J Cardiol 1991; 67:381-386. </li></ul>VT>VF 62% VF 8% Torsade 13% Bradyarrhymthmia 17%
  8. 8. Shake and shout Reposition
  9. 9. Airway Head-tilt, chin-lift Jaw-thrust
  10. 10. 2 rescue breathes 400 – 1000 ml 1 sec/breath Look, listen, feel 5-10 sec
  11. 11. CPR Checking carotid pulse
  12. 13. Causes of sudden cardiac death

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